Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
J Pain. 2013 Jun;14(6):638-47. doi: 10.1016/j.jpain.2013.01.778. Epub 2013 Apr 30.
Voltage-gated sodium channels (Nav) are essential for the generation and conduction of action potentials. Peripheral inflammation increases the expression of Nav1.7 and Nav1.8 in dorsal root ganglion (DRG) neurons, suggesting that they participate in the induction and maintenance of chronic inflammatory pain. However, how Nav1.7 and Nav1.8 are regulated in the DRG under inflammatory pain conditions remains unclear. Using a complete Freund's adjuvant (CFA)-induced chronic inflammatory pain model and Western blot analysis, we found that phosphorylated Akt (p-Akt) was significantly increased in the ipsilateral L4/5 DRGs of rats on days 3 and 7 after intraplantar CFA injection. Immunohistochemistry showed that the percentage of p-Akt-positive neurons in the DRG was also significantly increased in the ipsilateral L4/5 DRGs at these time points. Moreover, CFA injection increased the colocalization of p-Akt with Nav1.7 and Nav1.8 in L4/5 DRG neurons. Pretreatment of rats with an intrathecal injection of Akt inhibitor IV blocked CFA-induced thermal hyperalgesia and CFA-induced increases in Nav1.7 and Nav1.8 in the L4/5 DRGs on day 7 after CFA injection. Our findings suggest that the Akt pathway participates in inflammation-induced upregulation of Nav1.7 and Nav1.8 expression in DRG neurons. This participation might contribute to the maintenance of chronic inflammatory pain.
This article presents that inhibition of Akt blocks CFA-induced thermal hyperalgesia and CFA-induced increases in dorsal root ganglion Nav1.7 and Nav1.8. These findings have potential implications for use of Akt inhibitors to prevent and/or treat persistent inflammatory pain.
电压门控钠离子通道(Nav)对于动作电位的产生和传导至关重要。外周炎症增加背根神经节(DRG)神经元中 Nav1.7 和 Nav1.8 的表达,表明它们参与了慢性炎症性疼痛的诱导和维持。然而,在炎症性疼痛条件下,DRG 中的 Nav1.7 和 Nav1.8 是如何被调节的尚不清楚。我们使用完全弗氏佐剂(CFA)诱导的慢性炎症性疼痛模型和 Western blot 分析,发现足底内注射 CFA 后第 3 天和第 7 天,大鼠对侧 L4/5 DRG 中磷酸化 Akt(p-Akt)显著增加。免疫组织化学显示,在这些时间点,对侧 L4/5 DRG 中 p-Akt 阳性神经元的百分比也显著增加。此外,CFA 注射增加了 L4/5 DRG 神经元中 p-Akt 与 Nav1.7 和 Nav1.8 的共定位。预先用鞘内注射 Akt 抑制剂 IV 处理大鼠可阻断 CFA 诱导的热痛觉过敏和 CFA 诱导的 Nav1.7 和 Nav1.8 在 CFA 注射后第 7 天对侧 L4/5 DRG 的增加。我们的研究结果表明,Akt 通路参与了炎症诱导的 DRG 神经元中 Nav1.7 和 Nav1.8 表达的上调。这种参与可能有助于慢性炎症性疼痛的维持。
本文提出,抑制 Akt 可阻断 CFA 诱导的热痛觉过敏和 CFA 诱导的背根神经节 Nav1.7 和 Nav1.8 的增加。这些发现可能对使用 Akt 抑制剂预防和/或治疗持续性炎症性疼痛具有潜在意义。