Sleep patterns over 21-day period in rats with chronic constriction of sciatic nerve

The main purpose of the present study was to examine sleep patterns over 21-day periods of rats in a peripheral neuropathy model induced by sciatic nerve constriction. Evaluation of the recordings showed that chronic constrictive injury (CCI) induced sleep alterations such as reduced sleep efficiency and increased number of arousals, especially during the light period. Among these alterations, sleep patterns were most affected between day 2 and day 10. The rats took longer to get to sleep from day 2 to 7 days after the CCI in the light period. Additionally, latency to the first paradoxical sleep episode was reduced in the second to fourth day after CCI in both light and dark period recordings. In conclusion, sciatic nerve constriction induced poor sleep quality with disrupted sleep in rats, particularly during the first week of that condition.     

臭氧对大鼠神经病理性疼痛镇痛作用的实验研究

目的 探讨臭氧对大鼠神经病理性疼痛起镇痛作用的部位和所需的臭氧浓度.方法 应用成年雄性SD大鼠建立部分坐骨神经损伤(SNI)模型,采用随机数字表法分四组.即手术局部组、坐骨神经组、L5脊神经组、联合组(手术局部和L5脊神经),每组6只,于对应部位注射50μg/mL臭氧.另外,取SNI模型建立后12 d大鼠,采用随机数字表法分四组,每组6只.四个组分别以40μg/mL、50μg,mL、60μg/mL和70μg/mL臭氧浓度对联合注射部位处理.采用大鼠50%的机械刺激撤足阈值(PWT)为观察项目.结果 联合组和L5脊神经组在臭氧干预后机械痛阈明显升高,与其他处理组相比差异有统计学意义(P<0.05).在联合部位注射不同浓度臭氧的处理后,不同浓度间痛阈改变差异无统计学意义(P>0.05).结论 臭氧对神经病理性疼痛镇痛的作用部位在手术局部和L5脊神经处.40～70μg/mL的臭氧对神经病理性疼痛均有镇痛效果.     

CNS demyelination in autoimmune diseases

Autoimmune diseases represent a diverse group of disorders that have generally of unknown etiology and poorly understood pathogenesis. They may be organ-specific or systemic, giving rise to overlapping syndromes; more than one autoimmune disease may occur in the same patient. Numerous case reports have documented that multiple sclerosis (MS) may be present concurrently with other autoimmune diseases, most commonly rheumatoid arthritis, autoimmune thyroid disease, type I diabetes mellitus and pernicious anemia. Case reports of disseminated encephalomyelitis (DEM) coincidental with other autoimmune diseases are rare. Many of systemic autoimmune diseases cause central nervous system (CNS) demyelination and are frequently then diagnosed as MS, whereas they often are instances of DEM, the result of vascular, granulomatous or postinfectious manifestations. We have reviewed 15 patients with autoimmune diseases and CNS demyelination in order to determine the nature of the demyelinating process.     

Number of synapses increased in the rat spinal dorsal horn after sciatic nerve transection: a stereological study

We recently found that the number of synapses in the spinal dorsal horn, as estimated by stereological techniques, increased by 86% after chronic constriction injury of sciatic nerve in rats. In this study, we aimed to reveal whether transection of sciatic nerve was also associated with a plasticity change in the number of synapses. 18 adult SD rats were randomly divided into 3 groups undergoing (i) unilateral sham operation, (ii) unilateral sciatic nerve transection, and (iii) unilateral sciatic nerve transection with postoperative medication (parecoxib) for 3 days, respectively. 28 days postoperation, the L4-6 segment of the spinal cord was removed; paraffin-embedded sections were prepared and stained with Nissl's method and synaptophysin immunohistochemistry. The optical disector (a contemporary stereological technique) was used to estimate the numbers of neurons and synapses in the spinal dorsal horn. Compared to the non-operated side, the axotomy induced a 74.3% increase in the number of synapses per unit length of spinal cord or a 67.4% increase in the ratio between the numbers of synapses and neurons in the middle tissue block from the L4-6 segment on the operated side but not in either the rostral or caudal tissue block. Parecoxib had no effect on the parameters. In conclusion, peripheral nerve injury, model for neuropathic pain, is associated with a synaptic plasticity (numerical increase) in the spinal dorsal horn.     

Repair of peripheral nerve transections with fibrin sealant containing neurotrophic factors

Peripheral nerve injury is often followed by incomplete recovery of function and sometimes associated with neuropathic pain. There is, therefore, need for therapies which improve the speed of recovery and the final functional outcome after peripheral nerve injuries. In addition, neuropathic pain is not easily dealt with clinically and should preferably be eliminated. Neurotrophic factors have well-documented abilities to support neuron survival and stimulate neurite outgrowth, making them excellent candidates for use in repairing injured nerves. We investigated the possible beneficial effects of repairing the transected rat sciatic nerve by local application of a fibrin sealant containing nerve growth factor (NGF), glial cell line-derived neurotrophic factor (GDNF), or acidic fibroblast growth factor (aFGF). Fibrin sealant was used in conjunction with sutures. Evaluation of motor and sensory function, autotomy, and histological parameters was carried out from 1 to 12 weeks after injury. We demonstrate that NGF cotreatment decreased the occurance of autotomy, suggesting a reduction of neuropathic pain, and improved the performance in motor and sensory tests. In addition, the number of regenerating motoneurons was significantly increased after NGF administration. GDNF increased the speed of sensory recovery, but also markedly increased autotomy, indicating an increased degree of neuropathic pain. aFGF did not alter the outcome of the motor or sensory tests. Fibrin sealant could easily be used in conjunction with sutures to deliver neurotrophic substances locally to the damaged nerve and to enhance recovery of nerve function.     

Sciatic nerve transection increases gluthatione antioxidant system activity and neuronal nitric oxide synthase expression in the spinal cord

Glutathione (GSH) is a major non-enzymatic antioxidant which is present in all tissues. Its protective actions occur through different pathways such its role as a substrate of antioxidant enzymes, such as glutathione peroxidase (GPx) and glutathione-S-transferase (GST). Nitric oxide (NO) is involved in many physiological processes in the central nervous system, including nociception. In spite of much evidence concerning oxidative and nitrosative stress and neuropathic pain, the exact role of these molecules in pain processing is still unknown. Sciatic nerve transection (SNT) was employed to induce neuropathic pain in rats. Glutathione peroxidase (GPx) and glutathione-S-transferase (GST) activities, glutathione (GSH) content, GSH/GSSG ratio, nitric oxide metabolites (NOx) and neuronal nitric oxide synthase (nNOS) protein expression in the lumbosacral spinal cord were determined. All of these analyses were performed in the SNT and sham groups 1, 3, 7 and 15 days after surgery. There was an increase in GPx activity and in GSH content 3 days after surgery in both sham and SNT groups, but the GSH/GSSG ratio increased only in the SNT group in this time point. nNOS expression was upregulated 7 days post SNT. NOx was detected 1 day after surgery in sham and SNT groups, but at 7 and 15 days, the increase occurred only in SNT animals. These results support the role of the gluthatione system in pain physiology and highlight the involvement of NO as an important molecule related to nociception.     

Evaluation of artificial nerve conduit and autografts in peripheral nerve repair in the rat model of sciatic nerve injury

Objective: To investigate the therapeutic effect of artificial nerve conduit in the sciatic nerve injury and repair in the rat model.

Methods: A total of 60 adult male Sprague Dawley rats were evenly randomized into five groups to build the model of sciatic nerve injury and perform the injury repair experiment. The five groups were: group A which was treated with artificial nerve conduit, group B which was treated with common carotid artery (CCA) autograft, group C which was treated with sciatic nerve autograft, group D which was treated with sham operation, and group E as the normal control. The injury was repaired by direct coaptation of the nerve ends. Postoperatively, the rats’ behavior, motor nerve conduction velocity (MNCV), incubation period, amplitude, remaining rate of wet weight of the gastrocnemius muscle, the diameter and section area of the gastrocnemius cell, and the histological changes were assessed. The results were analyzed by one-way ANOVA and two-way ANOVA.

Results: Twelve days postoperatively, 36 rats in groups A, B, and C presented with denervated adermotrophia on the injured ankle. The electrophysiological indicators in groups D and E were constant and similar. The values of MNCV and amplitude were group C > group A > group B, with an increasing tendency. The values of the incubation period were group C < group A < group B with statistical difference (p < 0.05) and showed a decreasing tendency. The wet gastrocnemius muscle in groups D and E showed plump morphology with luster and elasticity. Groups A and C had similar atrophic gastrocnemius muscles and reduced flexibility while the phenomena were more severe in group B. Progressive decrease of the cell diameter and sectional area was observed in groups A, B, and C. The adhesion between the sciatic nerve and the surrounding area in groups A, B, and C had statistical significance (P < 0.05), with group B the most serious.

Conclusions: The results suggest that artificial nerve conduit facilitated functional and morphological regeneration of the nerve. It seemed more effective than CCA but inferior to sciatic nerve autograft in repairing sciatic nerve injury in the rat model.     

Long-lasting neonatal inflammation enhances pain responses to subsequent inflammation,but not peripheral nerve injury in adult rats

The early postnatal period has been suggested to be the vulnerable time for structural and functional reorganization of sensory systems, and painful stimuli at this time may alter neuronal circuits, thereby leading to changes in an individual's response to pain later in life. In the present study, we examined whether inflammatory experience in the early life can affect pain responses to subsequent noxious insults later in life. The two groups of neonatal rats, treated with an inflammatory irritant and untreated, were subjected to inflammation and peripheral nerve injury in adulthood. Neonatal inflammation was induced by injection of complete Freund's adjuvant (CFA, 25 μl) into the hindpaw or tail of newborn rat pups. Adult rats which had suffered from neonatal paw inflammation at P0 were subjected to re-injection of CFA into the paw neonatally exposed to CFA or L5 spinal nerve ligation. Paw thickness and histology of inflamed paw were examined to assess the neonatal inflammation. Adult animals whose tail had been subjected to CFA injection on P3 received tail-innervating nerve injury. The results showed that the neonatal CFA-treated rats suffered from chronic inflammation, confirmed by persistent increase of paw thickness and histological result of inflamed paw. These animals showed enhanced pain responses to re-inflammatory challenge by injection of CFA (200 μl) into the neonatally inflamed paw 8 weeks after birth compared with the neonatally untreated animals. However, neuropathic pain on the hindpaw and the tail which had been induced by peripheral nerve injury in the neonatal CFA-treated group were not different from those of the untreated group. The present data suggest that early neonatal long-lasting inflammation differentially affects pain responses later in life, depending on the types of subsequent noxious insults.     

吞噬细胞与多发性硬化相关性的研究进展

多发性硬化是一种有关中枢神经系统的慢性炎性脱髓鞘和神经退变性疾病,以炎症反应、脱髓鞘、轴突丢失和反应性神经胶质增生等为主要病理特征.多发性硬化涉及免疫和中枢神经两大系统,其中在免疫系统中有固有免疫系统和适应性免疫系统参与.而吞噬细胞是固有免疫系统里重要的组成部分,是介导多发性硬化免疫应答的主要效应细胞,既参与多发性硬化...     

Symptomatology and pathogenesis of different types of pain in multiple sclerosis

Multiple sclerosis (MS) is a progressive disease of the central nervous system. It is characterized by disseminated foci of demyelination, which are responsible for the diverse clinical picture of MS. Pain is a frequent but underestimated symptom of multiple sclerosis. It is estimated to affect 29–86% of MS patients in various stages of the disease and severely influences rehabilitation and quality of life. The pain experienced by MS patients is generally caused by nervous system damage during the course of the disease process and can usually be characterized as central neuropathic pain (less frequently as peripheral or nociceptive pain). The most frequent symptoms include dysesthetic extremity pain, painful tonic spasms, Lhermitte's sign, trigeminal neuralgia, headaches and low back pain. This paper discusses the probable mechanisms behind the development of pain in MS, the prevalence, classification, types of pain, as well as the most effective treatment methods.     

Gabapentin reverses mechanical allodynia induced by sciatic nerve ischemia and formalin-induced nociception in mice

The anticonvulsant drug gabapentin has been demonstrated to alleviate symptoms of painful diabetic neuropathy as well as other types of neuropathic pain. The aim of the present study was to investigate the effect of gabapentin in a recently developed mouse model of peripheral neuropathy. This model is based on a photochemical ischemic lesion of the sciatic nerve generated by laser-induced activation of the photosensitizing dye erythrosin B. Following laser irradiation of the sciatic nerve for 2, 5, or 10 min, tactile allodynia was observed during at least 3 weeks. The degree of allodynia was most marked following 10 min of irradiation. Subcutaneous administration of gabapentin [175-300 micromol/kg ( approximately 30-51 mg/kg), cumulative doses, at 1-h intervals] significantly reversed tactile allodynia induced by 10-min laser irradiation. The maximal dose of gabapentin increased the withdrawal threshold from approximately 0.55 to approximately 1.85 g (i.e., about 77% of the threshold in normal animals, approximately 2.4 g). Gabapentin did not affect the tactile withdrawal threshold in intact animals. A dose of gabapentin (100 micromol/kg, sc) that had no effect on allodynia was found to significantly reduce the pain behavior during phase 2 of the formalin test. The present study demonstrates that systemic administration of gabapentin suppresses both allodynia induced by an ischemic lesion of the sciatic nerve and pain behavior in the formalin test.     

Spinal versus brain microglial and macrophage activation traits determine the differential neuroinflammatory responses and analgesic effect of minocycline in chronic neuropathic pain

Substantial evidence indicates involvement of microglia/macrophages in chronic neuropathic pain. However, the temporal-spatial features of microglial/macrophage activation and their pain-bound roles remain elusive. Here, we evaluated microglia/macrophages and the subtypes in the lumbar spinal cord (SC) and prefrontal cortex (PFC), and analgesic-anxiolytic effect of minocycline at different stages following spared nerve injury (SNI) in rats. While SNI enhanced the number of spinal microglia/macrophages since post-operative day (POD)3, pro-inflammatory MHCII⁺ spinal microglia/macrophages were unexpectedly less abundant in SNI rats than shams on POD21. By contrast, less abundant anti-inflammatory CD172a (SIRPα)⁺ microglia/macrophages were found in the PFC of SNI rats. Interestingly in naïve rats, microglial/macrophage expression of CD11b/c, MHCII and MHCII⁺/CD172a⁺ ratio were higher in the SC than the cortex. Consistently, multiple immune genes involved in anti-inflammation, phagocytosis, complement activation and M2 microglial/macrophage polarization were upregulated in the spinal dorsal horn and dorsal root ganglia but downregulated in the PFC of SNI rats. Furthermore, daily intrathecal minocycline treatment starting from POD0 for two weeks alleviated mechanical allodynia most robustly before POD3 and attenuated anxiety on POD9. Although minocycline dampened spinal MHCII⁺ microglia/macrophages until POD13, it failed to do so on cortical microglia/macrophages, indicating that dampening only spinal inflammation may not be enough to alleviate centralized pain at the chronic stage. Taken together, our data provide the first evidence that basal microglial/macrophage traits underlie differential region-specific responses to SNI and minocycline treatment, and suggest that drug treatment efficiently targeting not only spinal but also brain inflammation may be more effective in treating chronic neuropathic pain.     

Cytokines and chemokines in cerebrospinal fluid and serum of adult patients with acute disseminated encephalomyelitis

Cytokines and chemokines contribute to the pathogenesis of acute disseminated encephalomyelitis (ADEM). Using a multiplex immunochemiluminescence ELISA, we measured 8 Th1/Th2 cytokines and 18 chemokines in the cerebrospinal fluid (CSF) and serum of 17 ADEM patients, 14 multiple sclerosis (MS) patients, and 7 healthy controls (HCs). Relative to HCs, ADEM patients had significantly high mean CSF concentrations of chemokines with attractant/activating properties towards neutrophils (CXCL1 and CXCL7), monocytes/T cells (CCL3 and CCL5), Th1 cells (CXCL10), and Th2 cells (CCL1, CCL22, and CCL17). Mean CSF concentrations of CXCL7, CCL1, CCL22, and CCL17 were higher in ADEM than in MS, whereas those of CCL11 were lower in MS than in ADEM and HCs. CSF pleocytosis correlated with CSF concentrations of CXCL1, CXCL10, CCL1, CCL17, and CCL22. Most of the functionally homologous chemokines correlated with each other. CSF Th1/Th2 cytokines were not detectable in most samples. Their mean concentrations did not differ in the three groups, and the same held for serum cytokines and chemokines. Our data suggest that the upregulation of chemokines active on neutrophils and Th2 cells differentiates ADEM from MS inflammation, and that both Th1 and Th2 chemokines might be produced in ADEM. Chemokines upregulated in ADEM could become CSF biomarkers after a posteriori evaluations in unselected case series.     

多发性硬化的免疫研究进展

多发性硬化(multiple sclerosis.MS)是一种病因不明的中枢神经系统(central nervous system,CNS)自身免疫性疾病,以炎性脱髓鞘为主要特征,以髓鞘脱失、神经胶质细胞增生、不同程度的轴索病变为主要病理特点.     

Microglia, but not astrocytes, react to sciatic nerve injury in aging rats

Peripheral nerve axotomy activates microglia and astrocytes within regions of brainstem or spinal cord from which the nerve arises. The present study demonstrates that unilateral sciatic axotomy in rats 2 to 18 months of age results in differing responses with age between these two glial populations. By 4 days postaxotomy, both astrocytes and microglia become activated in 2-month-old rats, whereas only the microglial population shows evidence of activation in rats 8 to 18 months of age.     

Clinical, electrophysiological, and prognostic study of postinjection sciatic nerve injury: An avoidable cause of loss of limb in the peripheral medical service

Background:

Post injection sciatic nerve injury is a common cause of sciatic nerve mononeuropathy in the developing world largely due to inadequate health care facilites in the rural regions.

Objective:

The study was conducted to analyse the pattern of this nerve lesion in clinical and electrophysiological parameters and also to study the outcome in a conservatively treated cohort.

Materials and Methods:

One hundred and six patients who underwent evaluation at our laboratory from 2000 to 2006 for post injection sciatic neuropathy formed the study population. Twenty two of these were followed up (mean 6.6 months) for the outcome.

Results:

In the cases with full data, common peroneal division of the sciatic nerve was affected alone or predominantly. On follow up, 72% cases showed little or partial recovery. Thirty two percent patients had residual trophic changes and causalgia at their last visit.

Conclusion:

The majority of cases of postinjection sciatic nerve injury have poor prognosis on conservative treatment.     

Spinalization increases the mechanical stimulation-induced withdrawal reflex threshold after a sciatic cut in the rat

The purpose of the present study was to establish whether supraspinal structures modulate mechanical ‘adjacent hyperalgesia'. After a chronic sciatic cut, the paw withdrawal threshold to mechanical stimulation was lower, and the latency of noxious radiant heat-induced withdrawal reflex was shorter at the traumatized side than at the intact side. Then the rats were spinalized, and the withdrawal threshold to mechanical stimulus increased at the injured side, but the withdrawal latency induced by noxious heat decreased at the intact side. No side differences between the injured and the intact side could be detected after spinalization. Thus supraspinal structures may participate in maintenance of mechanically evoked paw withdrawal reflex after a sciatic injury.     

Autoimmune encephalomyelitis in rhesus monkeys induced by immunization with cerebral endothelial cell membrane

Summary It is postulated that multiple sclerosis might be an autoimmune demyelinating disease of the central nervous system (CNS). The mechanisms involved are unknown but, since the blood-brain barrier (BBB) is damaged, injury to endothelial cells is likely to have occurred. Our previous studies have led us to investigate the autoimmune effect of injuring the blood-brain barrier by immunizing rhesus monkeys with an endothelial cell membrane from the same kind of animals. The immunized animals developed a chronic or a relapsing neurological illness. Histological and ultrastructural examinations of the brain in the acute stage showed infiltrates of mononuclear cells around the blood vessels of the white matter of cerebrum, cerebellum, pons and midbrain, while in the chronic phase, large areas of demyelination and remyelination, especially in the white matter regions, were present. The animals immunized with extraneural antigen, an endothelial cell membrane obtained from human umbilical cord, developed no neurological illness. This results indicate that the brain endothelial cell membrane has an inflammatory encephalitogenic activity which could produce widespread demyelination in animals. The animal model described here may prove to be useful in the pathogenetic investigation of human autoimmune demyelinating diseases.Supported by the Intractable Disease Division, Public Health Bureau, Japanese Ministry of Health and Welfare, the grants (61570385, 63570363) from Japanese Ministry of Education     

Isolated sixth nerve palsy: an uncommon presenting sign of multiple sclerosis

We describe three patients in whom an isolated sixth nerve palsy was the only clinical symptom or sign of multiple sclerosis (MS). Data were collected prospectively over 6 years on these three patients, who showe no other signs of brainstem dysfunction or prior symptoms; in addition. Retrospective analysis of all patients with MS and all patients with sixth nerve palsy referred to a neuro-ophthalmology service between 1982 and 1998 showed isolated sixth nerve palsy to be the presenting sign of MS in only 0.5% of these patients. MS was the cause of isolated sixth nerve palsy in 0.8% of all patients and in 1.6% of those aged 18–50 years. Although it has been previously suggested that sixth nerve palsy is an ot uncommon presenting sign of MS, our results suggest it is rare. Received: 15 November 1999/Received in revised form: 15 March 2000/Accepted: 26 April 2000     

Origin of CD11b+ macrophage-like cells in the CNS of PLP-overexpressing mice: low influx of haematogenous macrophages and unchanged blood-brain-barrier in the optic nerve

We have recently reported that overexpression of proteolipid protein in oligodendrocytes leads to a pathologically relevant increase of both CD8+ T-lymphocytes and CD11b+ cells in the CNS. We now focussed on the origin of the CD11b+ cells in the optic nerve, a well established structure for the analysis of the mutant, using bone marrow chimeric mice. Although there is an age-related increase in CD11b+ cells in the myelinated part of the optic nerve of the mutants, the percentage of infiltrating cells was not increased, but enhanced proliferation was detectable. In the non-myelinated optic nerve head, the rate of infiltrating CD11b+ cells and albumin extravasation was high in both genotypes. However, albumin extravasation was also high in the rostral myelinated part, where CD11b+ cell influx was low. Our study demonstrates an intrinsic origin of CD11b+ cells in the presence of an unchanged blood-brain-barrier in a CNS myelin mutant.