Neuropeptide Y Y1 receptor effects on pulpal nociceptors

Neuropeptide Y (NPY) is an important modulatory neuropeptide that regulates several physiological systems, including the activity of sensory neurons. We evaluated whether activation of the NPY Y1 receptor could modulate the activity of capsaicin-sensitive nociceptors in trigeminal ganglia and dental pulp. We tested this hypothesis by measuring capsaicin-stimulated calcitonin gene-related peptide release (CGRP) as a measure of nociceptor activity. Capsaicin-evoked CGRP release was inhibited by 50% (p < 0.05) in trigeminal ganglia and by 26% (p < 0.05) in dental pulp when tissues were pre-treated with [Leu(31),Pro(34)]NPY. The Y1 receptor was found to co-localize with the capsaicin receptor TRPV1 in trigeminal ganglia. These results demonstrate that activation of the Y1 receptor results in the inhibition of the activity of capsaicin-sensitive nociceptors in the trigeminal ganglia and dental pulp. These findings are relevant to the physiological modulation of dental nociceptors by endogenous NPY and demonstrate an important novel analgesic target for the treatment of dental pain.     

Lipopolysaccharide from Porphyromonas gingivalis sensitizes capsaicin-sensitive nociceptors

Although odontogenic infections are often accompanied by pain, little is known about the potential mechanisms mediating this effect. In this study we tested the hypothesis that trigeminal nociceptive neurons are directly sensitized by lipopolysaccharide (LPS) isolated from an endodontic pathogen, Porphyromonas gingivalis. In vitro studies conducted with cultures of rat trigeminal neurons demonstrated that pretreatment with LPS produced a significant increase in the capsaicin-evoked release of calcitonin gene-related peptide (CGRP) when compared with vehicle pretreatment, thus showing sensitization of the capsaicin receptor, TRPV1, by LPS. Furthermore, confocal microscopic examination of human tooth pulp samples showed the colocalization of the LPS receptor (toll-like receptor 4, TLR4) with CGRP-containing nerve fibers. Collectively, these results suggest the direct sensitization of nociceptors by LPS at concentrations found in infected canal systems as one mechanism responsible for the pain associated with bacterial infections.     

Trigeminal nociceptors express prostaglandin receptors

Orofacial inflammation is associated with prostaglandin release and the sensitization of nociceptive receptors such as the transient receptor potential subtype V(1) (TRPV(1)). We hypothesized that certain PGE(2) receptor subtypes (EP1-EP4) are co-expressed with TRPV(1) in trigeminal nociceptors and sensitize responses to a TRPV(1) agonist, capsaicin. Accordingly, combined in situ hybridization was performed with immunohistochemistry on rat trigeminal ganglia. We next evaluated the effects of specific EP2 and EP3 agonists (butaprost and sulprostone) in cultured trigeminal ganglia neurons. The results showed that EP2 and EP3 are expressed in trigeminal neurons (58% and 53% of total neurons, respectively) and are co-expressed in TRPV(1)-positive neurons (64% and 67 % of TRPV(1)-positive neurons, respectively). Moreover, most of the cells expressing EP2 or EP3 mRNA were of small to medium diameter (< 30 microm). The application of butaprost and sulprostone triggered neuropeptide exocytosis, and butaprost sensitized capsaicin responses. Analysis of these data, collectively, supports the hypothesis that prostaglandins regulate trigeminal TRPV(1) nociceptors via activation of the EP2 and EP3 receptors.     

Trigeminal nociceptors express TLR-4 and CD14: a mechanism for pain due to infection

Although certain bacterial species appear to be risk factors for pain due to odontogenic infections, comparatively little is known about the potential mechanisms mediating this effect. In this study, we tested the hypothesis that trigeminal nociceptive neurons express the TLR4 or CD14 receptors, thus enabling sensory neurons to detect and respond to tissue levels of bacterial substances such as lipopolysaccharide (LPS). Immunohistochemical analyses of human and rat trigeminal neurons demonstrated that a capsaicin-sensitive subclass of nociceptors (defined by expression of TRPV1, a capsaicin receptor) expresses both TLR4 and CD14. Moreover, human dental pulp collected from patients with caries lesions demonstrated co-localization of TLR4 and CD14, with markers of peripheral sensory neurons. Collectively, these studies indicate that the capsaicin-sensitive subclass of trigeminal nociceptors expresses TLR4 and CD14. These results indicate that pain due to bacterial infections may result, in part, from direct activation of nociceptors by bacterial products such as LPS.     

脱落乳牙牙髓干细胞聚合体再生牙髓实验研究

目的    利用动物实验模型证明使用小型猪脱落乳牙牙髓干细胞（stem cells from minipig exfoliated deciduous teeth, SPED）聚合体进行原位牙髓再生的可行性。方法    分离和培养SPED,检测和分析其细胞生物学行为,进而诱导制备SPED聚合体;建立年轻恒牙牙髓坏死的小型猪动物模型,设置SPED聚合体再生组和传统根尖诱导成形治疗组;术后4个月进行常规组织学取材,利用HE、免疫荧光染色等方法观察牙髓再生和牙根尖形成情况。结果    SPED聚合体再生组受试牙齿组织学HE染色检测发现,牙根继续发育并形成正常的根尖形态,此外全长根管内可见类牙髓结构的再生组织,免疫荧光染色可见组织中CGRP、TRPV1、TRPM8表达阳性细胞的规则分布;而传统根尖诱导成形治疗组受试牙齿仅在根管内形成不规则的钙化组织,未见牙髓组织形成。结论    SPED聚合体在小型猪体内可以实现牙髓再生,同时再生牙髓具有正常组织学形态,而且具有牙本质形成和诱导根尖形成的生理功能。     

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??Objective    To regenerate dental pulp in animal experimental model by using dental pulp stem cells from minipig exfoliated deciduous teeth ??SPED??. Methods    Separate the deciduous dental pulp stem cells of Mini-Pig. Analyze the biological properties of SPED and prepare the cell aggregate of SPED. Establish the experimental animal model of young permanent teeth with dental pulp necrosis. The animals were divided to SPED Aggregate Regeneration Group and Traditional Induced Root Apex Formation Group. HE and immunofluorescence staining were used to observe dental pulp regeneration and root apex formation after 4 months. Results    SPED aggregates regenerated dental pulp and promote the root development. Immunofluorescence staining showed positive expression of CGRP?? TRPV1?? TRPM8 in regenerated dental pulp tissue. However?? there was no pulp tissue regenerated in Traditional Induced Root Apex Formation Group?? in which only the irregular calcified tissues were formed at root canal. Conclusion    SPED aggregate can regenerate dental pulp and the regenerated tissue not only has the normal morphological structure?? but also has the physiological functions of forming dentin and inducing root apex formation.     

The effect of capsaicin on substance P expression in pulp tissue inflammation

AIM: To evaluate the effect of capsaicin on substance P (SP) expression during induced inflammation in rat pulp tissue. METHODOLOGY: Radioimmunoanalysis was used to measure SP levels in 36 mandibular molar pulps taken from six Wistar rats. Twelve samples were obtained from healthy pulps and used as negative control group. Another 12 samples were obtained after inducing inflammation with mechanical pulp exposure; these were used as the positive control group. Capsaicin was infiltrated into the inferior dental nerve in the experimental group and 12 samples were obtained after mechanical pulp exposure. RESULTS: The lowest SP expression was found in mechanically exposed pulps where capsaicin pretreatment had been carried out (0.028 ng mL(-1)), followed by healthy pulps (0.302 ng mL(-1)). The highest SP expression was found in mechanically exposed pulps with no capsaicin pretreatment (124 ng mL(-1)). The Kruskal-Wallis test showed statistically significant differences between the groups (P < 0.001). CONCLUSION: Inferior dental nerve infiltration with capsaicin reduces SP expression in dental pulp tissue in rats.     

CGRP1受体在大鼠牙齿及牙周组织中的表达

目的 :研究大鼠牙体、牙周组织中神经肽CGRP1受体的存在及其结合位点。方法 :利用原位杂交方法对大鼠牙齿及牙周组织切片进行染色 ,在显微镜下观察CGRP1受体的定位。结果 :CGRP1受体主要存在于大鼠牙髓及牙周组织的较大血管内皮细胞 ,未在硬组织内发现CGRP1受体。结论 :CGRP1受体在口腔组织中主要分布于较大血管 ,CGRP通过CGRP1受体对大血管起作用 ,调节口腔血流传导信号。     

Vascular and cellular responses to pro-inflammatory stimuli in rat dental pulp

Dental pulp reactivity to various pro-inflammatory stimuli was independently evaluated in rats in terms of a vascular permeability increase and leukocyte recruitment. Substance P, calcitonin-gene related peptide (CGRP) and prostaglandin E(2) (in the picomol range) were applied to the exposed pulp from anesthetised animals and the plasma extravasation measured by the Evans blue content in the tissue following 10 min of administration. Leukocyte recruitment was evaluated morphometrically by counting the cell number present in serial sections of 1:3 4 microm pulp tissue 6 h after bacterial endotoxin (LPS; 0.06-1.2 microg/site) administration. Increase in pulp vascular permeability and cellular recruitment due to the injection of mentioned mediators in the skin or LPS in the peritoneal cavity were used as positive controls. Increase in vascular permeability in the pulp occurred in the same dose-range as observed in the skin, being CGRP the most active substance in both cases. However, it was necessary a higher dose of LPS (1.2 microg) to induce a similar cell recruitment in the pulp as that observed in the rat peritoneal cavity (0.3 microg). These data indicate that dental pulp reactivity presents the same pattern of increase in vascular permeability to other tissues in the rat, being CGRP the most potent mediator in this respect. In addition, they suggest the presence of CGRP receptors in the dental pulp. However, an adequate leukocyte recruitment response to bacterial endotoxin was not mounted, suggesting a deficiency in adhesion molecules in blood vessels in the rat dental pulp.     

Role of substance P and calcitonin gene-related peptide in the regulation of interleukin-8 and monocyte chemotactic protein-1 expression in human dental pulp

AIM: To determine whether leucocyte infiltration during neurogenic inflammation in the pulp is regulated by neuropeptides via inducing the release of proinflammatory chemokines interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) from human dental pulp. METHODOLOGY: Cultured primary pulp cells and pulp tissue explants were stimulated with substance P (SP) and/or calcitonin gene-related peptide (CGRP). IL-8 or MCP-1, secreted from cultured cells or produced in pulp explants, was analysed by enzyme-linked immunosorbent assay. RESULTS: Substance P induced IL-8 secretion from cultured pulp cells (approximately threefold increase over control, P < 0.05) and from pulp tissue explants (two- to three fold). SP only minimally to moderately induced MCP-1 (approximately two fold) in cultured pulp cells. While MCP-1 induction in cultured pulp cells was detected after 24 h of SP stimulation, no induction was observed in pulp tissue. CGRP did not induce IL-8, but moderately increased MCP-1 production (approximately three fold) in cultured pulp cells. There was no synergistic induction of MCP-1 by SP plus CGRP stimulation of pulp cells. CONCLUSIONS: Substance P is a stronger inducer of IL-8 production in dental pulp than CGRP. IL-8 is more strongly induced than MCP-1 by SP, suggesting a more important role for IL-8 than MCP-1 in leucocyte infiltration during neurogenic inflammation in dental pulp.     

Expression and characterization of vanilloid receptor subtype 1 in human dental pulp cell cultures

The expression of the vanilloid receptor subtype 1 (VR1, TRPV1) was detected in human dental pulp fibroblasts (PF-10) using RT-PCR, Western blotting, and immunocytochemical analysis. As revealed by ELISA, capsaicin induced IL-6 expression in PF-10 cells, and the VR1 antagonist capsazepine dose-dependently inhibited capsaicin-induced IL-6 production, indicating that capsaicin-induced IL-6 expression is related to VR1 activation. The interaction between capsaicin and mitogen-activated protein kinases (MAPKs) was investigated. The phosphorylation of p38 MAPK and c-Jun NH2-terminal kinase (JNK) were detected after capsaicin stimulation. p38 MAPK is involved in capsaicin-induced IL-6 production, as shown by the use of specific inhibitors of this kinase. The result of EMSA showed that capsaicin inhibited tumor necrosis factor-alpha (TNF-alpha)-induced nuclear factor-kappa B (NF-kappaB) activation in PF-10 cell cultures. These results suggest that the activation of VR1 plays an important role in dental pulp inflammation.     

Prostaglandin E2 enhances bradykinin-evoked iCGRP release in bovine dental pulp

Mediators produced during inflammation are responsible for hyperalgesia and expression of neurotransmitters and receptors in the nervous system. The production of bradykinin (BK) and the prostaglandins (PGs) may regulate initiation of pain. This study tested the hypothesis that BK and prostaglandin E2 (PGE2) have a positive interaction in evoking neurosecretion of immunoreactive calcitonin gene-related peptide (iCGRP). Bovine dental pulp was prepared and stimulated by the superfusion method with BK alone and in combination with PGE2. Kinin receptor antagonists to bradykinin-evoked release of iCGRP were also tested. Also tested was the hypothesis that dental pulp contains either the B1 or B2 or both BK receptors. Results showed that PGE2 enhanced BK-evoked iCGRP release by more than 50%. Western immunoblots revealed detectable B2 receptor protein with no detectable B1 receptor protein. We conclude that BK evokes iCGRP release from bovine dental pulp which is enhanced by a positive interaction with PGE2. Neurosecretion is evoked from isolated terminals of dental pulp fibers via the bradykinin B2 receptor-dependent mechanism.     

An in vitro method to evaluate regulation of neuropeptide release from dental pulp.

Although pulpal neuropeptides such as calcitonin gene-related peptide and substance P may mediate neurogenic inflammation, little is known about the regulation of neuropeptide release from dental pulp. This article describes an in vitro method for superfusing dental pulp which permits the study of mechanisms regulating the release of immunoreactive CGRP (iCGRP). Tissue extracts from bovine dental pulp dilute in parallel to authentic calcitonin gene-related peptide and substance P peptide standards when assayed by radioimmunoassay. Pulpal levels of iCGRP were 17-fold greater than levels of immunoreactive substance P. Administration of a potassium pulse evoked a significant release of iCGRP from dental pulp (155 +/- 21 fmol/g/9 min) as compared with iCGRP spontaneously released from concurrent control chambers (18 +/- 11 fmol/g/9 min). The in vitro superfusion of pulp tissue may serve as a useful method for identifying peripherally acting drugs which modulate nociceptor secretory activity and for determining their mechanisms of action.     

beta 2-Adrenoceptor regulation of CGRP release from capsaicin-sensitive neurons

Previous studies have suggested that neurotransmitter substances from the sympatho-adrenomedullary system regulate pulpal blood flow (PBF), in part, by the inhibition of vasoactive neuropeptide release from pulpal sensory neurons. However, no study has evaluated the role of beta-adrenoceptors. We evaluated the hypothesis that activation of beta-adrenoceptors inhibits immunoreactive calcitonin gene-related peptide (iCGRP) release from capsaicin-sensitive nociceptive neurons via in vitro superfusion of bovine dental pulp. Either norepinephrine or epinephrine inhibited capsaicin-evoked iCGRP. The norepinephrine effect was blocked by the selective beta(2)-adrenoceptor antagonist, ICI 118,551, but not by pre-treatment with the selective beta(1)-adrenoceptor antagonist, atenolol. In addition, application of albuterol, a selective beta(2)-adrenoceptor agonist, significantly blocked capsaicin-evoked release of iCGRP. Collectively, these studies demonstrate that activation of beta(2)-adrenoceptors in dental pulp significantly reduces exocytosis of neuropeptides from capsaicin-sensitive nociceptors. This effect may have physiologic significance in regulating PBF. Moreover, since capsaicin selectively activates nociceptors, beta(2)-adrenoceptor agonists may have clinical utility as peripherally acting therapeutics for dental pain and inflammation.     

Microhardness changes in dentine after neonatal capsaicin application

AIM: To determine if desensitization of the nociceptive innervation in the dental pulp has an effect on odontoblast function in the rat. METHODOLOGY: Neonatal systemic application of capsaicin was used to selectively eliminate nociceptive innervation. 12 capsaicin-treated rats were intravitally perfused at 150 days of life with 4% formaldehyde and jaws were prepared for Vicker's microhardness (VMH) measurement. As a control, 12 rats were injected with vehicle on the 3rd day of life and intravital perfusion was carried out exactly as those used for the experimental group. Immunohistological labeling of CGRP was carried out in both groups to assure the efficiency of desensitization in the experimental group. The VMH was measured in the incisors of each animal for a quantitative analysis of dentine quality. RESULTS: Vicker's microhardness was significantly higher in the control rats compared with the capsaicin-treated rats (P < 0.001). CONCLUSIONS: Neonatal systemic application of capsaicin produces changes in the quality of dentine in the rat over time and therefore it is suggestive that selective elimination of the nociceptive innervation in pulpal tissue may effect odontoblast function.     

Topical capsaicin application causes cold hypersensitivity in awake monkeys

Recent animal studies have demonstrated that many trigeminal ganglion neurons co-express TRPV1 and TRPA1 receptors following peripheral inflammation. In the present study, we examined whether cold receptors were sensitized by capsaicin in awake monkeys. Two monkeys were trained to detect a change in cold stimulus temperature (30 degrees C to 0.5, 1.0, 1.5 or 2.0 degrees C) applied to the facial skin. A total of 589 trials were studied, and the number of escape and hold-through trials and detection latency were measured. The number of escape trials was increased after capsaicin treatment, whereas that of hold-through trials was decreased. Detection latency was significantly decreased after capsaicin treatment. The present findings suggest that topical application of capsaicin to the facial skin induces reversible hypersensitivity to a facial cold stimulus in behaving monkeys.     

实验性牙髓炎大鼠三叉神经系统CGRP的动态表达

目的:观察牙髓炎大鼠三叉神经节及牙髓中CGRP的分布,探讨神经系统参与牙髓病理改变的信号调节作用。方法:建立完全弗氏佐剂诱发的大鼠牙髓炎及痛敏模型,应用免疫组化法标记CGRP的表达变化。结果:炎症刺激后,初级感觉神经元及其轴突的CGRP表达明显增强,1周后显著性减少。而牙髓CGRP阳性传出神经纤维在牙髓炎症刺激后显著减少,1周后呈回升趋势。结论:三叉神经系统通过调节CGRP的表达参与牙髓的炎症及痛觉过敏过程。     

咬合创伤牙髓组织中CGRP免疫阳性纤维的变化

目的：探讨胶合创伤对牙髓组织中降钙素基因相关肽（CGRP）的影响。方法：利用免疫组织化学方法，观察大鼠牙齿在咬合创伤后1天、3天、7天、15天、1个月等不同实验期牙髓组织中CGRP免疫阳性纤维的变化。结果：咬合创伤引起大鼠牙髓组织中CGRP免疫反应阳性纤维出现形态、分布、密度的改变。结论：咬合创伤可使牙髓组织中的神经末梢释放CGRP、CGRP可能参与了创伤所致的牙髓炎症及修复过程。     

Calcitonin gene related peptide: a sensory transmitter in dental pulps?

Nerve fibers displaying calcitonin gene related peptide (CGRP) immunoreactivity occurred in dental pulps of several mammals, including man. The CGRP fibers were more numerous in the apical parts than in the coronal parts and were distributed around small blood vessels as well as in the pulpal stroma without any obvious relation to blood vessels. The trigeminal, spinal and jugular-nodose ganglia harbored a moderate supply of CGRP immunoreactive perikarya and nerve fibers. Immunocytochemic double staining revealed the coexistence of CGRP and SP in a population of perikarya in the sensory ganglia and suggested coexistence of the two peptides in perivascular nerve fibers in the cat dental pulp. The cervical sympathetic ganglia did not contain CGRP-immunoreactive perikarya. Cervical sympathectomy (studied in the guinea-pig and rat) did not affect the frequency or distribution of pulpal CGRP fibers. The distribution of CGRP fibers within the dental pulp and the presence of CGRP perikarya in sensory ganglia known to supply the dental pulps indicate that the pulpal CGRP fibers are sensory in nature and that CGRP together with SP may participate in the regulation of local blood flow and the response to local inflammation.     

Calcitonin gene related peptide: a sensory transmitter in dental pulps?

Abstract — Nerve fibers displaying calcitonin gene related peptide (CGRP) immunoreactivity occurred in dental pulps of several mammals, including man. The CGRP fibers were more numerous in the apical parts than in the coronal parts and were distributed around small blood vessels as well as in the pulpal stroma without any obvious relation to blood vessels. The trigeminal, spinal and jugular-nodose ganglia harbored a moderate supply of GGRP immunoreactive perikarya and nerve fibers. Immunocytochemic double staining revealed the coexistence of CGRP and SP in a population of perikarya in the sensory ganglia and suggested coexistence of the two peptides in perivascular nerve fibers in the cat dental pulp. The cervical sympathetic ganglia did not contain CGRP-immnunoreactive perikarya. Cervical sympathectomy (studied in the guinea-pig and rat) did not affect the frequency or distribution of pulpal CGRP fibers. The distribution of CGRP fibers within the dental pulp and the presence of CGRP perikarya in sensory ganglia known to supply the dental pulps indicate that the pulpal CGRP fibers are sensory in nature and that CGRP together with SP may participate in the regulation of local blood flow and the response to local inflammation.