Myalgia! Where does it come from?

Acta neurologica Taiwanica Pub Date : 2023-12-30
Hsun-Hua Lee, Chih-Cheng Chen
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Abstract

Myalgia (also called muscle pain or muscle ache) is a symptom associated with many diseases, including fibromyalgia, neurodegenerative diseases, degenerative spine diseases, etc. Myalgia is a major medical problem affecting 60~85% of the population (lifetime prevalence). However, our understanding of chronic myalgia is still limited and effective treatment for intractable myalgia like fibromyalgia is still lacking. Although multifactorial, one known source of muscle pain is tissue acidosis. Experimental muscle pain can be induced by the intramuscular infusion of a buffered acidic solution in humans. As well, animal studies have revealed that acidic infusion activates chemosensitive nociceptors via the proton-sensing ion channels and receptors. Intriguingly, acid signaling in muscle afferents is promiscuous and could be either pro-nociceptive or antinociceptive, so we have coined the term sngception to describe the somatosensory function of acid sensation. Recent single-cell RNAseq studies have shown proton-sensing ion channels and receptors are expressed in all subpopulations of the somatosensory neurons, including nociceptors and non-nociceptive mechanoreceptors. Here, we address how the acid signaling is integrated in muscle afferents and why muscle pain can be chronic and intractable in mouse models of fibromyalgia. Besides acidosis, we have recently found oxidative stress can be another factor to activate proton-sensing ion channels and thus trigger fibromyalgia-like pain in mice. Together, understanding how the acid signaling works in muscle afferents will provide novel therapeutic strategies for myalgia.

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肌痛!它从何而来?
肌痛(也叫肌肉痛或肌肉酸痛)是一种与许多疾病相关的症状,包括纤维肌痛、神经退行性疾病、退行性脊柱疾病等。肌痛是影响60~85%人口的主要医学问题(终生患病率)。然而,我们对慢性肌痛的了解仍然有限,对顽固性肌痛如纤维肌痛的有效治疗仍然缺乏。虽然是多因素的,但肌肉疼痛的一个已知来源是组织酸中毒。实验性肌肉疼痛可通过在人体肌肉内灌注一种缓冲酸性溶液而引起。此外,动物研究表明,酸性输注通过质子感应离子通道和受体激活化学敏感伤害感受器。有趣的是,肌肉传入事件中的酸信号是混杂的,可能是促痛觉的,也可能是抗痛觉的,所以我们创造了“痛觉”这个术语来描述酸感觉的体感功能。最近的单细胞RNAseq研究表明,质子感应离子通道和受体在所有体感觉神经元亚群中都有表达,包括伤害感受器和非伤害感受器。在这里,我们讨论酸信号是如何在肌肉传入事件中整合的,以及为什么在纤维肌痛小鼠模型中肌肉疼痛是慢性和难治性的。除了酸中毒,我们最近发现氧化应激可能是激活质子感应离子通道的另一个因素,从而引发小鼠纤维肌痛样疼痛。总之,了解酸信号如何在肌肉传入事件中起作用将为肌痛提供新的治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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