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The Journal of Neuroscience, January 1, 2003, 23(1):158-166
Redistribution of NaV1.8 in Uninjured Axons Enables
Neuropathic Pain
Michael S.
Gold1, 2, 4,
Daniel
Weinreich3, 4,
Chang-Sook
Kim5,
Ruizhong
Wang5,
James
Treanor6,
Frank
Porreca5, and
Josephine
Lai5
Departments of 1 Oral and Craniofacial Biological
Sciences, 2 Anatomy and Neurobiology, and
3 Pharmacology, and the 4 Program in
Neuroscience, University of Maryland, Baltimore, Maryland 21201, 5 Department of Pharmacology, University of Arizona Health
Sciences Center, Tucson, Arizona 85724, and 6 Amgen,
Thousand Oaks, California 91320
The underlying mechanisms of neuropathic pain are poorly
understood, and existing treatments are mostly ineffective. We recently demonstrated that antisense mediated "knock-down" of the sodium channel isoform, NaV1.8, reverses neuropathic pain behavior
after L5/L6 spinal nerve ligation (SNL), implicating a critical
functional role of NaV1.8 in the neuropathic state. Here we
have investigated mechanisms through which NaV1.8
contributes to the expression of experimental neuropathic pain.
NaV1.8 does not appear to contribute to neuropathic pain
through an action in injured afferents because the channel is
functionally downregulated in the cell bodies of injured neurons and
does not redistribute to injured terminals. Although there was little
change in NaV1.8 protein or functional channels in the cell
bodies of uninjured neurons in L4 ganglia, there was a striking
increase in NaV1.8 immunoreactivity along the sciatic
nerve. The distribution of NaV1.8 reflected predominantly the presence of functional channels in unmyelinated axons. The C-fiber
component of the sciatic nerve compound action potential (CAP) was
resistant (>40%) to 100 µM TTX after SNL, whereas both A- and C-fiber components of sciatic nerve CAP were blocked (>90%) by
100 µM TTX in sham-operated rats or the contralateral
sciatic nerve of SNL rats. Attenuating expression of NaV1.8
with antisense oligodeoxynucleotides prevented the redistribution of
NaV1.8 in the sciatic nerve and reversed neuropathic pain.
These observations suggest that aberrant activity in uninjured C-fibers
is a necessary component of pain associated with partial nerve injury.
They also suggest that blocking NaV1.8 would be an
effective treatment of neuropathic pain.
Key words:
voltage-gated Na+; tetrodotoxin
resistant; nerve injury; peripheral nerve; dorsal root ganglion; nociceptor
Copyright © 2003 Society for Neuroscience 0270-6474/03/231158-09$05.00/0
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