Anti-allodynic efficacy of botulinum neurotoxin A in a model of neuropathic pain

Neuropathic pain is typified by injuries to the peripheral and central nervous system and derives from such causes as cancer, diabetes, multiple sclerosis, post-herpetic neuralgia, physical trauma or surgery, and many others. Patients suffering neuropathic pain do not respond to conventional treatment with non-steroidal anti-inflammatory drugs and show a reduced sensitivity to opiates often associated with serious side effects. Recently, it has been demonstrated that botulinum neurotoxin serotype-A (BoNT/A) is able to induce analgesia in inflammatory pain conditions. The goal of this research was to test if BoNT/A was able to relieve also neuropathic pain symptoms. By using chronic constriction injury of the sciatic nerve, a mouse model of neuropathic pain, we observed that peripheral administration of BoNT/A strongly reduced the mechanical allodynia associated with this neuropathy. Remarkably, a single non-toxic dose of BoNT/A was sufficient to induce anti-allodynic effects, which lasted for at least 3 weeks. This result is particularly relevant since neuropathic pain is poorly treated by current drug therapies. This communication enlarges our knowledge on potentially new medical uses of BoNT/A in efforts to ameliorate human health conditions, with very important implications in the development of new pharmacotherapeutic approaches against neuropathic pain.     

Short- but not long-lasting treadmill running reduces allodynia and improves functional recovery after peripheral nerve injury

We analyzed the effects of different treadmill running protocols on the functional recovery after chronic constriction injury (CCI) of the sciatic nerve in mice. We found that a treadmill protocol of short-lasting running (1 h/d for 5 days after CCI) reduced the neuropathy-induced mechanical allodynia and normalized the weight bearing and the sciatic static index of the injured hindpaw. At difference, a treadmill protocol of long-lasting running (1 h/d for more than 5 days after CCI) was unfavorable both for allodynia and for functional recovery. Behavioral results were correlated with immunofluorescence assays of microglia and astrocytes activation in L4/L5 lumbar spinal cord sections. We found a differential pattern of activation characterized by: (i) reduced microglia expression, after both short- and long-lasting treadmill running; (ii) reduced astrocytes expression after short-lasting treadmill running; and, (iii) persistence of astrocytes expression after long-lasting treadmill running. Finally, in sections of injured sciatic nerves, we analyzed the expression of Cdc2 and GAP-43 proteins that are both up-regulated during peripheral regenerative processes. Compared to mice subjected to long-lasting treadmill running, mice subjected to short-lasting treadmill running showed an acceleration of the regenerative processes at the injured sciatic nerve. Our data demonstrate that short-lasting treadmill running, by reducing the neuropathic pain symptoms and facilitating the regenerative processes of the injured nerve, have beneficial rehabilitative effects on the functional recovery after peripheral nerve injury.     

大鼠坐骨神经受压和解压后背根节和脊髓内神经元nNOS表达的变化

目的 :观察坐骨神经受压及解压后大鼠腰段背根节和脊髓内神经元型一氧化氮合酶 (nNOS)表达的变化 ,借以探讨外周神经源性痛的发病和影响机制。方法 :大鼠随机分为压迫组、解压组和对照组 ,采用聚乙烯管压迫坐骨神经的动物模型 ,用免疫细胞化学方法并结合计算机图像分析进行研究。结果 :与对照组比较 ,压迫组和解压组腰4～ 6背根节中nNOS的表达显著增加 ,相应节段脊髓背角的表达则明显降低 ;解压组与压迫组比较 ,背根节中nNOS的表达明显减少 ,而脊髓背角的已经下调的nNOS表达则回升 ,但仍然低于对照组水平。结论 :NO可能与神经源性痛时在中枢和外周的痛觉敏感性形成和神经系统长时程改变有关。     

Different patterns of morphological changes in the hippocampus and dentate gyrus accompany the differential expression of disability following nerve injury

Physical and psychological trauma which results in mood disorders and the disruption of complex behaviours is associated with reductions in hippocampal volume. Clinical evaluation of neuropathic pain reveals mood and behavioural change in a significant number of patients. A rat model of neuropathic injury results in complex behavioural changes in a subpopulation (~30%) of injured rats; these changes are co‐morbid with a range of other ‘disabilities’. The specific objective of this study was to determine in rats the morphology of the hippocampus and dentate gyrus in individuals with and without complex behavioural disruptions following a constriction injury of the sciatic nerve, and to determine whether rats that develop disabilities following nerve injury have a reduced hippocampal volume compared with injured rats with no disabilities. The social behaviours of nerve‐injured rats were evaluated before and after nerve injury. The morphology of the hippocampus of rats with and without behavioural disruptions was compared in serial histological sections. Single‐housing and repeated social‐interaction testing had no effect on the morphology of either the hippocampus or the dentate gyrus. Rats with transient or ongoing disability identified by behavioural disruption following sciatic nerve injury, show bilateral reductions in hippocampal volume, and lateralised reduction in the dentate gyrus (left side). Disabled rats display a combination of behavioural and physiological changes, which resemble many of the criteria used clinically to diagnose mood disorders. They also show reductions in the volume of the hippocampus similar to people with clinically diagnosed mood disorders. The sciatic nerve injury model reveals a similarity to the human neuropathic pain presentation presenting an anatomically specific focus for the investigation of the neural mechanisms underpinning the co‐morbidity of chronic pain and mood disorder.     

Optical coherence tomography reveals in vivo cortical plasticity of adult mice in response to peripheral neuropathic pain

We examined neural plasticity in mice in vivo using optical coherence tomography (OCT) of primary somatosensory (S1) and motor (M1) cortices of mice under the influence of sciatic nerve chronic constriction injury (CCI), a model of neuropathic pain widely utilized in rats. The OCT system used in this study provided cross-sectional images of the cortical tissue of mice up to a depth of about 1mm with longitudinal resolution up to 11 microm. This is the first study to evaluate neural plasticity in vivo using OCT. CCI mice exhibited cold allodynia and spontaneous pain behaviors, which are signs of neuropathic pain, 30 days after sciatic nerve ligation, when OCT observation of S1 and M1 cortices was carried out. The scattering intensity of near-infrared light within the hind paw area of S1 and M1 regions in the contralateral hemisphere was significantly higher than in the ipsilateral hemisphere. These CCI-induced increases in scattering intensity within cortical regions associated with the hind paw probably reflect elevated neural activity associated with neuropathic pain. Synapses and mitochondria are believed to have high light scattering coefficients, since they contain remarkably high concentrations of proteins and complicated membrane structure. Number densities of mitochondria and synapses are known to increase in parallel with increases in neural activity. Our findings thus suggest that neuropathic pain gives rise to neural plasticity within the hind paw area of S1 and M1 contralateral to the ligated sciatic nerve.     

局麻药长时间阻滞外周神经对神经源性疼痛发生过程中背根神经节内GAP-43表达的影响

用免疫组织化学方法观察了局麻药长时间阻滞外周神经对神经源性疼痛发生过程中生长相关蛋白(GAP-43)在背根神经节内表达的影响。实验选用SD大鼠35只,随机分成正常对照组、单纯坐骨神经横切组、坐骨神经横切前阻滞组、坐骨神经横切后阻滞组4大组,后三大组再按术后取材时间分为3、7d两个时间组。暴露大鼠右侧坐骨神经,于坐骨结节远端约1cm处横断坐骨神经。根据分组,阻滞组分别从横切前1h和横切后4h开始对神经横切的近心端进行长效局麻药阻滞,持续整个观察期。术后不同时间取与伤侧坐骨神经相连的背根神经节(DRG),应用免疫组织化学和图像分析的方法研究背根神经节中GAP-43的表达并进行定量分析。结果表明:术后3、7d,单纯坐骨神经横切组背根神经节内的GAP-43表达增高,而阻滞组内的GAP-43表达与正常组无差别。本研究结果提示坐骨神经横切前1h或之后4h开始局麻药阻滞神经均能抑制神经源性疼痛发生过程中GAP-43的高表达。     

Both MHC and non-MHC genes regulate development of experimental neuropathic pain in rats

We have previously demonstrated that differences in neuropathic pain-like behaviors after sciatic nerve injury genetically maps to the major histocompatibility complex (MHC) in rats carrying RT1(c) or RT1(av1) haplotypes on the Piebald Virol Glaxo (PVG) background. In order to further explore the genetic contribution to neuropathic pain, we have here examined the MHC-congenic rat strains PVG-RT1(n) and PVG-RT1(av1) and the inbred strains PVG (RT1(c)) and Brown-Norway (BN; RT1(n)). All studied strains developed mechanical hypersensitivity (allodynia-like behavior) of the hind paw after photochemically induced sciatic nerve injury. However, the PVG-RT1(n) and PVG strains displayed significantly more allodynia than PVG-RT1(av1) and BN rats. In addition, the BN strain demonstrated an elevated threshold for the baseline response. The results demonstrate that both MHC and non-MHC genes influence experimental neuropathic pain in rats and also suggest that allelic variation contained in the RT1(av1) haplotype on the PVG background protects against neuropathic pain.     

神经源性痛大鼠模型腰髓后角A_β纤维生芽的变化(英文)

已有研究表明 ,外周神经损伤后 Aβ神经元的初级传入末梢在脊髓的病理性生芽与损伤后痛觉超敏的形成有关。为了证实外周神经损伤后形成的这种生芽是否具有可逆性 ,本研究以大鼠坐骨神经压迫造成神经源性痛模型 ,采用跨神经节的霍乱毒素 B亚单位结合辣根过氧化物酶 ( CB-HRP)作为示踪剂 ,四甲基联苯胺 ( TMB)反应呈色追踪 Aβ初级传入末梢。结果证实 :对坐骨神经的压迫也能够导致痛觉过敏和 Aβ纤维末梢生芽侵入脊髓后角 层 ,并且这种生芽不伴随对神经压迫的解除而逆转。中枢神经系统的这种结构重组及其不可逆性可能是神经源性痛的产生和维持的重要原因     

植入微型刺激器对大鼠神经损伤后自残及神经再生的影响

本实验利用大鼠坐骨神经钳夹损伤模型，观察了电针（Ａ组）、直流刺激器（Ｂ组）及双向平衡电脉冲刺激器（Ｃ组）对神经损伤后自残及神经再生的影响，Ｄ组为对照。结果：（１）术后１７ｄ，Ｃ组的右后足趾自残率为１３％，而Ａ、Ｂ及Ｄ组分别为４６％、５３％及８０％，Ｃ组的自残率显著低于其它各组（Ｐ＜０．００１）；（２）右侧屈肌反射阈：当刺激强度为３５±５Ｖ（Ｃ组）、４５±５Ｖ（Ａ和Ｂ组）时，可引出短潜伏期（４５～１５０ｍｓ）的Ａ类及长潜伏期（１２５～５２５ｍｓ）Ｃ类传入纤维反应，而当刺激强度增至６５±５Ｖ时，于Ｄ组仅见长潜伏期（１９０～６００ｍｓ）的Ｃ类传入纤维反应；（３）术后１７ｄ脊神经节的标记细胞百分享分别为１１．１％（Ｃ组）、５．７％（Ｂ组）、５．２％（Ａ组）及１．１％（Ｄ组）；脊髓前角的标记细胞百分率分别为１６．６％（Ｃ组）、８．１％（８组）、７．４％（Ａ组）及１．９％（Ｄ组）。上述结果表明：双向平衡电脉冲刺激器在抑制神经损伤后自残及促进周围神经再生等方面具有更显著的生理功效。     

Hyperalgesia and increased neuropathic pain-like response in mice lacking galanin receptor 1 receptors

The neuropeptide galanin may have a role in modulation of nociception, particularly after peripheral nerve injury. The effect of galanin is mediated by at least three subtypes of receptors. In the present study, we assessed the nociceptive sensitivity in mice lacking the galanin receptor 1 gene (Galr1) and the development of neuropathic pain-like behaviours after photochemically induced partial sciatic nerve ischaemic injury. Under basal condition, Galr1 knock-out (Galr1(-/-)) mice had shortened response latency on the hot plate, but not tail flick and paw radiant heat, tests. The mechanical sensitivity was not different between Galr1(-/-) and wild type (Galr1(+/+)) mice, whereas the cold response was moderately enhanced in Galr1(-/-) mice. Both Galr1(-/-) mice and Galr1(+/+) controls developed mechanical and heat hypersensitivity after partial sciatic nerve injury. The duration of such pain-like behaviours was significantly increased in Galr1(-/-). The Galr1(-/-) mice and Galr1(+/+) mice did not differ in their recovery from deficits in toe-spread after sciatic nerve crush.The results provide some evidence for an inhibitory function for the neuropeptide galanin acting on galanin receptor 1 (GALR1) in nociception and neuropathic pain after peripheral nerve injury in mice.     

Crossed-withdrawal reflex in a rat model of neuropathic pain: implications in neural plasticity

Recently we developed a neuropathic rat model employing a distal sciatic nerve branch injury, in which rats show vigorous behavioral signs of neuropathic pain. This study was performed to evaluate the crossed-withdrawal reflex in which any stimuli applied to the uninjured side produces allodynic signs on the injured side in our neuropathic pain model. Rats that received neuropathic surgery developed behavioral signs of neuropathic pain. In addition, these rats developed pain responses of the injured paw to stimuli applied to the contralateral uninjured paw, therefore, demonstrating 'the crossed-withdrawal reflex.' Moreover, electrical stimulation of the uninjured paw developed evoked potentials in the ventral root on the injured side. These results suggest that information processing from input on the uninjured side to output on the injured side, can be facilitated in rats with a nerve injury and that neuroplasticity may contribute to the crossed-withdrawal reflex.     

坐骨神经选择性损伤痛模型小鼠脊髓背角线粒体解偶连蛋白UCP4的表达变化

目的:观察线粒体保护蛋白解偶联蛋白4(uncoupling protein 4,UCP4)在坐骨神经选择性损伤(sparednerve injury,SNI)模型小鼠脊髓背角中的表达变化。方法:健康C57BL/6小鼠分为假手术对照组(n=21)和坐骨神经分支选择性损伤SNI组(n=21),实验组损伤后饲养3,7,14 d。行为学采用测定小鼠热痛阈和Von Frey机械性痛阈;用免疫荧光组织化学染色法检测对比小鼠脊髓L3-6节段背角内UCP4免疫阳性细胞的数量。结果:SNI术后3 d,小鼠手术侧热痛阈和机械性痛阈明显低于假手术组,术后14 d达最低值。UCP4分布于正常小鼠脊髓背角,SNI后3 d损伤组小鼠脊髓背角中的UCP4表达降低,图像分析表明UCP4的光密度与对照组比较,差异有统计学意义(P<0.05);脊髓背角中UCP4的表达在14 d时其降低程度最明显,图像分析表明光密度与对照组、3d和7 d比较,差异均有统计学意义(P<0.05)。结论:SNI后脊髓背角线粒体保护蛋白UCP4表达降低可能参与神经病理性疼痛的中枢敏化过程。     

Implication of spinal protein kinase C in the suppression of morphine-induced rewarding effect under a neuropathic pain-like state in mice

We previously demonstrated that spinal protein kinase C (PKC) is involved in the development of a neuropathic pain-like state induced by sciatic nerve ligation, and the morphine-induced rewarding effect is attenuated by sciatic nerve ligation in rodents. Here we first investigated whether sciatic nerve injury could change the activity of a conventional PKC (cPKC) and an atypical PKC isoform PKCzeta in the mouse spinal cord. The second experiment was to investigate whether direct inhibition of spinal PKC by intrathecal (i.t.) administration of a specific PKC inhibitor, 2-[8-[(dimethylamino)methyl]-6,7,8,9-tetrahydropyrido[1,2-a]indol-3-yl]-3-(1-methyl-1H-indole-3-yl)maleimide (RO-32-0432), could affect the rewarding effect induced by morphine following sciatic nerve ligation in mice. We found here that the activities of both cPKC and PKCzeta in the spinal cord were clearly increased following sciatic nerve ligation. Furthermore, i.t. administration of RO-32-0432 reversed a long-lasting pain-like syndrome as indicated by thermal hyperalgesia following sciatic nerve ligation in mice. These data provide direct evidence that activated cPKC and PKCzeta in the spinal cord may contribute to the development and maintenance of neuropathic pain. In the present study, we confirmed that the morphine-induced place preference was significantly suppressed by sciatic nerve ligation. It should be mentioned that i.t. pretreatment with RO-32-0432 significantly reversed the attenuation of morphine-induced rewarding effect following sciatic nerve ligation. These results suggest that activation of PKCs, including cPKC and PKCzeta, within the spinal cord is directly responsible for the attenuation of the morphine-induced rewarding effect under a neuropathic pain-like state following sciatic nerve ligation in mice.     

Role of input from saphenous afferents in altered spinal processing of noxious signal that follows sciatic nerve constriction in rats

An investigation was made into a possible contribution of saphenous nerve to altered central processing of noxious information following sciatic nerve chronic constriction (CCI) in rats. Spinal sciatic neuron spontaneous and noxious evoked activities were recorded in CCI rats, CCI rats with saphenous nerve sectioned just before the sciatic nerve constriction and sham operated rats. The results show (1) high values of spontaneous and noxious evoked activities with prolonged afterdischarges in CCI rats with intact saphenous, (2) comparable high values of spontaneous activity, but significantly reduced noxious evoked activity and afterdischarges in CCI rats with sectioned saphenous, (3) values in the normal range in the sham rats. Potential mechanisms underlying these results are discussed.     

大鼠坐骨神经损伤后诱导型一氧化氮合酶表达的变化

为了探讨大鼠坐骨神经损伤后再生过程中诱导型一氧化氮合酶(iNOS)表达的变化及意义,本研究采用大鼠坐骨神经切断缝合模型,分别于术后1、3、7、14、21及28d取吻合口远端的神经,采用免疫组织化学和实时荧光定量聚合酶链反应(RT-PCR)方法检测损伤神经远端iNOSmRNA及其蛋白的表达水平。结果显示:假手术对照组坐骨神经中未见明显的iNOS阳性产物,iNOSmRNA表达极低。实验组神经损伤后iNOSmRNA及其蛋白的表达水平均明显增高(P<0.01),iNOS阳性产物的吸光度(A)值在术后7d达高峰。iNOSmRNA表达在术后1、3、7d维持较高水平,此后则明显下降。上述结果说明大鼠坐骨神经损伤后神经纤维中iNOS的表达增加,iNOS可能在周围神经损伤后的再生过程中起着一定的作用。     

Does the Tibial and Sural Nerve Transection Model Represent Sympathetically Independent Pain?

Neuropathic pain can be divided into sympathetically maintained pain (SMP) and sympathetically independent pain (SIP). Rats with tibial and sural nerve transection (TST) produce neuropathic pain behaviors, including spontaneous pain, tactile allodynia, and cold allodynia. The present study was undertaken to examine whether rats with TST would represent SMP- or SIP-dominant neuropathic pain by lumbar surgical sympathectomy. The TST model was generated by transecting the tibial and sural nerves, leaving the common peroneal nerve intact. Animals were divided into the sympathectomy group and the sham group. For the sympathectomy group, the sympathetic chain was removed bilaterally from L2 to L6 one week after nerve transection. The success of the sympathectomy was verified by measuring skin temperature on the hind paw and by infra red thermography. Tactile allodynia was assessed using von Frey filaments, and cold allodynia was assessed using acetone drops. A majority of the rats exhibited withdrawal behaviors in response to tactile and cold stimulations after nerve stimulation. Neither tactile allodynia nor cold allodynia improved after successful sympathectomy, and there were no differences in the threshold of tactile and cold allodynia between the sympathectomy and sham groups. Tactile allodynia and cold allodynia in the neuropathic pain model of TST are not dependent on the sympathetic nervous system, and this model can be used to investigate SIP syndromes.     

Circulatory depression following low frequency stimulation of the sciatic nerve in anesthetized rats

Earlier-experiments have shown that afferent-electrical-stimulation-of-the sciatic nerve for 30 min induces a long-lasting post-stimulatory endorphin-dependent decrease in blood pressure in awake spontaneously hypertensive rats (SHR). In the present study we have examined whether this depressor response can be observed also in anesthetized SHR. The sciatic nerve was stimulated for 30 min with low-frequent (3 Hz) trains of impulses and the changes in blood pressure, heart rate and renal nerve activity were observed during the stimulation and in the post-stimulatory period. Animals anesthetized with Nembutal, Althesin and N₂O did not show any post-stimulatory depression. In contrast, during chloralose anesthesia combined with muscle paralysis with Flaxedil, sciatic nerve stimulation induced a long-lasting post-stimulatory decrease in blood pressure due to central inhibition of sympathetic activity. The decrease in blood pressure could be prevented by naloxone and was therefore likely to be mediated via activation of central endorphin systems.     

CC-chemokine MIP-1α in the spinal cord contributes to nerve injury-induced neuropathic pain

We investigated the involvement of spinal macrophage inflammatory protein-1α (MIP-1α), an inflammatory chemokine, in partial sciatic nerve ligation (PSL)-induced neuropathic pain in mice. PSL increased MIP-1α mRNA levels as well as levels of the MIP-1α receptor, CCR1, but not CCR5 in the spinal dorsal horn. PSL-induced tactile allodynia and thermal hyperalgesia were prevented by intrathecal (i.t.) injection of a neutralizing antibody of MIP-1α (2 ng). Recombinant MIP-1α (10 pmol, i.t.) elicited long-lasting tactile allodynia and thermal hyperalgesia in naïve mice. These results suggest that peripheral nerve injury elicits the up-regulation of spinal MIP-1α and CCR1 to participate in neuropathic pain.     

大鼠异体神经移植后再生神经的荧光逆行标记

用Ｗｉｓｔａｒ大鼠作为实验模型，切除１ｃｍ坐骨神经，再用同系Ｗｉｓｔａｒ大鼠坐骨神经行异体桥接，修复坐骨神经的缺损。用Ｆｌｕｏｒｏ－Ｇｏｌｄ或Ｆａｓｔ Ｂｌｕｅ两种荧光标记物，进行示踪检验，证实Ｗｉｓｔａｒ鼠异体神经桥接能修复周围神经的缺损。