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Interleukin-6 induces nascent protein synthesis in human dorsal root ganglion nociceptors primarily via MNK-eIF4E signaling 白细胞介素-6 主要通过 MNK-eIF4E 信号诱导人背根神经节痛觉感受器的新生蛋白质合成
Q2 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ynpai.2024.100159
Molly E. Mitchell , Gema Torrijos , Lauren F. Cook, Juliet M. Mwirigi, Lucy He, Stephanie Shiers, Theodore J. Price

Plasticity of dorsal root ganglion (DRG) nociceptors in the peripheral nervous system requires new protein synthesis. This plasticity is believed to be responsible for the physiological changes seen in DRG nociceptors in animal models of chronic pain. Experiments in human DRG (hDRG) neurons also support this hypothesis, but a direct observation of nascent protein synthesis in response to a pain promoting substance, like interleukin-6 (IL-6), has not been measured in these neurons. To fill this gap in knowledge, we used acutely prepared human DRG explants from organ donors. These explants provide a physiologically relevant microenvironment, closer to in vivo conditions, allowing for the examination of functional alterations in DRG neurons reflective of human neuropathophysiology. Using this newly developed assay, we demonstrate upregulation of the target of the MNK1/2 kinases, phosphorylated eIF4E (p-eIF4E), and nascently synthesized proteins in a substantial subset of hDRG neurons following exposure to IL-6. To pinpoint the specific molecular mechanisms driving this IL-6-driven increase in nascent proteins, we used the specific MNK1/2 inhibitor eFT508. Treatment with eFT508 resulted in the inhibition of IL-6-induced increases in p-eIF4E and nascent proteins. Additionally, using TRPV1 as a marker for nociceptors, we found that these effects occurred in a large number of human nociceptors. Our findings provide clear evidence that IL-6 drives nascent protein synthesis in human TRPV1+ nociceptors primarily via MNK1/2-eIF4E signaling. The work links animal findings to human nociception, creates a framework for additional hDRG signaling experiments, and substantiates the continued development of MNK inhibitors for pain.

周围神经系统中背根神经节(DRG)痛觉感受器的可塑性需要新蛋白质的合成。这种可塑性被认为是慢性疼痛动物模型中 DRG 感受器发生生理变化的原因。在人类 DRG(hDRG)神经元中进行的实验也支持这一假设,但还没有在这些神经元中直接观察到新生蛋白质合成对白细胞介素-6(IL-6)等促痛物质的反应。为了填补这一知识空白,我们使用了器官捐献者的急性制备的人类 DRG 外植体。这些外植体提供了与生理相关的微环境,更接近于体内条件,可以检查 DRG 神经元的功能变化,反映人类神经病理生理学。利用这种新开发的检测方法,我们证明了暴露于 IL-6 后,大量 hDRG 神经元亚群中的 MNK1/2 激酶靶标、磷酸化 eIF4E(p-eIF4E)和新合成蛋白质的上调。为了明确驱动这种由 IL-6 驱动的新生蛋白质增加的特定分子机制,我们使用了特异性 MNK1/2 抑制剂 eFT508。使用 eFT508 可抑制 IL-6 诱导的 p-eIF4E 和新生蛋白的增加。此外,使用 TRPV1 作为痛觉感受器的标记,我们发现这些效应发生在大量人类痛觉感受器中。我们的研究结果提供了明确的证据,证明 IL-6 主要通过 MNK1/2-eIF4E 信号转导来驱动人类 TRPV1+ 痛觉感受器中新生蛋白质的合成。这项工作将动物研究结果与人类痛觉联系起来,为更多的 hDRG 信号实验建立了框架,并为继续开发 MNK 疼痛抑制剂提供了依据。
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引用次数: 0
Quantitative orbital tightening for pain assessment using machine learning with DeepLabCut 利用 DeepLabCut 进行机器学习,定量评估眼眶紧缩的疼痛程度
Q2 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ynpai.2024.100164
Saurav Gupta, Akihiro Yamada, Jennifer Ling, Jianguo G. Gu

Pain assessment in animal models is essential for understanding mechanisms underlying pathological pain and developing effective pain medicine. The grimace scale (GS), facial expression features in pain such as orbital tightening (OT), is a valuable measure for assessing pain in animal models. However, the classical grimace scale for pain assessment is labor-intensive, subject to subjectivity and inconsistency, and is not a quantitative measure. In the present study, we utilized machine learning with DeepLabCut to annotate the superior and inferior eyelid margins and the medial and lateral canthus of the eyes in animals’ video images. Based on the annotation, we quantified the eyelid distance and palpebral fissure width of the animals’ eyes so that the degree of OT in animals with pain could be measured and described quantitatively. We established criteria for the inclusion and exclusion of the annotated images for quantifying OT, and validated our quantitative grimace scale (qGS) in the mice with pain caused by capsaicin injections in the orofacial or hindpaw regions, the Nav1.8-ChR2 mice following orofacial noxious stimulation with laser light, and the oxaliplatin-treated mice following tactile stimulation with a von Frey filament. We showed that both the eyelid distance and the palpebral fissure width were shortened significantly in the animals in pain compared to the control animals without nociceptive stimulation. Collectively, the present study has established a quantitative orbital tightening for pain assessment in mice using DeepLabCut, providing a new tool for pain assessment in preclinical studies with mice.

动物模型中的疼痛评估对于了解病理疼痛的内在机制和开发有效的止痛药物至关重要。面部表情量表(GS)、眼眶紧缩(OT)等疼痛时的面部表情特征是评估动物模型疼痛的重要指标。然而,用于疼痛评估的经典面无表情量表需要耗费大量人力,存在主观性和不一致性,而且不是一种定量测量方法。在本研究中,我们利用 DeepLabCut 进行机器学习,为动物视频图像中的眼睑上缘和下缘以及眼睛的内眦和外眦进行标注。根据注释,我们量化了动物眼睛的眼睑距离和睑裂宽度,从而可以定量测量和描述疼痛动物的OT程度。我们制定了纳入和排除用于量化 OT 的注释图像的标准,并在口面部或后爪部注射辣椒素引起疼痛的小鼠、用激光刺激口面部引起疼痛的 Nav1.8-ChR2 小鼠和用 von Frey 灯丝进行触觉刺激的奥沙利铂治疗小鼠中验证了我们的定量面无表情量表(qGS)。我们发现,与未受痛觉刺激的对照组动物相比,疼痛组动物的眼睑距离和睑裂宽度都明显缩短。总之,本研究利用 DeepLabCut 建立了小鼠疼痛评估的定量眼眶紧缩度,为小鼠临床前研究中的疼痛评估提供了一种新工具。
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引用次数: 0
Neurotensin-expressing lateral hypothalamic neurons alleviate neuropathic and inflammatory pain via neurotensin receptor signaling 表达神经紧张素的下丘脑外侧神经元通过神经紧张素受体信号传导缓解神经病理性疼痛和炎症性疼痛
Q2 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ynpai.2024.100172
Rabail Khan , Beenhwa Lee , Kufreobong Inyang , Hope Bemis , Raluca Bugescu , Geoffroy Laumet , Gina Leinninger
Persistent, severe pain negatively impacts health and wellbeing, but half of patients do not receive adequate relief from current treatments. Understanding signals that modulate central pain processing could point to new strategies to manage severe pain. Administering Neurotensin (Nts) or Nts receptor (NtsR) agonists into the brain provides analgesia comparable to pharmacologic opioids. However, the endogenous sources of Nts that modify pain processing and might be leveraged for pain relief remained unknown. We previously characterized a large population of Nts-expressing neurons in the lateral hypothalamic area (LHANts neurons) that project to brain regions that participate in descending control of pain processing. We hypothesized that LHANts neurons are an endogenous source of Nts and activating them would alleviate pain dependent on Nts signaling via NtsRs. To test this, we injected NtsCre mice in the LHA with AAVs to cre-dependently express either mCherry (Control) or the excitatory hM3Dq in LHANts neurons, permitting their stimulation after treatment with the hM3Dq ligand clozapine N-oxide (CNO). Activating LHANts neurons had no effect on thermal pain and mechanical responses in naïve mice. By contrast, both spared nerve injury- (SNI) and complete Freund’s adjuvant (CFA)-induced mechanical hypersensitivity was completely reversed by CNO-stimulation of LHANts neurons. Pretreatment with the Nts receptor antagonist SR142948 reduced CNO-mediated analgesia, indicating that LHANts neurons alleviate chronic pain in an Nts receptor-dependent manner. Taken together these data identify LHANts neurons as an endogenous source of Nts that modulates central pain processing and may inform future development of Nts-based targets to treat severe pain.
持续的剧烈疼痛会对健康和幸福产生负面影响,但半数患者无法从现有治疗中得到充分缓解。了解调节中枢疼痛处理的信号可以为控制剧烈疼痛找到新策略。将神经紧张素(Nts)或Nts受体(NtsR)激动剂注入大脑可提供与药物阿片类药物相当的镇痛效果。然而,改变疼痛处理并可用于缓解疼痛的 Nts 的内源性来源仍然未知。我们之前描述了下丘脑外侧区大量表达 Nts 的神经元群(LHANts 神经元)的特征,这些神经元投射到参与疼痛处理降序控制的脑区。我们假设 LHANts 神经元是 Nts 的内源性来源,激活它们将减轻依赖于通过 NtsRs 发送 Nts 信号的疼痛。为了验证这一点,我们给 LHA 中的 NtsCre 小鼠注射了 AAVs,使其在 LHANts 神经元中独立表达 mCherry(对照组)或兴奋性 hM3Dq,并允许它们在接受 hM3Dq 配体氯氮平 N-氧化物(CNO)处理后受到刺激。激活 LHANts 神经元对天真小鼠的热痛和机械反应没有影响。相比之下,CNO刺激LHANts神经元可完全逆转神经损伤(SNI)和完全弗氏佐剂(CFA)诱导的机械超敏反应。预处理 Nts 受体拮抗剂 SR142948 会降低 CNO 介导的镇痛效果,这表明 LHANts 神经元以 Nts 受体依赖的方式缓解慢性疼痛。总之,这些数据确定了 LHANts 神经元是调节中枢疼痛处理的 Nts 的内源性来源,并可能为未来开发基于 Nts 的治疗严重疼痛的靶点提供信息。
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引用次数: 0
An investigation on the role of oxytocin in chronic neuropathic pain in a Wistar rat model 催产素在 Wistar 大鼠慢性神经病理性疼痛模型中的作用研究
Q2 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ynpai.2024.100152
Michaela de Kock , Sean Chetty , Ahmed Sherif Isa , Lihle Qulu-Appiah

Introduction Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side effect with ineffective preventative and curative treatment. Currently, only Duloxetine has been recommended as effective treatment for CIPN, which has shown individual-dependent, short-term analgesic effects, with limiting adverse effects and poor bioavailability. The neuropeptide, oxytocin, may offer significant analgesic and anxiolytic potential, as it exerts central and peripheral attenuating effects on nociception. However, it is unknown whether the intervention administered in a model of CIPN is an effective therapeutic alternative or adjuvant. Materials and Methods The intervention was divided into two phases. Phase 1 aimed to induce CIPN in adult Wistar rats using the chemotherapeutic agent Paclitaxel. Mechanical (electronic von Frey filament) and thermal (acetone evaporation test and Hargreaves test) hypersensitivity testing were used to evaluate changes due to the neuropathic induction. Phase 2 consisted of a 14-day intervention period with saline (o.g.), duloextine (o.g.), or oxytocin (i.n.) administered as treatment. Following the intervention, anxiety-like behaviour was assessed using the elevated plus maze (EPM) and light–dark box protocols. Analysis of peripheral plasma corticosterone, peripheral plasma oxytocin, and hypothalamic oxytocin concentrations were assessed using ELISA assays. Results The findings showed that we were able to successfully establish a model of chemotherapy-induced peripheral neuropathy during Phase 1, determined by the increase in mechanical and thermal nociceptive responses following Paclitaxel administration. Furthermore, the animals treated with oxytocin displayed a significant improvement in mechanical sensitivity over the intervention phase, indicative of an improvement in nociceptive sensitivity in the presence of neuropathic pain. Animals that received Paclitaxel and treated with oxytocin also displayed significantly greater explorative behaviour during the EPM, indicative of a reduced presence of anxiety-like behaviour. Conclusion Our results support the hypothesis that intranasally administered oxytocin may augment the analgesic and anxiolytic effects of duloxetine in a chemotherapy induced peripheral neuropathy model in a Wistar rat. Future studies should consider administering the treatments in combination to observe the potential synergistic effects.

化疗引起的周围神经病变(CIPN)是一种剂量限制性副作用,预防和治疗效果不佳。目前,只有度洛西汀被推荐为治疗 CIPN 的有效药物,但其镇痛效果受个体影响,且为短期镇痛,不良反应有限,生物利用度较低。神经肽催产素可能具有显著的镇痛和抗焦虑潜力,因为它对痛觉具有中枢和外周减弱作用。然而,在 CIPN 模型中实施的干预措施是否是一种有效的替代疗法或辅助疗法尚不得而知。干预分为两个阶段。第一阶段旨在使用化疗药物紫杉醇诱导成年 Wistar 大鼠产生 CIPN。采用机械(电子冯弗雷灯丝)和热敏(丙酮蒸发试验和哈格里夫斯试验)超敏试验来评估神经病理性诱导引起的变化。第二阶段包括为期 14 天的干预期,采用生理盐水(口服)、度洛司汀(口服)或催产素(静注)作为治疗。干预后,使用高架加迷宫(EPM)和光-暗箱方案评估焦虑样行为。使用酶联免疫吸附分析法评估了外周血浆皮质酮、外周血浆催产素和下丘脑催产素的浓度。研究结果表明,我们能够在第一阶段成功建立化疗诱导的周围神经病变模型,该模型由紫杉醇给药后机械和热痛觉反应的增加决定。此外,接受催产素治疗的动物在干预阶段的机械敏感性显著提高,这表明神经病理性疼痛的痛觉敏感性得到了改善。接受紫杉醇和催产素治疗的动物在EPM期间的探索行为也明显增加,这表明焦虑样行为减少了。我们的研究结果支持这一假设:在Wistar大鼠化疗诱发周围神经病变模型中,鼻内注射催产素可增强度洛西汀的镇痛和抗焦虑作用。未来的研究应考虑将这两种疗法结合使用,以观察其潜在的协同效应。
{"title":"An investigation on the role of oxytocin in chronic neuropathic pain in a Wistar rat model","authors":"Michaela de Kock ,&nbsp;Sean Chetty ,&nbsp;Ahmed Sherif Isa ,&nbsp;Lihle Qulu-Appiah","doi":"10.1016/j.ynpai.2024.100152","DOIUrl":"10.1016/j.ynpai.2024.100152","url":null,"abstract":"<div><p><strong><em>Introduction</em></strong> Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side effect with ineffective preventative and curative treatment. Currently, only Duloxetine has been recommended as effective treatment for CIPN, which has shown individual-dependent, short-term analgesic effects, with limiting adverse effects and poor bioavailability. The neuropeptide, oxytocin, may offer significant analgesic and anxiolytic potential, as it exerts central and peripheral attenuating effects on nociception. However, it is unknown whether the intervention administered in a model of CIPN is an effective therapeutic alternative or adjuvant. <strong><em>Materials and Methods</em></strong> The intervention was divided into two phases. Phase 1 aimed to induce CIPN in adult Wistar rats using the chemotherapeutic agent Paclitaxel. Mechanical (electronic von Frey filament) and thermal (acetone evaporation test and Hargreaves test) hypersensitivity testing were used to evaluate changes due to the neuropathic induction. Phase 2 consisted of a 14-day intervention period with saline (o.g.), duloextine (o.g.), or oxytocin (i.n.) administered as treatment. Following the intervention, anxiety-like behaviour was assessed using the elevated plus maze (EPM) and light–dark box protocols. Analysis of peripheral plasma corticosterone, peripheral plasma oxytocin, and hypothalamic oxytocin concentrations were assessed using ELISA assays. <strong><em>Results</em></strong> The findings showed that we were able to successfully establish a model of chemotherapy-induced peripheral neuropathy during Phase 1, determined by the increase in mechanical and thermal nociceptive responses following Paclitaxel administration. Furthermore, the animals treated with oxytocin displayed a significant improvement in mechanical sensitivity over the intervention phase, indicative of an improvement in nociceptive sensitivity in the presence of neuropathic pain. Animals that received Paclitaxel and treated with oxytocin also displayed significantly greater explorative behaviour during the EPM, indicative of a reduced presence of anxiety-like behaviour. <strong><em>Conclusion</em></strong> Our results support the hypothesis that intranasally administered oxytocin may augment the analgesic and anxiolytic effects of duloxetine in a chemotherapy induced peripheral neuropathy model in a Wistar rat. Future studies should consider administering the treatments in combination to observe the potential synergistic effects.</p></div>","PeriodicalId":52177,"journal":{"name":"Neurobiology of Pain","volume":"16 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2452073X24000035/pdfft?md5=442035faf3faa47ca01167ceecffeeb0&pid=1-s2.0-S2452073X24000035-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140097506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Induction of long-term hyperexcitability by memory-related cAMP signaling in isolated nociceptor cell bodies 记忆相关的 cAMP 信号在离体痛觉感受器细胞体中诱导长期过度兴奋性
Q2 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ynpai.2024.100166
Alexis Bavencoffe , Michael Y. Zhu , Sanjay V. Neerukonda , Kayla N. Johnson , Carmen W. Dessauer , Edgar T. Walters
Persistent hyperactivity of nociceptors is known to contribute significantly to long-lasting sensitization and ongoing pain in many clinical conditions. It is often assumed that nociceptor hyperactivity is mainly driven by continuing stimulation from inflammatory mediators. We have tested an additional possibility: that persistent increases in excitability promoting hyperactivity can be induced by a prototypical cellular signaling pathway long known to induce late-phase long-term potentiation (LTP) of synapses in brain regions involved in memory formation. This cAMP-PKA-CREB-gene transcription-protein synthesis pathway was tested using whole-cell current clamp methods on small dissociated sensory neurons (primarily nociceptors) from dorsal root ganglia (DRGs) excised from previously uninjured (“naïve”) male rats. Six-hour treatment with the specific Gαs-coupled 5-HT4 receptor agonist, prucalopride, or with the adenylyl cyclase activator forskolin induced long-term hyperexcitability (LTH) in DRG neurons that manifested 12–24 h later as action potential (AP) discharge (ongoing activity, OA) during artificial depolarization to −45 mV, a membrane potential that is normally subthreshold for AP generation. Prucalopride treatment also induced significant long-lasting depolarization of resting membrane potential (from −69 to −66 mV), enhanced depolarizing spontaneous fluctuations (DSFs) of membrane potential, and produced trends for reduced AP threshold and rheobase. LTH was prevented by co-treatment of prucalopride with inhibitors of PKA, CREB, gene transcription, or protein synthesis. As in the induction of synaptic memory, many other cellular signals are likely to be involved. However, the discovery that this prototypical memory induction pathway can induce nociceptor LTH, along with reports that cAMP signaling and CREB activity in DRGs can induce hyperalgesic priming, suggest that early, temporary, cAMP-induced transcriptional and translational mechanisms can induce nociceptor LTH that might last for long periods. The present results also raise the question of whether reactivation of primed signaling mechanisms by re-exposure to inflammatory mediators linked to cAMP synthesis during subsequent challenges to bodily integrity can “reconsolidate” nociceptor memory, extending the duration of persistent hyperexcitability.
众所周知,在许多临床病症中,痛觉感受器的持续亢进在很大程度上导致了长期敏感化和持续疼痛。人们通常认为,痛觉感受器亢进主要是由炎症介质的持续刺激驱动的。我们还测试了另一种可能性:兴奋性的持续上升会促进过度活跃,而这种兴奋性的持续上升是由一种典型的细胞信号通路诱导的,这种信号通路长期以来一直被认为能诱导参与记忆形成的脑区突触的晚期长期电位(LTP)。研究人员使用全细胞电流钳方法,对从先前未受伤("天真")的雄性大鼠背根神经节(DRGs)中切除的小型离体感觉神经元(主要是痛觉感受器)进行了 cAMP-PKA-CREB 基因转录-蛋白合成途径测试。用特异性 Gαs 偶联 5-HT4 受体激动剂普鲁卡必利或腺苷酸环化酶激活剂福斯可林处理 DRG 神经元六小时后,可诱导其长期兴奋性过高(LTH),12-24 小时后表现为在人工去极化至 -45 mV 时出现动作电位(AP)放电(持续活动,OA),而这个膜电位通常是产生 AP 的阈下电位。普卡必利治疗也会诱导静息膜电位的显著持久去极化(从-69 到-66 mV),增强膜电位的去极化自发波动(DSFs),并产生 AP 阈值和流变基础降低的趋势。普鲁卡必利与 PKA、CREB、基因转录或蛋白质合成抑制剂联合处理可防止 LTH。与突触记忆的诱导一样,许多其他细胞信号也可能参与其中。然而,这一典型记忆诱导途径可诱导痛觉感受器 LTH 的发现,以及 DRGs 中 cAMP 信号传导和 CREB 活性可诱导超痛引物的报道表明,早期、暂时、cAMP 诱导的转录和翻译机制可诱导痛觉感受器 LTH,并可能持续很长时间。本研究结果还提出了一个问题,即在随后身体完整性受到挑战时,再次暴露于与 cAMP 合成有关的炎症介质是否会重新激活已启动的信号机制,从而 "重新巩固 "痛觉感受器记忆,延长持续过度兴奋的持续时间。
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引用次数: 0
The timing of the mouse hind paw incision does not influence postsurgical pain 小鼠后爪切口的时间不会影响术后疼痛
Q2 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ynpai.2024.100161
Eleri L.F. McEachern , Maria Zilic , Susana G. Sotocinal , Nader Ghasemlou , Jeffrey S. Mogil

Chronobiological approaches have emerged as tools to study pain and inflammation. Although time–of-day effects on the expression of pain after injury have been studied, it remains unaddressed whether the timing of the injury itself can alter subsequent pain behaviors. The aim of this study was to assess postsurgical pain behaviors in a mouse hind paw incision assay in a circadian-dependent manner. Incisions were made at one of four equally spaced time points over a 24-hour period, with evoked and spontaneous pain behaviors measured using the von Frey mechanical sensitivity test, Hargreaves’ radiant heat paw-withdrawal test, and the Mouse Grimace Scale. Algesiometric testing was performed in C57BL/6 mice prior to and at multiple time points after incision injury, at the same time of day, until pain resolution. No statistically significant differences were observed between groups. This study adds to the literature on circadian rhythms and their influence on pain in the pursuit of more biologically informed pre- and postoperative care.

时间生物学方法已成为研究疼痛和炎症的工具。尽管人们已经研究了受伤后疼痛表达的时间效应,但受伤时间本身是否会改变随后的疼痛行为仍未得到解决。本研究的目的是在小鼠后爪切口实验中以昼夜节律依赖的方式评估手术后的疼痛行为。在 24 小时内的四个等间距时间点之一进行切口,使用 von Frey 机械敏感性测试、哈格里夫斯辐射热爪抽离测试和小鼠龇牙量表测量诱发和自发疼痛行为。在 C57BL/6 小鼠切口损伤之前和之后的多个时间点,在每天的同一时间对其进行藻胆测定,直到疼痛缓解为止。各组之间未观察到明显的统计学差异。这项研究为有关昼夜节律及其对疼痛影响的文献提供了新的资料,从而为术前和术后护理提供了更多生物学依据。
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引用次数: 0
The pace of biological aging significantly mediates the relationship between internalized stigma of chronic pain and chronic low back pain severity among non-hispanic black but not non-hispanic white adults 在非西班牙裔黑人而非非西班牙裔白人成年人中,生物衰老的速度对慢性疼痛内化耻辱感与慢性腰背痛严重程度之间的关系有明显的中介作用
Q2 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ynpai.2024.100170
Khalid W. Freij , Fiona B.A.T. Agbor , Kiari R. Kinnie , Vinodh Srinivasasainagendra , Tammie L. Quinn , Hemant K. Tiwari , Robert E. Sorge , Burel R. Goodin , Edwin N. Aroke
This study aimed to determine the nature of the relationship between the internalized stigma of chronic pain (ISCP), the pace of biological aging, and racial disparities in nonspecific chronic low back pain (CLBP). We used Dunedin Pace of Aging from the Epigenome (DunedinPACE), Horvath’s, Hannum’s, and PhenoAge clocks to determine the pace of biological aging in adults, ages 18 to 82 years: 74 no pain, 56 low-impact pain, and 76 high-impact pain. Individuals with high-impact pain reported higher levels of ISCP and DunedinPACE compared to those with low-impact or no pain (p < 0.001). There was no significant relationship between ISCP and epigenetic age acceleration from Horvath, Hannum, and PhenoAge clocks (p > 0.05). Mediation analysis showed that an association between ISCP and pain severity and interference was mediated by the pace of biological aging (p ≤ 0.001). We further found that race moderated the indirect effect of ISCP on pain severity and interference, with ISCP being a stronger positive predictor of the pace of biological aging for non-Hispanic Blacks (NHBs) than for non-Hispanic Whites (NHWs). Future bio-behavioral interventions targeting internalized stigma surrounding chronic pain at various levels are necessary. A deeper understanding of the biological aging process could lead to improvements in managing nonspecific chronic low back pain (CLBP), particularly within underserved minority populations.
本研究旨在确定慢性疼痛内化成见(ISCP)、生物衰老速度和非特异性慢性腰背痛(CLBP)的种族差异之间关系的性质。我们使用 Dunedin Pace of Aging from the Epigenome (DunedinPACE)、Horvath's、Hannum's 和 PhenoAge 时钟来确定 18 至 82 岁成年人的生物衰老速度:74 人无疼痛感,56 人有轻微疼痛感,76 人有剧烈疼痛感。与低度疼痛或无疼痛的人相比,高度疼痛的人报告的 ISCP 和 DunedinPACE 水平更高(p < 0.001)。ISCP与来自Horvath、Hannum和PhenoAge时钟的表观遗传年龄加速度之间没有明显关系(p > 0.05)。中介分析表明,ISCP 与疼痛严重程度和干扰之间的关系是由生物衰老速度中介的(p ≤ 0.001)。我们还发现,种族调节了 ISCP 对疼痛严重程度和干扰的间接影响,对于非西班牙裔黑人(NHBs)而言,ISCP 对生物衰老速度的正向预测作用强于非西班牙裔白人(NHWs)。未来有必要在各个层面针对围绕慢性疼痛的内化成见采取生物行为干预措施。加深对生物衰老过程的了解,可以改善非特异性慢性腰背痛(CLBP)的管理,尤其是在服务不足的少数民族人群中。
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引用次数: 0
Is exercise therapy the first-line treatment for chronic pain? 运动疗法是治疗慢性疼痛的一线疗法吗?
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ynpai.2024.100154
Emiko Senba
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引用次数: 0
A review of dorsal root ganglia and primary sensory neuron plasticity mediating inflammatory and chronic neuropathic pain 背根神经节和初级感觉神经元可塑性介导炎症性和慢性神经性疼痛综述
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ynpai.2024.100151
Kyeongran Jang, Sandra M. Garraway

Pain is a sensory state resulting from complex integration of peripheral nociceptive inputs and central processing. Pain consists of adaptive pain that is acute and beneficial for healing and maladaptive pain that is often persistent and pathological. Pain is indeed heterogeneous, and can be expressed as nociceptive, inflammatory, or neuropathic in nature. Neuropathic pain is an example of maladaptive pain that occurs after spinal cord injury (SCI), which triggers a wide range of neural plasticity. The nociceptive processing that underlies pain hypersensitivity is well-studied in the spinal cord. However, recent investigations show maladaptive plasticity that leads to pain, including neuropathic pain after SCI, also exists at peripheral sites, such as the dorsal root ganglia (DRG), which contains the cell bodies of sensory neurons. This review discusses the important role DRGs play in nociceptive processing that underlies inflammatory and neuropathic pain. Specifically, it highlights nociceptor hyperexcitability as critical to increased pain states. Furthermore, it reviews prior literature on glutamate and glutamate receptors, voltage-gated sodium channels (VGSC), and brain-derived neurotrophic factor (BDNF) signaling in the DRG as important contributors to inflammatory and neuropathic pain. We previously reviewed BDNF’s role as a bidirectional neuromodulator of spinal plasticity. Here, we shift focus to the periphery and discuss BDNF-TrkB expression on nociceptors, non-nociceptor sensory neurons, and non-neuronal cells in the periphery as a potential contributor to induction and persistence of pain after SCI. Overall, this review presents a comprehensive evaluation of large bodies of work that individually focus on pain, DRG, BDNF, and SCI, to understand their interaction in nociceptive processing.

疼痛是一种感觉状态,是外周痛觉输入和中枢处理复杂整合的结果。疼痛包括急性和有益于愈合的适应性疼痛,以及通常是持续性和病理性的适应性疼痛。疼痛其实是多种多样的,在本质上可以表现为痛觉性、炎症性或神经病理性疼痛。神经病理性疼痛是脊髓损伤(SCI)后出现的适应不良性疼痛的一个例子,它引发了广泛的神经可塑性。对脊髓中痛觉过敏的痛觉处理进行了深入研究。然而,最近的研究表明,导致疼痛(包括 SCI 后的神经性疼痛)的不适应可塑性也存在于外周部位,如包含感觉神经元细胞体的背根神经节(DRG)。本综述讨论了 DRG 在痛觉处理过程中扮演的重要角色,它是炎症性疼痛和神经性疼痛的基础。具体而言,它强调了痛觉感受器过度兴奋对疼痛状态加剧的关键作用。此外,它还回顾了之前有关谷氨酸和谷氨酸受体、电压门控钠通道(VGSC)和脑源性神经营养因子(BDNF)信号传导的文献,这些都是导致炎症性和神经性疼痛的重要因素。我们之前回顾了 BDNF 作为脊柱可塑性双向神经调节因子的作用。在此,我们将重点转移到外周,讨论 BDNF-TrkB 在痛觉感受器、非痛觉感受器感觉神经元和外周非神经元细胞上的表达,这是 SCI 后诱发和持续疼痛的潜在因素。总之,本综述全面评估了单独关注疼痛、DRG、BDNF 和 SCI 的大量研究工作,以了解它们在痛觉处理过程中的相互作用。
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引用次数: 0
Pain-sensorimotor interactions: New perspectives and a new model 疼痛-感觉-运动的相互作用:新视角和新模型
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ynpai.2024.100150
Greg M. Murray , Barry J. Sessle

How pain and sensorimotor behavior interact has been the subject of research and debate for many decades. This article reviews theories bearing on pain-sensorimotor interactions and considers their strengths and limitations in the light of findings from experimental and clinical studies of pain-sensorimotor interactions in the spinal and craniofacial sensorimotor systems. A strength of recent theories is that they have incorporated concepts and features missing from earlier theories to account for the role of the sensory-discriminative, motivational-affective, and cognitive-evaluative dimensions of pain in pain-sensorimotor interactions. Findings acquired since the formulation of these recent theories indicate that additional features need to be considered to provide a more comprehensive conceptualization of pain-sensorimotor interactions. These features include biopsychosocial influences that range from biological factors such as genetics and epigenetics to psychological factors and social factors encompassing environmental and cultural influences. Also needing consideration is a mechanistic framework that includes other biological factors reflecting nociceptive processes and glioplastic and neuroplastic changes in sensorimotor and related brain and spinal cord circuits in acute or chronic pain conditions. The literature reviewed and the limitations of previous theories bearing on pain-sensorimotor interactions have led us to provide new perspectives on these interactions, and this has prompted our development of a new concept, the Theory of Pain-Sensorimotor Interactions (TOPSMI) that we suggest gives a more comprehensive framework to consider the interactions and their complexity. This theory states that pain is associated with plastic changes in the central nervous system (CNS) that lead to an activation pattern of motor units that contributes to the individual’s adaptive sensorimotor behavior. This activation pattern takes account of the biological, psychological, and social influences on the musculoskeletal tissues involved in sensorimotor behavior and on the plastic changes and the experience of pain in that individual. The pattern is normally optimized in terms of biomechanical advantage and metabolic cost related to the features of the individual’s musculoskeletal tissues and aims to minimize pain and any associated sensorimotor changes, and thereby maintain homeostasis. However, adverse biopsychosocial factors and their interactions may result in plastic CNS changes leading to less optimal, even maladaptive, sensorimotor changes producing motor unit activation patterns associated with the development of further pain. This more comprehensive theory points towards customized treatment strategies, in line with the management approaches to pain proposed in the biopsychosocial model of pain.

几十年来,疼痛和感觉运动行为如何相互作用一直是研究和辩论的主题。本文回顾了有关疼痛与感觉运动相互作用的理论,并根据脊柱和颅面感觉运动系统中疼痛与感觉运动相互作用的实验和临床研究结果,探讨了这些理论的优势和局限性。最新理论的一个优势在于它们纳入了早期理论中缺失的概念和特征,以解释疼痛-感觉-运动相互作用中感觉-辨别、动机-情感和认知-评价维度的作用。自这些最新理论提出以来所获得的研究结果表明,还需要考虑更多的特征,以提供更全面的疼痛-感觉-运动互动概念。这些特征包括生物-心理-社会影响,从遗传学和表观遗传学等生物因素到心理因素以及包括环境和文化影响在内的社会因素。此外,还需要考虑一个机理框架,其中包括反映痛觉过程的其他生物因素,以及急性或慢性疼痛情况下感觉运动及相关大脑和脊髓回路中的神经胶质细胞和神经可塑性变化。通过查阅文献,我们发现以往关于疼痛-感觉运动相互作用的理论存在局限性,这促使我们提出了一个新概念--疼痛-感觉运动相互作用理论(TOPSMI),我们认为该理论为考虑相互作用及其复杂性提供了一个更全面的框架。该理论认为,疼痛与中枢神经系统(CNS)的可塑性变化有关,这种变化会导致运动单元的激活模式,从而促进个体的适应性感觉运动行为。这种激活模式考虑到了生物、心理和社会对参与感觉运动行为的肌肉骨骼组织的影响,以及对个体的塑性变化和疼痛体验的影响。这种模式通常会根据个体肌肉骨骼组织的特点,在生物力学优势和新陈代谢成本方面进行优化,旨在最大限度地减少疼痛和任何相关的感觉运动变化,从而维持体内平衡。然而,不利的生物-心理-社会因素及其相互作用可能会导致中枢神经系统的可塑性变化,从而导致不太理想的、甚至是不适应的感觉运动变化,产生与进一步疼痛发展相关的运动单元激活模式。这一更为全面的理论指出了定制化的治疗策略,与疼痛的生物心理社会模式中提出的疼痛管理方法相一致。
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Neurobiology of Pain
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