BDNF from microglia causes the shift in neuronal anion gradient underlying neuropathic pain

Neuropathic pain that occurs after peripheral nerve injury depends on the hyperexcitability of neurons in the dorsal horn of the spinal cord. Spinal microglia stimulated by ATP contribute to tactile allodynia, a highly debilitating symptom of pain induced by nerve injury. Signalling between microglia and neurons is therefore an essential link in neuropathic pain transmission, but how this signalling occurs is unknown. Here we show that ATP-stimulated microglia cause a depolarizing shift in the anion reversal potential (E(anion)) in spinal lamina I neurons. This shift inverts the polarity of currents activated by GABA (gamma-amino butyric acid), as has been shown to occur after peripheral nerve injury. Applying brain-derived neurotrophic factor (BDNF) mimics the alteration in E(anion). Blocking signalling between BDNF and the receptor TrkB reverses the allodynia and the E(anion) shift that follows both nerve injury and administration of ATP-stimulated microglia. ATP stimulation evokes the release of BDNF from microglia. Preventing BDNF release from microglia by pretreating them with interfering RNA directed against BDNF before ATP stimulation also inhibits the effects of these cells on the withdrawal threshold and E(anion). Our results show that ATP-stimulated microglia signal to lamina I neurons, causing a collapse of their transmembrane anion gradient, and that BDNF is a crucial signalling molecule between microglia and neurons. Blocking this microglia-neuron signalling pathway may represent a therapeutic strategy for treating neuropathic pain.     

Mechanism for chronic pain generation

Neuropathic pain and the other abnormalities of sensation induced by axon injury or by peripheral nerve inflammation should result from functional compensations of the injured neurons during their regeneration. Ectopic distribution of proteins related to Na⁺, K⁺ and Ca²⁺ channels as well as of receptors on both membranes of injured axon and its cell body becomes a main pacemaker from which spontaneous ectopic afferent of primary sensatory neurons and crosstalk between neurons occur. Abnormal ectopic afferent activities lead to disorders of the sensation, such as hyperalgesia, allodynia, spontaneous pain and paraesthesia. Administration of some ion channel agents and/or α2-adrenergic blockers has shown efficiency in preventing neuropathic pain development and in relieving neuropathic pain.     

Effect of nocistatin in pain modulation

Using tail-flick latency as the nociceptive index and von Frey hair to measure the mechanical allodynia, the aim of the present study is to determine whether nocistatin, injected intracerebroventricularly (i.c.v.), would reverse the anti-morphine effect of orphanin FQ (OFQ), and, injected i.c.v. or intrathecally (Lt.), would inhibit the mechanical allodynia in a L5 and L6 spinal nerve ligation model of neuropathic pain in rats. The results show that i.c.v. injection of nocistatin produces no significant changes in the TFL, nor does it affect morphine analgesia. In addition, i.c.v. or i.t. nocistatin produces no significant changes in withdrawal threshold of the nerve-lesioned hind paw. However, nocistatin significantly reverses the antagonistic effect of OFQ on morphine analgesia when it was coinjected i.c.v. with OFQ. The results suggest that nocistatin can reverse the anti-morphine effect of OFQ in rat brain, but cannot inhibit the mechanical allodynia of neuropathic pain in rat brain and spinal cord.     

黄芪甲苷对CCI模型所致神经损伤修复的机制初步研究

大部分镇痛药在很多患者身上有镇痛效果,但是有严重的副作用,因此临床上亟需找到安全有效的能够治疗神经痛的药物。黄芪桂枝五物汤作为传统治疗药物有一定的治疗效果。黄芪甲苷为黄芪桂枝五物汤的主要成分,采用SD大鼠,用黄芪甲苷对CCI模型所致神经损伤进行修复治疗,采用免疫印迹和免疫组化等方法,研究细胞损伤修复进展情况。结果表明,AG能显著下调DRGs中P2X3、TRPA1、TRPV1表达,通过抑制这些在疼痛传递过程中有重要蛋白的表达,从而起到镇痛的作用。     

大鼠坐骨神经切断后经皮低频高强度电刺激相应脊髓节段中GAP-43表达的变化

目的探讨成年Wister大鼠在坐骨神经切断后GAP-43于相应脊髓节段前角运动神经元内的表达变化.方法选取健康成年雄性Wister大鼠60只,将坐骨神经切断,随机分为实验组和对照组,实验组给予经皮低频高强度电刺激,分别于术后1,2,4,8,12,16周处死,取其L4~L6脊髓,利用免疫组织化学技术检测GAP-43在相应脊髓节段中的表达变化,并利用影像分析系统进行统计学分析.结果对照组:1周时前角细胞胞体内GAP-43有明显表达,4周时达到高峰,5~8周时逐渐下调,9~16周时GAP-43在前角细胞胞体内中仍有少量表达,并呈弱阳性.实验组:1周时前角细胞胞体内GAP-43有明显表达,2周时达到高峰,且在4~16周时在神经元中仍有表达,并呈阳性.结论坐骨神经切断可导致成年大鼠相应脊髓节段中前角运动神经元GAP-43表达明显增加,可证明在周围神经损伤后神经元的再生能力增强,但时效很短.而给予低频高强度电刺激疗法后,GAP-43的表达在时长和量上都有明显增加.     

Trans-synaptic shift in anion gradient in spinal lamina I neurons as a mechanism of neuropathic pain

Modern pain-control theory predicts that a loss of inhibition (disinhibition) in the dorsal horn of the spinal cord is a crucial substrate for chronic pain syndromes. However, the nature of the mechanisms that underlie such disinhibition has remained controversial. Here we present evidence for a novel mechanism of disinhibition following peripheral nerve injury. It involves a trans-synaptic reduction in the expression of the potassium-chloride exporter KCC2, and the consequent disruption of anion homeostasis in neurons of lamina I of the superficial dorsal horn, one of the main spinal nociceptive output pathways. In our experiments, the resulting shift in the transmembrane anion gradient caused normally inhibitory anionic synaptic currents to be excitatory, substantially driving up the net excitability of lamina I neurons. Local blockade or knock-down of the spinal KCC2 exporter in intact rats markedly reduced the nociceptive threshold, confirming that the reported disruption of anion homeostasis in lamina I neurons was sufficient to cause neuropathic pain.     

大鼠急性脊髓损伤后肝癌衍生生长因子的表达

目的:观察大鼠受损伤脊髓组织中肝癌衍生生长因子(Hepatoma-derived growthfactor,HDGF)表达的变化.方法:将40只成年大白鼠随机分成对照组(A组)和脊髓损伤组(B组),每组20只.脊髓损伤组采用改良的Allen’s打靶法制备,并于术后24 h处死大鼠,取损伤脊髓节段进行免疫组织化学染色.观察HDGF在正常对照组以及脊髓损伤后表达情况.以表达指数作为统计学指标,采用X2检验分析各组间的变化.结果:HDGF主要表达在神经细胞核中.15例损伤脊髓标本表现为HDGF表达指数为Ⅱ组,对照组中表达指数为Ⅱ组仅4只(P<0.05).结论:HDGF高表达于损伤脊髓组织中,提示HDGF可能参与脊髓损伤的修复.     

Urinary bladder hyporeflexia and reduced pain-related behaviour in P2X3-deficient mice

Extracellular ATP is implicated in numerous sensory processes ranging from the response to pain to the regulation of motility in visceral organs. The ATP receptor P2X3 is selectively expressed on small diameter sensory neurons, supporting this hypothesis. Here we show that mice deficient in P2X3 lose the rapidly desensitizing ATP-induced currents in dorsal root ganglion neurons. P2X3 deficiency also causes a reduction in the sustained ATP-induced currents in nodose ganglion neurons. P2X3-null mice have reduced pain-related behaviour in response to injection of ATP and formalin. Significantly, P2X3-null mice exhibit a marked urinary bladder hyporeflexia, characterized by decreased voiding frequency and increased bladder capacity, but normal bladder pressures. Immunohistochemical studies localize P2X3 to nerve fibres innervating the urinary bladder of wild-type mice, and show that loss of P2X3 does not alter sensory neuron innervation density. Thus, P2X3 is critical for peripheral pain responses and afferent pathways controlling urinary bladder volume reflexes. Antagonists to P2X3 may therefore have therapeutic potential in the treatment of disorders of urine storage and voiding such as overactive bladder.     

Peripheral nerve injury triggers central sprouting of myelinated afferents.

The central terminals of primary afferent neurons are topographically highly ordered in the spinal cord. Peripheral receptor sensitivity is reflected by dorsal horn laminar location: low-threshold mechanoreceptors terminate in laminae III and IV (refs 2, 3) and high-threshold nociceptors in laminae I, II and V (refs 4,5). Unmyelinated C fibres, most of which are nociceptors, terminate predominantly in lamina II (refs 5, 7). There is therefore an anatomical framework for the transfer of specific inputs to localized subsets of dorsal horn neurons. This specificity must contribute to the relationship between a low-intensity stimulus and an innocuous sensation and a noxious stimulus and pain. We now show that after peripheral nerve injury the central terminals of axotomized myelinated afferents, including the large A beta fibres, sprout into lamina II. This structural reorganization in the adult central nervous system may contribute to the development of the pain mediated by A-fibres that can follow nerve lesions in humans.     

野木瓜注射液对大鼠脊髓背角广动力范围神经元诱发放电的影响

对雄性Wistar大鼠,结合微电极细胞外记录技术,观察了不同浓度(10%,25%,50%,100%)野木瓜注射液对电刺激大鼠坐骨神经诱发的脊髓背角广动力范围神经元放电活动的影响.结果表明:野木瓜注射液对脊髓背角广动力范围神经元的诱发放电频率具有浓度依赖的抑制作用(P<0.05).野木瓜注射液在脊髓水平上干预痛觉信息的传导和加工,可能是其产生镇痛作用的原因之一.     

基因重组碱性成纤维细胞生长因子对大鼠脊髓损伤神经保护作用

目的 :探索碱性成纤维细胞生长因子 (bFGF)对大鼠脊髓损伤的神经保护作用 方法 :将吸入bFGF的胶原蛋白海绵或空白海绵贴敷于大鼠脊髓损伤处 ,术后 1、2、3周 ,对大鼠机能进行评分 ,并对大脑运动皮质进行电镜观察分析 结果 :术后 1、2、3周 ,bFGF组大鼠运动评分均明显优于对照组 (Ρ <0 .0 5) ,运动皮质电镜结果显示bFGF组线粒体、内质网轻度肿胀 ,神经毡结构正常 ,无明显胶质细胞增生 程度较对照组明显减轻 结论 :bFGF对大鼠脊髓受损神经纤维起源脑区—运动皮质的神经细胞具有明显的保护作用 ,进而使大鼠运动功能受损明显减轻     

Warm-coding deficits and aberrant inflammatory pain in mice lacking P2X3 receptors

ATP activates damage-sensing neurons (nociceptors) and can evoke a sensation of pain. The ATP receptor P2X3 is selectively expressed by nociceptors and is one of seven ATP-gated, cation-selective ion channels. Here we demonstrate that ablation of the P2X3 gene results in the loss of rapidly desensitizing ATP-gated cation currents in dorsal root ganglion neurons, and that the responses of nodose ganglion neurons to ATP show altered kinetics and pharmacology resulting from the loss of expression of P2X(2/3) heteromultimers. Null mutants have normal sensorimotor function. Behavioural responses to noxious mechanical and thermal stimuli are also normal, although formalin-induced pain behaviour is reduced. In contrast, deletion of the P2X3 receptor causes enhanced thermal hyperalgesia in chronic inflammation. Notably, although dorsal-horn neuronal responses to mechanical and noxious heat application are normal, P2X3-null mice are unable to code the intensity of non-noxious 'warming' stimuli.     

大鼠SNL神经性疼痛模型的建立

摘要:目的　建立大鼠L5和L6脊神经结扎(Spinal nerve ligation,SNL)疼痛模型并进行评价, 方法　根据大鼠痛阈值测定结果,选择90只符合要求的SD雄性大鼠进行手术操作,术后每隔1d测定大鼠后足的机械痛阈值,比较术前和术后大鼠对疼痛刺激的反应变化。 结果　术后大鼠左足的痛阈值逐渐降低,至10d 后趋于稳定,与术前有明显差异(P≤0.01);右足的痛阈值微有升高,保持在稳定的水平内。 结论　本研究建立的大鼠SNL模型机械痛阈变化明显,稳定性好,可靠性高,可以作为大鼠一种神经病理性疼痛的模型。     

Preliminary animal studies on observation of injured spinal cord with intraoperative ultrasound backscatter microscopy

Many studies have shown that strategies of nerve regeneration and cell-based transplantation are valid based on animal models of spinal cord injury (SCI).To apply these strategies and bridge spinal cord defects,the identification and precise localization of lesions during spinal cord surgery is necessary.The aim of the present experiment was to evaluate the capabilities of ultrasound backscatter microscopy (UBM) in identifying morphologic changes after SCI.After laminectomy,high-resolution ultrasound images of the spinal cord were obtained in one normal and seven spinal cord-injured adult Wistar rats using a UBM system with a 55-MHz center frequency scanner.Comparison between histoanatomic and UBM images was also performed.The results showed that UBM can identify cysts after the experimental SCI is removed in adult rats.In addition,the glial scar formed in secondary injury showed obvious hyperechoic speckle in the UBM image and correlated with the histoanatomic image.UBM has obvious clinical value in nerve regeneration and cell-based transplantation strategies in injured spinal cords.     

神经病理性疼痛的小胶质细胞机制

小胶质细胞是中枢神经系统内重要的免疫细胞,起递呈抗原、吞噬病原体、分泌多种细胞因子和神经修复的作用。神经损伤后,小胶质细胞会被激活,可释放大量的细胞因子、炎性介质,激活补体,引起神经炎症和神经免疫反应,导致各种神经功能紊乱,引起痛觉过敏和异常痛敏。本文从小胶质细胞的激活、以及激活途径的关键分子TLR4来探讨神经病理性疼痛的发病机制。     

Brain-derived neurotrophic factor rescues developing avian motoneurons from cell death.

During normal vertebrate development, about half of spinal motoneurons are lost by a process of naturally occurring or programmed cell death. Additional developing motoneurons degenerate after the removal of targets or afferents. Naturally occurring motoneuron death as well as motoneuron death after loss of targets or after axotomy can be prevented by in vivo treatment with putative target (muscle) derived or other neurotrophic agents. Motoneurons can also be prevented from dying in vitro and in vivo (Y.Q.-W., R.W., D.P., J. Johnson and L. Van Eldik, unpublished data and refs 7, 13, 14) by treatment with central nervous system extracts (brain or spinal cord) and purified central nervous system and glia-derived proteins. Here we report that in vivo treatment of chick embryos with brain-derived neurotrophic factor rescues motoneurons from naturally occurring cell death. Furthermore, in vivo treatment with brain-derived neurotrophic factor (and nerve growth factor) also prevents the induced death of motoneurons that occurs following the removal of descending afferent input (deafferentation). These data indicate that members of the neurotrophin family can promote the survival of developing avian motoneurons.     

氢吗啡酮对炎性痛大鼠脊髓ERK1/2信号通路的影响

目的 探讨氢吗啡酮对炎性痛大鼠脊髓ERK1/2信号通路的影响.方法 选择SPF级雄性大鼠30只,随机分为3组,正常组、模型组和氢吗啡酮组;检测各组大鼠热痛阈和机械痛阈;ELISA检测血清中TNF-α、IL-6和IL-10的含量;Western blot检测各组大鼠脊髓中ERK1/2和p-ERK1/2蛋白表达水平;qRT...     

体育功能锻炼对截瘫患者康复影响及评价分析

目的:探讨体育功能锻炼对截瘫患者后期康复治疗的影响及康复评价.方法:76例在脊髓损伤后出现截瘫患者,进行体育功能锻炼的康复治疗,追踪记录,采用美国脊髓损伤学会(ASIA)脊髓损伤神经功能分类国际标准评价康复效果.结果:经统计,胸腰髓不完全损害者康复锻炼前后ASIA损伤评分运动、感觉评分均有显著意义(P<0.05).胸腰髓完全损伤者运动、感觉ASIA评分好转较明显(P<0.05).结论:体育功能锻炼能帮助截瘫患者后期恢复,显著改善和提高患者的综合功能.     

UDP acting at P2Y6 receptors is a mediator of microglial phagocytosis

Microglia, brain immune cells, engage in the clearance of dead cells or dangerous debris, which is crucial to the maintenance of brain functions. When a neighbouring cell is injured, microglia move rapidly towards it or extend a process to engulf the injured cell. Because cells release or leak ATP when they are stimulated or injured, extracellular nucleotides are thought to be involved in these events. In fact, ATP triggers a dynamic change in the motility of microglia in vitro and in vivo, a previously unrecognized mechanism underlying microglial chemotaxis; in contrast, microglial phagocytosis has received only limited attention. Here we show that microglia express the metabotropic P2Y6 receptor whose activation by endogenous agonist UDP triggers microglial phagocytosis. UDP facilitated the uptake of microspheres in a P2Y6-receptor-dependent manner, which was mimicked by the leakage of endogenous UDP when hippocampal neurons were damaged by kainic acid in vivo and in vitro. In addition, systemic administration of kainic acid in rats resulted in neuronal cell death in the hippocampal CA1 and CA3 regions, where increases in messenger RNA encoding P2Y6 receptors that colocalized with activated microglia were observed. Thus, the P2Y6 receptor is upregulated when neurons are damaged, and could function as a sensor for phagocytosis by sensing diffusible UDP signals, which is a previously unknown pathophysiological function of P2 receptors in microglia.     

Reduced vas deferens contraction and male infertility in mice lacking P2X1 receptors

P2X1 receptors for ATP are ligand-gated cation channels, present on many excitable cells including vas deferens smooth muscle cells. A substantial component of the contractile response of the vas deferens to sympathetic nerve stimulation, which propels sperm into the ejaculate, is mediated through P2X receptors. Here we show that male fertility is reduced by approximately 90% in mice with a targeted deletion of the P2X1 receptor gene. Male mice copulate normally--reduced fertility results from a reduction of sperm in the ejaculate and not from sperm dysfunction. Female mice and heterozygote mice are unaffected. In P2X1-receptor-deficient mice, contraction of the vas deferens to sympathetic nerve stimulation is reduced by up to 60% and responses to P2X receptor agonists are abolished. These results show that P2X1 receptors are essential for normal male reproductive function and suggest that the development of selective P2X1 receptor antagonists may provide an effective non-hormonal male contraceptive pill. Also, agents that potentiate the actions of ATP at P2X1 receptors may be useful in the treatment of male infertility.