骨纤维发育不良中的疼痛:在临床前模型中识别伤害性感受机制。

Pain in fibrous dysplasia: identifying nociceptive mechanisms in a preclinical model.

作者信息

Hopkins Chelsea, de Castro Luis Fernandez, Benthin Julie, Diaz-delCastillo Marta, Manjappa Pravallika, Boyce Alison, Mendoza Ruth Elena Martinez, Mora Juan Antonio Vazquez, Lopez-Delgado Giovanni Emmanuel, Gomez Lizeth Yazmin Ponce, Mohamed Khaled Elhady, Linley John E, Collins Michael T, Jimenez-Andrade Juan Miguel, Heegaard Anne-Marie

机构信息

Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, 2100, Denmark.

Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, 9000, MD, United States.

出版信息

J Bone Miner Res. 2025 Jun 25;40(7):891-903. doi: 10.1093/jbmr/zjaf039.

Abstract

Pain is a common symptom of fibrous dysplasia (FD), a rare mosaic disorder characterized by fibro-osseous lesions in the bone. Despite the prevalence of pain in FD patients, there is little knowledge about the nociceptive mechanisms and few efficacious treatments. As such, understanding FD pain is essential for patient care. The overall aim of this study was to identify nocifensive behaviors and potential underlying mechanisms in a transgenic mouse model of FD, previously shown to display high face and translational validity. Significant nocifensive behaviors were observed in FD mice (male and female), compared to control mice in the burrowing, grid hanging, home cage activity, and wheel running assays. These changes corresponded to lesion development, as visualized by X-ray imaging. Behavioral deficits improved when analgesics were administered, indicating a nociceptive origin. Tibias and femurs from FD mice demonstrated characteristic FD lesions and the presence of mono- and multi-nucleated CD68+ cells, calcitonin gene-related peptide sensory nerve fibers, and vascularization. Lumbar dorsal root ganglia from male FD mice displayed increased staining for activating transcription factor-3 and tyrosine hydroxylase neurons. No difference was observed in the spinal cords between the FD and control groups for glial cell presence and neuropeptide expression. Bone marrow stromal cells were obtained from FD and control mice and cultured in vitro. FD cells developed an increased concentration of inflammatory cytokines (IL-6, tumor necrosis factor-alpha), chemokines (monocyte chemoattractant protein, keratinocyte chemoattractant/human growth-regulated oncogene), and nerve growth factor as compared to controls. Taken together, this study demonstrated for the first time that nociceptive mechanisms such as axonal growth in FD lesions, nerve injury, and inflammation may contribute to FD pain, and it provides a foundation for conducting further studies of pain- and disease-modifying therapeutics for FD patients.

摘要

疼痛是骨纤维发育不良(FD)的常见症状,骨纤维发育不良是一种罕见的镶嵌性疾病,其特征是骨骼中存在纤维性骨病变。尽管FD患者中疼痛很普遍,但对伤害感受机制了解甚少,有效治疗方法也很少。因此,了解FD疼痛对患者护理至关重要。本研究的总体目标是在FD转基因小鼠模型中确定伤害防御行为和潜在的潜在机制,该模型先前已显示出较高的表面效度和转化效度。与对照小鼠相比,在掘洞、网格悬挂、笼内活动和转轮实验中,FD小鼠(雄性和雌性)出现了明显的伤害防御行为。这些变化与X射线成像显示的病变发展相对应。给予镇痛药后行为缺陷得到改善,表明其起源于伤害感受。FD小鼠的胫骨和股骨显示出特征性的FD病变,并且存在单核和多核CD68 +细胞、降钙素基因相关肽感觉神经纤维和血管形成。雄性FD小鼠的腰背部背根神经节中,激活转录因子-3和酪氨酸羟化酶神经元的染色增加。FD组和对照组在脊髓中胶质细胞的存在和神经肽表达方面未观察到差异。从FD小鼠和对照小鼠中获取骨髓基质细胞并进行体外培养。与对照组相比,FD细胞产生的炎性细胞因子(IL-6、肿瘤坏死因子-α)、趋化因子(单核细胞趋化蛋白、角质形成细胞趋化因子/人类生长调节致癌基因)和神经生长因子浓度增加。综上所述,本研究首次证明,FD病变中的轴突生长、神经损伤和炎症等伤害感受机制可能导致FD疼痛,并为进一步研究针对FD患者的疼痛和疾病改善疗法奠定了基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeb6/12188752/c9e8c3718ad6/zjaf039f1.jpg

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