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Pain and aging: A unique challenge in neuroinflammation and behavior. 疼痛和衰老:神经炎症和行为方面的独特挑战。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069231203090
Shishu Pal Singh, Josee Guindon, Prapti H Mody, Gabriela Ashworth, Jonathan Kopel, Sai Chilakapati, Owoicho Adogwa, Volker Neugebauer, Michael D Burton

Chronic pain is one of the most common, costly, and potentially debilitating health issues facing older adults, with attributable costs exceeding $600 billion annually. The prevalence of pain in humans increases with advancing age. Yet, the contributions of sex differences, age-related chronic inflammation, and changes in neuroplasticity to the overall experience of pain are less clear, given that opposing processes in aging interact. This review article examines and summarizes pre-clinical research and clinical data on chronic pain among older adults to identify knowledge gaps and provide the base for future research and clinical practice. We provide evidence to suggest that neurodegenerative conditions engender a loss of neural plasticity involved in pain response, whereas low-grade inflammation in aging increases CNS sensitization but decreases PNS sensitivity. Insights from preclinical studies are needed to answer mechanistic questions. However, the selection of appropriate aging models presents a challenge that has resulted in conflicting data regarding pain processing and behavioral outcomes that are difficult to translate to humans.

慢性疼痛是老年人面临的最常见、最昂贵且可能使人衰弱的健康问题之一,每年的可归因成本超过6000亿美元。人类疼痛的患病率随着年龄的增长而增加。然而,性别差异、与年龄相关的慢性炎症和神经可塑性变化对疼痛整体体验的影响尚不清楚,因为衰老中的相反过程是相互作用的。这篇综述文章检查和总结了老年人慢性疼痛的临床前研究和临床数据,以确定知识差距,并为未来的研究和临床实践提供基础。我们提供的证据表明,神经退行性疾病会导致与疼痛反应有关的神经可塑性丧失,而衰老中的低度炎症会增加中枢神经系统的敏感性,但会降低PNS的敏感性。需要临床前研究的见解来回答机制问题。然而,选择合适的衰老模型带来了挑战,导致疼痛处理和行为结果的数据相互矛盾,难以转化为人类。
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引用次数: 0
Pain-related behavioral and electrophysiological actions of dynorphin A (1-17). dynorphin A的疼痛相关行为和电生理作用(1-17)。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069231186592
Justin E LaVigne, Ian M Adams, Marena A Montera, Karin N Westlund, Sascha Ra Alles

Dynorphin A (1-17) (DynA17) has been identified as a key regulator of both sensory and affective dimensions of chronic pain. Following nerve injury, increases in DynA17 have been reported in the spinal and supraspinal areas involved in chronic pain. Blocking these increases provides therapeutic benefits in preclinical chronic pain models. Although heavily characterized at the behavioral level, how DynA17 mediates its effects at the cellular physiological level has not been investigated. In this report, we begin to decipher how DynA17 mediates its direct effects on mouse dorsal root ganglion (DRG) cells and how intrathecal administration modifies a key node in the pain axis, the periaqueductal gray These findings build on the plethora of literature defining DynA17 as a critical neuropeptide in the pathophysiology of chronic pain syndromes.

肌啡肽A (1-17) (DynA17)已被确定为慢性疼痛感觉和情感维度的关键调节因子。神经损伤后,DynA17在慢性疼痛的脊髓和棘上区增加。阻断这些增加在临床前慢性疼痛模型中提供治疗益处。虽然DynA17在行为水平上有很大的特征,但在细胞生理水平上如何介导其作用尚未被研究。在本报告中,我们开始解读DynA17如何介导其对小鼠背根神经节(DRG)细胞的直接作用,以及鞘内给药如何改变疼痛轴上的关键节点——导水管周围灰色。这些发现建立在大量文献的基础上,这些文献将DynA17定义为慢性疼痛综合征病理生理学中的关键神经肽。
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引用次数: 1
Activation of neurons and satellite glial cells in the DRG produces morphine-induced hyperalgesia. 激活 DRG 中的神经元和卫星神经胶质细胞可产生吗啡诱导的痛觉减退。
IF 2.8 3区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-01 DOI: 10.1177/17448069231181973
Shunsuke Yamakita, Daisuke Fujita, Kazuki Sudo, Daiki Ishikawa, Kohsuke Kushimoto, Yasuhiko Horii, Fumimasa Amaya

Activation of neurons and glial cells in the dorsal root ganglion is one of the key mechanisms for the development of hyperalgesia. The aim of the present study was to examine the role of neuroglial activity in the development of opioid-induced hyperalgesia. Male rats were treated with morphine daily for 3 days. The resultant phosphorylation of extracellular signal-regulated kinase (ERK) 1/2 in the dorsal root ganglion was analyzed by immunohistochemistry and Western blotting. Pain hypersensitivity was analyzed using behavioral studies. The amount of cytokine expression in the dorsal root ganglion was also analyzed. Repeated morphine treatment induced hyperalgesia and marked induction of phosphorylated ERK1/2 in the neurons and satellite glial cells on day 3. An opioid receptor antagonist, toll like receptor-4 inhibitor, MAP/ERK kinase (MEK) inhibitor and gap junction inhibitor inhibited morphine-induced hyperalgesia and ERK1/2 phosphorylation. Morphine treatment induced alteration of cytokine expression, which was inhibited by the opioid receptor antagonist, toll like receptor-4 inhibitor, MEK inhibitor and gap junction inhibitor. Dexamethasone inhibited morphine-induced hyperalgesia and ERK1/2 phosphorylation after morphine treatment. The peripherally restricted opioid receptor antagonist, methylnaltrexone, inhibited hyperalgesia and ERK1/2 phosphorylation. Morphine activates ERK1/2 in neurons and satellite glial cells in the dorsal root ganglion via the opioid receptor and toll like receptor-4. ERK1/2 phosphorylation is gap junction-dependent and is associated with the alteration of cytokine expression. Inhibition of neuroinflammation by activation of neurons and glia might be a promising target to prevent opioid-induced hyperalgesia.

激活背根神经节中的神经元和神经胶质细胞是产生超痛感的关键机制之一。本研究旨在探讨神经胶质细胞活动在阿片类药物诱导的痛觉减退中的作用。雄性大鼠每天接受吗啡治疗 3 天。通过免疫组织化学和 Western 印迹法分析了背根神经节中细胞外信号调节激酶(ERK)1/2 的磷酸化情况。通过行为研究分析了痛觉过敏性。还分析了背根神经节中细胞因子的表达量。重复吗啡处理可诱导痛觉减退,并在第3天明显诱导神经元和卫星神经胶质细胞磷酸化ERK1/2。阿片受体拮抗剂、类收费受体-4抑制剂、MAP/ERK激酶(MEK)抑制剂和间隙连接抑制剂抑制了吗啡诱导的痛觉减退和ERK1/2磷酸化。阿片受体拮抗剂、收费样受体-4 抑制剂、MEK 抑制剂和间隙连接抑制剂可抑制吗啡诱导的细胞因子表达。地塞米松可抑制吗啡诱导的痛觉减退和吗啡治疗后的ERK1/2磷酸化。外周限制性阿片受体拮抗剂甲纳曲酮抑制了超痛感和ERK1/2磷酸化。吗啡通过阿片受体和类收费受体-4激活背根神经节神经元和卫星胶质细胞中的ERK1/2。ERK1/2 磷酸化依赖于间隙连接,并与细胞因子表达的改变有关。通过激活神经元和神经胶质细胞来抑制神经炎症可能是预防阿片类药物引起的痛觉减退的一个有希望的靶点。
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引用次数: 0
Retraction Notice. 撤回通知。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069231155072
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引用次数: 0
Transcription factor ETS proto-oncogene 1 contributes to neuropathic pain by regulating histone deacetylase 1 in primary afferent neurons. 转录因子 ETS 原癌基因 1 通过调节初级传入神经元中的组蛋白去乙酰化酶 1 促成神经性疼痛。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069231152125
Hong-Li Zheng, Shi-Yu Sun, Tong Jin, Ming Zhang, Ying Zeng, Qiaoqiao Liu, Kehui Yang, Runa Wei, Zhiqiang Pan, Fuqing Lin

Nerve injury can induce aberrant changes in ion channels, enzymes, and cytokines/chemokines in the dorsal root ganglia (DRGs); these changes are due to or at least partly governed by transcription factors that contribute to the genesis of neuropathic pain. However, the involvement of transcription factors in neuropathic pain is poorly understood. In this study, we report that transcription factor (TF) ETS proto-oncogene 1 (ETS1) is required for the initiation and development of neuropathic pain. Sciatic nerve chronic constrictive injury (CCI, a clinical neuropathic pain model) increases ETS1 expression in the injured male mouse DRG. Blocking this upregulation alleviated CCI-induced mechanical allodynia and thermal hyperalgesia, with no apparent effect on locomotor function. Mimicking this upregulation results in the genesis of nociception hypersensitivity; mechanistically, nerve injury-induced ETS1 upregulation promotes the expression of histone deacetylase 1 (HDAC1, a key initiator of pain) via enhancing its binding activity to the HDAC1 promotor, leading to the elevation of spinal central sensitization, as evidenced by increased expression of p-ERK1/2 and GFAP in the dorsal spinal horn. It appears that the ETS1/HDAC1 axis in DRG may have a critical role in the development and maintenance of neuropathic pain, and ETS1 is a potential therapeutic target in neuropathic pain.

神经损伤可诱导背根神经节(DRGs)中的离子通道、酶和细胞因子/趋化因子发生异常变化;这些变化是由转录因子引起的,或者至少部分是由转录因子控制的,而转录因子有助于神经性疼痛的发生。然而,人们对转录因子参与神经病理性疼痛的情况知之甚少。在这项研究中,我们报告了转录因子(TF)ETS原癌基因1(ETS1)是神经病理性疼痛的起始和发展所必需的。坐骨神经慢性收缩性损伤(CCI,一种临床神经病理性疼痛模型)会增加ETS1在受伤雄性小鼠DRG中的表达。阻断这种上调可减轻CCI引起的机械异感和热痛,但对运动功能无明显影响。从机理上讲,神经损伤诱导的 ETS1 上调会通过增强组蛋白去乙酰化酶 1(HDAC1,疼痛的关键启动因子)与 HDAC1 启动子的结合活性来促进其表达,从而导致脊髓中枢敏化的升高,脊髓背角 p-ERK1/2 和 GFAP 的表达增加就是证明。由此看来,DRG 中的 ETS1/HDAC1 轴可能在神经病理性疼痛的发生和维持中起着关键作用,而 ETS1 是神经病理性疼痛的潜在治疗靶点。
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引用次数: 0
Non-nociceptive and nociceptive-like trigeminal Aβ-afferent neurons of rats: Distinct electrophysiological properties, mechanical and chemical sensitivity. 大鼠非伤害性和样伤害性三叉神经a β传入神经元:不同的电生理特性、机械和化学敏感性。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069221148958
Ryan Vaden, Jianguo Gu

The role of Aβ-afferents in somatosensory function is often oversimplified as low threshold mechanoreceptors (LTMRs) with large omission of Aβ-afferent involvement in nociception. Recently, we have characterized Aβ-afferent neurons which have large diameter somas in the trigeminal ganglion (TG) and classified them into non-nociceptive and nociceptive-like TG afferent neurons based on their electrophysiological properties. Here, we extend our previous observations to further characterize electrophysiological properties of trigeminal Aβ-afferent neurons and investigate their mechanical and chemical sensitivity by patch-clamp recordings from large-diameter TG neurons in ex vivo TG preparations of adult male and female rats. Based on cluster analysis of electrophysiological properties, trigeminal Aβ-afferent neurons can be classified into five discrete types (type I, IIa, IIb, IIIa, and IIIb), which responded differentially to mechanical stimulation and sensory mediators including serotonin (5-HT), acetylcholine (ACh) and adenosine triphosphate (ATP). Notably, type I neuron action potential (AP) was small in amplitude, width was narrow in duration, and peak dV/dt repolarization was great with no deflection observed, whereas discretely graded differences were observed for type IIa, IIb, IIIa, and IIIb, as AP increased in amplitude, width broadened in duration, and peak dV/dt repolarization reduced with the emergence of increasing deflection. Type I, IIa, and IIb neurons were mostly mechanically sensitive, displaying robust and rapidly adapting mechanically activated current (IMA) in response to membrane displacement, while IIIa and IIIb, conversely, were almost all mechanically insensitive. Interestingly, mechanical insensitivity coincided with increased sensitivity to 5-HT and ACh. Together, type I, IIa and IIb display features of LTMR Aβ-afferent neurons while type IIIa and type IIIb show properties of nociceptive Aβ-afferent neurons.

a - β传入在体感觉功能中的作用通常被过分简化为低阈值机械感受器(LTMRs),而忽略了a - β传入对伤害感觉的参与。最近,我们对三叉神经节(TG)中具有大直径胞体的a β-传入神经元进行了表征,并根据其电生理特性将其分为非伤害性和类伤害性TG传入神经元。在此,我们扩展了之前的观察结果,进一步表征了三叉神经a β传入神经元的电生理特性,并通过膜片钳记录了成年雄性和雌性大鼠离体TG制剂中大直径TG神经元的机械和化学敏感性。根据电生理特性聚类分析,三叉神经a β传入神经元可分为I型、IIa型、IIb型、IIIa型和IIIb型5种类型,它们对机械刺激和5-羟色胺(5-HT)、乙酰胆碱(ACh)、三磷酸腺苷(ATP)等感觉介质的反应存在差异。其中,I型神经元动作电位(AP)振幅小,宽度窄,持续时间短,dV/dt复极峰明显且无偏转,而IIa、IIb、IIIa和IIIb型神经元动作电位(AP)振幅增大,宽度变宽,且随着偏转的增加,dV/dt复极峰减小。I、IIa和IIb型神经元大多是机械敏感的,在响应膜位移时表现出鲁强和快速适应的机械激活电流(IMA),而IIIa和IIIb型神经元则相反,几乎都是机械不敏感的。有趣的是,机械不敏感与对5-羟色胺和乙酰胆碱的敏感性增加同时发生。I型、IIa型和IIb型表现为LTMR a β-传入神经元的特征,而IIIa型和IIIb型表现为伤害性a β-传入神经元的特征。
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引用次数: 3
Saltatory conduction and intrinsic electrophysiological properties at the nodes of ranvier of Aα/β-afferent fibers and Aα-efferent fibers in rat sciatic nerves. 大鼠坐骨神经中Aα/β-传入纤维和Aα-传出纤维ranvier节的盐传导和内在电生理特性。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069231187366
Sotatsu Tonomura, Jianguo Gu

Large-diameter myelinated fibers in sciatic nerves are composed of both Aα/β-afferent fibers and Aα-efferent fibers to convey sensory and motor impulses, respectively, via saltatory conduction for rapid leg responses. Saltatory conduction and electrophysiological properties at the nodes of Ranvier (NRs) of these sciatic nerve fibers have not been directly studied. We used ex vivo sciatic nerve preparations from rats and applied patch-clamp recordings at the NRs of both Aα/β-afferent fibers and Aα-efferent fibers in the sciatic nerves to characterize their saltatory conduction and intrinsic electrophysiological properties. The velocity and frequency of saltatory conduction in both types of fibers were similar. Resting membrane potentials (RMPs), input resistance, action potential (AP) threshold, and AP rheobase were also not significantly different at the NRs of the two types of fibers in the sciatic nerves. In comparison with Aα/β-afferent fibers, Aα-efferent fibers in the sciatic nerves show higher amplitude and broader width of APs at their NRs. At the NRs of both types of fibers, depolarizing voltages evoked transient inward currents followed by non-inactivating outward currents, and the inward currents and non-inactivating outward currents at the NRs were not significantly different between the two types of fibers. Using AP-clamp, inward currents during AP upstroke were found to be insignificant difference, but amplitudes of non-inactivating outward currents during AP repolarization were significantly lower at the NRs of Aα-efferent fibers than at the NRs of Aα/β-afferent fibers in the sciatic nerves. Collectively, saltatory conduction, ionic currents, and intrinsic electrophysiological properties at the NRs of Aα/β-afferent fibers and Aα-efferent fibers in the sciatic nerves are generally similar, but some differences were also observed.

坐骨神经中的大直径有髓鞘纤维由Aα/β-传入纤维和Aα-传出纤维组成,分别通过跳跃传导传递感觉和运动脉冲,以实现快速腿部反应。尚未直接研究这些坐骨神经纤维在Ranvier(NRs)节点的盐传导和电生理特性。我们使用大鼠离体坐骨神经制剂,并对坐骨神经中Aα/β传入纤维和Aα传出纤维的NRs进行膜片钳记录,以表征它们的跳跃传导和内在电生理特性。两种纤维的跳跃传导速度和频率相似。坐骨神经中两种类型纤维的静息膜电位(RMP)、输入电阻、动作电位(AP)阈值和AP变阻性基底在NR处也没有显著差异。与Aα/β传入纤维相比,坐骨神经中的Aα传出纤维在其NRs处表现出更高的AP幅度和更宽的宽度。在两种类型的纤维的NRs处,去极化电压引起瞬时向内电流,然后是非失活向外电流,并且在NRs处的向内电流和非失活对外电流在两种纤维之间没有显著差异。使用AP钳,发现AP上行过程中的内向电流差异不显著,但在AP复极过程中,坐骨神经中Aα-传出纤维的NRs处的非失活外向电流振幅显著低于Aα/β-传入纤维的NRs处的振幅。总的来说,坐骨神经中Aα/β传入纤维和Aα传出纤维的跳跃传导、离子电流和NRs的内在电生理特性通常相似,但也观察到一些差异。
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引用次数: 0
Silencing of TRPV4-expressing sensory neurons attenuates temporomandibular disorders pain. 沉默表达trpv4的感觉神经元可减轻颞下颌疾病的疼痛。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069231185696
Fabiana C Dias, Zilong Wang, Garrett Scapellato, Yong Chen

Identification of potential therapeutic targets is needed for temporomandibular disorders (TMD) pain, the most common form of orofacial pain, because current treatments lack efficacy. Considering TMD pain is critically mediated by the trigeminal ganglion (TG) sensory neurons, functional blockade of nociceptive neurons in the TG may provide an effective approach for mitigating pain associated with TMD. We have previously shown that TRPV4, a polymodally-activated ion channel, is expressed in TG nociceptive neurons. Yet, it remains unexplored whether functional silencing of TRPV4-expressing TG neurons attenuates TMD pain. In this study, we demonstrated that co-application of a positively charged, membrane-impermeable lidocaine derivative QX-314 with the TRPV4 selective agonist GSK101 suppressed the excitability of TG neurons. Moreover, co-administration of QX-314 and GSK101 into the TG significantly attenuated pain in mouse models of temporomandibular joint (TMJ) inflammation and masseter muscle injury. Collectively, these results suggest TRPV4-expressing TG neurons represent a potential target for TMD pain.

颞下颌紊乱(TMD)疼痛是最常见的口面部疼痛,目前的治疗方法缺乏疗效,因此需要确定潜在的治疗靶点。考虑到TMD疼痛是由三叉神经节(TG)感觉神经元介导的,对TG中的伤害性神经元进行功能阻断可能是减轻TMD相关疼痛的有效途径。我们之前已经证明TRPV4是一种多模态激活的离子通道,在TG伤害性神经元中表达。然而,表达trpv4的TG神经元的功能性沉默是否会减轻TMD疼痛仍未得到证实。在这项研究中,我们证明了带正电、膜不渗透的利多卡因衍生物QX-314与TRPV4选择性激动剂GSK101共同应用可抑制TG神经元的兴奋性。此外,QX-314和GSK101在TG中共同给药可显著减轻颞下颌关节(TMJ)炎症和咬肌损伤小鼠模型的疼痛。总的来说,这些结果表明表达trpv4的TG神经元代表了TMD疼痛的潜在靶点。
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引用次数: 0
Corrigendum to "Rac1/PAK1 signaling contributes to bone cancer pain by Regulation dendritic spine remodeling in rats". “Rac1/PAK1信号通过调节大鼠树突棘重塑而导致骨癌症疼痛”更正。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069231182501
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引用次数: 0
Transcriptome analysis reveals dysregulation of inflammatory and neuronal function in dorsal root ganglion of paclitaxel-induced peripheral neuropathy rats. 转录组分析显示紫杉醇诱导的周围神经病变大鼠背根神经节炎症和神经元功能失调。
IF 3.3 3区 医学 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.1177/17448069221106167
Wuping Sun, Shaomin Yang, Songbin Wu, Xiyuan Ba, Donglin Xiong, Lizu Xiao, Yue Hao

Chemotherapy-induced peripheral neuropathy (CIPN) is the most common side-effect of anti-cancer therapy. To date, there are no clinically effective analgesics that could prevent and treat CIPN. However, the exact pathogenesis of CIPN is still unclear. In the present study, we use the paclitaxel-induced peripheral neuropathy (PIPN) model, aiming to better understand the transcriptomic level of the Dorsal root ganglia (DRG) neurons in rats with PIPN. mRNA from each DRG sample was reverse transcribed to cDNA and sequenced using next-generation high throughput sequencing technology. Quantitative RT-PCR verification was used to confirm the identified Differentially expressed genes (DEGs) in the DRG of PIPN rats. RNAseq results have identified 384 DEGs (adjusted P-value < 0.05; fold change ≥ 2) in the DRG of rats 14 days after paclitaxel injection in total, including 97 up-regulated genes, and 287 down-regulated genes. GO analysis revealed that these DEGs were majorly involved in neuropeptide activity, chemokine receptor activity, defense response, and inflammatory response. Kyoto Encyclopedia of Gene and Genomes analysis showed that neuroactive ligand-receptor interaction and cytokine-cytokine receptor interaction were involved in sensory neurons of rats with PIPN. Besides, comparison analysis identified that 11 DEGs in the PIPN model are shared with either inflammatory pain (Ces1d, Cfd, Retn, and Fam150b) or neuropathic pain (Atf3, Csrp3, Ecel1, Gal, Sprr1a, Tgm1, and Vip). Quantitative RT-PCR results also confirmed the validation of the RNAseq data. These results suggested that neuroactive ligand-receptor interaction and cytokine-cytokine receptor interaction are majorly involved in sensory neurons of rats with PIPN. Immune, inflammatory responses and neuron functional changes are the major pathogenesis of PIPN. Paclitaxel-induced peripheral neuropathy has shared characteristics with both inflammatory pain and neuropathic pain.

化疗引起的周围神经病变(CIPN)是抗癌治疗最常见的副作用。迄今为止,还没有临床有效的镇痛药可以预防和治疗CIPN。然而,CIPN的确切发病机制尚不清楚。在本研究中,我们采用紫杉醇诱导的周围神经病变(PIPN)模型,旨在更好地了解PIPN大鼠背根神经节(DRG)神经元的转录组水平。每个DRG样本的mRNA逆转录为cDNA,并使用下一代高通量测序技术进行测序。采用定量RT-PCR验证PIPN大鼠DRG中鉴定的差异表达基因(DEGs)。RNAseq结果鉴定出384个deg(调整p值< 0.05;紫杉醇注射后14 d大鼠DRG的折叠变化≥2),其中上调基因97个,下调基因287个。氧化石墨烯分析显示,这些deg主要参与神经肽活性、趋化因子受体活性、防御反应和炎症反应。京都基因与基因组百科分析显示,PIPN大鼠感觉神经元参与神经活性配体-受体相互作用和细胞因子-细胞因子受体相互作用。此外,比较分析发现,PIPN模型中的11个DEGs与炎性疼痛(Ces1d、Cfd、Retn和Fam150b)或神经性疼痛(Atf3、Csrp3、Ecel1、Gal、Sprr1a、Tgm1和Vip)共有。定量RT-PCR结果也证实了RNAseq数据的有效性。这些结果表明,PIPN大鼠的感觉神经元主要参与神经活性配体-受体相互作用和细胞因子-细胞因子受体相互作用。免疫、炎症反应和神经元功能改变是PIPN的主要发病机制。紫杉醇诱导的周围神经病变具有炎症性疼痛和神经性疼痛的共同特征。
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引用次数: 8
期刊
Molecular Pain
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