颈椎根性痛大鼠模型建立及背根节IB4~-Aδ类神经元介导机械性痛觉敏化的机制
[Abstract]:Cervical radicularpathy pain (CRP) is the more common occupational disease caused by the work of modern high pressure office, which seriously affects people's quality of life and has the characteristic of spontaneous aggravation. Compared with back pain, CRP patients have no symptoms of hindrance, and 97.5% patients are due to chronic pain. Diagnosis, including long term spontaneous pain, limb disspread pain, and "lightning like" pain caused by rotation and compression of the cervical vertebra and joints. Because of the deep anatomical position of the cervical vertebra, the cervical plexus intersecting and branching, the operation of the cervical vertebra is difficult, the animal model of the cervical vertebra is lacking, and the CRP animal is painful. It is difficult to observe. The current mechanism of the occurrence and development of neuropathic pain in the peripheral neck is not clear. We established the model of lumbar back neuropathic pain in the early stage of our laboratory. In the body study, the abnormal spontaneous discharge (spontaneous activity, SA) produced by the Dorsol root ganglion (DRG) in this model was found in this model. DRG neurons in the physiological state are rare, and on the contrary, a large number of heterotopic SA. studies in DRG neurons under chronic pain conditions show that in the single fiber recording experiment, the conduction velocity of the fibers expressed in the peripheral nervous system SA is more than that of the a-kind of myelinated fibers, but few C like unmyelinated fibers participate in the CCD model in the CCD model, which indicates that the injured DRG is damaged. The origin of neuron SA may depend on the subthreshold membrane potential oscillation (subthreshold membrane potential oscillation, SMPO) of neurons, while the changes in the activation and inactivation of the ionic channels on the membrane of the cell often accompany the changes in the intrinsic properties of the membrane of the cell membrane. Therefore, the primary sensory DRG neurons in the pathological pain model are often expressed in the pathological pain model. The excitability of the peripheral nerve transmitted to the sensory region of the spinal cord caused by a large number of increased pain afferents will cause the plasticity of the first stage synapses in the spinal cord. Morphological studies suggest that DRG neurons sensitized to the peripheral nervous system and the dorsal horn nerve terminals of the spinal cord are associated with a series of activation genes under chronic pain conditions. But it is not clear how the DRG neuron changes and its mechanism in the case of CRP. Previous studies have shown that the mechanical sensory function of DRG neurons is involved in mechanical pain sensitivity. But the DRG sensory neurons have different subtypes of neurons and bear different sensory functions. The neurons of mechanical sensitization are more likely to be machine than the insensitive neurons. There is a lack of classified observation on the specific DRG neurons in the pain model, and the various cell and molecular targets in the peripheral chronic pain mechanism are not clear. In the first part of this subject, our results are as follows: (1) to establish the rat model of the simulated clinical CRP symptoms and to identify the behavioral characteristics of the CRP model rats; (2) C RP rat model DRG sensory neurons are used to study the electrophysiological indexes of the subtypes of the subtypes to identify the important cells and molecular targets related to CRP. First, we set up a "L" type of steel column by inserting a "L" steel column in the rat's cervical vertebra C7/C8, to form a stable chronic compression injury of DRG, and to simulate the pathological characteristics of the herniation of intervertebral disc or the stenosis of the vertebral joint. The results showed that the CRP model group had a significant decrease in the pain threshold of bilateral forefoot contraction at 1 days after the operation than the sham operation group. It reached the maximum at the 4 day after the operation and continued to the four weeks after the operation. Then we observed the thermal pain sensitivity of the CRP model animal, and caused the injury by using the hot light source to the bilateral plantar skin of the bilateral forefoot. Heat stimulation. The results showed that the latent period of the upper limb pain in the CRP model animals shortened obviously on the third day after the operation, but it was mild. The shortening of the latent period of the heat pain contraction could last to 4 weeks after the operation. At the same time, we observed the spontaneous pain behavior of the CRP animals. The spontaneous pain behavior was measured in one minute to the affected side of the extremities,.CRP The model animals showed a significant increase in the spontaneous pain of the affected side limbs in the 1 day after the operation. The maximum value was reached within one week, and the time of self pain decreased slowly after two weeks after the operation. The immunohistochemical results showed that the proportion of neurons of the c-Fos protein was expressed on the C7 and C8 pressure side DRG 12 hours after the CRP model operation. A significant increase was achieved at 24 hours after the operation, and there was a significant difference after 48 hours. In the shallow layer of the dorsal horn of the spinal cord, the spinal neurons expressing c-Fos protein increased significantly after 12 hours of DRG injury and reached the maximum at 24 hours after the CRP model, and there was still a significant difference between the 48 hour group and the sham operation group. The expression of c-Fos protein in sensory neurons was in accordance with the change trend of DRG neurons. In order to repeat the results of c-Fos protein, we observed the expression of phosphorylated extracellular signal related kinase (Extracellular signal-related kinase, ERK) in DRG and spinal neurons in CRP model animals after 24 hours after 5. The results showed that 24 after the operation. The expression of P ERK1/2 in the affected DRG and spinal cord neurons in the affected side was significantly higher than that in the sham operation group. The results showed that on the CRP rat model, the early activation of the DRG neurons, the abnormal excitement of the sensory neurons, the increase of the afferent area of the central nervous system to the pain sensation area of the central nervous system caused the excitation of the sensory neurons of the dorsal horn of the spinal cord and the activation of the.DRG God in the pain conduction pathway. It was divided into A beta neurons, IB4~-A delta neurons, IB4~- and IB4~+C neuron.IB4~-A delta neurons more excited than other DRG neurons, and the abnormal SA was highly expressed in IB4~-A Delta small neurons, while the C- God Jing Yuan in the CRP model group did not appear any self generating activity.IB4~-A Delta in the CRP model group. The SA of the small neurons is consistent with the action potential amplitude and can be steadily continued for more than two hours in the record. The results suggest that the CRP model IB4~-A delta neurons exhibit a significant SA. previous study that the IB4~-A Delta DRG neuron mediated the peripheral mechanical touch with its special cellular membrane flexibility mechanical properties. We have found that: (1) the mechanical sensitivity of IB4~-A delta neurons in the CRP model; (2) the mechanism of ion channel that mediates the mechanical sensitivity of DRG neurons; (3) the peripheral pain target of the CRP model of mechanical hyperalgesia. We use the micromanipulator to direct the machine directly to the surface of the cell body surface of the DRG IB4~-A Delta DRG neuron of the whole cell forceps. Stress stimulation (mechanical stimuli, MS), the stimulation intensity control does not cause any damage to the cell membrane. The result shows that the control group observed the neuronal discharge after MS. In the CRP group, the same MS stimulation causes the ultrahigh frequency neuron discharge, and the high-frequency MS discharge frequency is 10 times higher than the SA frequency, and the neuron can still be stimulated after the stimulation. In order to maintain a long time high frequency discharge level, the ion channel mechanism studies showed that the Ih current density in the hyperpolarization-activated cyclic nucleotide-gated (HCN) channel expressed in the CRP model group of IB4~-A delta neurons was significantly increased, which could be a painful behavioral change and DRG in CRP model animals. The mechanism.CRP model of the morphological changes in the spinal cord did not change the Ih current reversal potential.HCN channel protein and the IB4 double standard fluorescence results of the IB4~- A delta neurons. The HCN1 and HCN3 subtypes increased in IB4~-DRG neurons after the CRP model, while the HCN2 subtype did not significantly alter the specific blocker of the.HCN channel. The model group IB4~-A delta neurons include the hyperexcitability electrical activity of high frequency discharge caused by SA and MS, but no effect on the normal action potential. The intrathecal injection of ZD7288 group and the saline group reverses the decrease of the reflex threshold of the animals caused by the 70%CRP model. In the heat pain detection, there is no obvious improvement in the incubation period of the heat pain. In the test of self pain, the ZD7288 group significantly reduced the spontaneous pain behavior of the CRP model animal compared with the saline group, and the analgesic effect of the single dose was more than 12 hours. The results showed that the high expression of HCN1 and HCN3 subtypes on the IB4~-A delta neurons was the ionic channel basis of CRP mediated neuronal hyper excitability and the inhibition of CRP DRG by.ZD7288. Neurons are excitable without affecting the physiological functions of normal sensory neurons, and provide a new strategy for the treatment of CRP.
【学位授予单位】:第四军医大学
【学位级别】:博士
【学位授予年份】:2016
【分类号】:R681.5;R-332
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