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Journal of Neuroscience, Vol 12, 86-95, Copyright © 1992 by Society for Neuroscience
Protons selectively induce lasting excitation and sensitization to mechanical stimulation of nociceptors in rat skin, in vitro
KH Steen, PW Reeh, F Anton and HO Handwerker
Institut fur Physiologie und Biokybernetik, Universitat Erlangen- Nurnberg, Germany.
In ischemic and in inflamed tissues, pH levels down to 5.4 have been
measured, and this local acidosis may contribute to pain and hyperalgesia
in disease states. To evaluate the role of acid pH in nociception, we have
studied identified primary afferents in a rat skin- saphenous nerve
preparation in vitro where the receptive fields can be superfused at the
highly permeable corium side with controlled solutions. The nerve endings
were exposed to CO2-saturated synthetic interstitial fluid (SIF;pH 6.1) and
to carbogen-gassed SIF phosphate buffered to different acid pH levels (5
min duration, 10 min intervals). Mechanical thresholds were repeatedly
tested in a "blind" fashion by von Frey hair stimulation. Low-threshold
mechanosensitive A beta- (n = 12) and A delta-fibers (n = 11) were not
excited or sensitized by acid pH levels. In 24 of 96 nociceptor type C- and
A delta-fibers, irregular low-frequency discharge with poor response
characteristics was induced. However, a distinct subpopulation of
mechanoheat sensitive, "polymodal" C-units (n = 25; 38%) showed
stimulus-related responses increasing with proton concentration and
encoding the time course of the pH change. Threshold levels were found to
range from pH 6.9 to 6.1; mean maximum discharge was at pH 5.2. All such
fibers responded to CO2 as well as to phosphate-buffered solution at the
same pH 6.1. The CO2 responses, however, displayed significantly shorter
latencies and more pronounced dynamic phases. The carboanhydrase blocker
acetazolamide markedly delayed and reduced the CO2 responses. Prolonged
application of acid pH (30 min) evoked nonadapting activity irrespective of
oxygen supply. Many, but certainly not all, fibers sensitive to protons
were also driven by capsaicin (10(- 6) M, 10(-5) M) and vice versa.
Repeated or prolonged treatment with low pH induced a significant and
lasting decrease of the mechanical (von Frey) thresholds in almost all
C-fibers tested (from 35 to 16 mN, on average), and this occurred whether
or not a fiber was excited by protons. The sensitizing effect was more
pronounced the higher the initial von Frey thresholds (0.75 rank
correlation). This sensitization to mechanical stimulation was in contrast
to the combined action of other inflammatory mediators, bradykinin, 5-HT,
histamine and prostaglandin E2. In conclusion, we suggest that pH
sensitivity of nociceptors may be an important source of pain and
hyperalgesia.
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