 |
Previous Article | Next Article 
The Journal of Neuroscience, September 1, 1999, 19(17):7670-7678
Spinal Substance P Receptor Expression and Internalization in
Acute, Short-Term, and Long-Term Inflammatory Pain States
Prisca
Honoré1, 2,
Patrick M.
Menning1, 2,
Scott D.
Rogers1, 2,
Michael
L.
Nichols1, 2,
Allan I.
Basbaum3,
Jean-Marie
Besson4, and
Patrick W.
Mantyh1, 2
1 Neurosystems Center, Department of Preventive
Sciences, Psychiatry and Neuroscience, University of Minnesota,
Minneapolis, Minnesota 55455, 2 Veterans Affairs
Medical Center, Minneapolis, Minnesota 55417, 3 Department
of Anatomy and Physiology and W. M. Keck Foundation Center for
Integrative Neuroscience, University of California, San Francisco, San
Francisco, California 94143, and 4 Institut National de la
Sante et de la Recherche Medicale U161, 75014 Paris, France
 |
ABSTRACT |
Inflammatory pain involves the sensitization of both primary
afferent and spinal cord neurons. To explore the neurochemical changes
that contribute to inflammatory pain, we have examined the expression
and ligand-induced internalization of the substance P receptor (SPR) in
the spinal cord in acute, short-term, and long-term inflammatory pain
states. These inflammatory models included unilateral injection of
formalin (8-60 min), carrageenan (3 hr), and complete Freund's
adjuvant (CFA; 3 d) into the rat hindpaw as well as
adjuvant-induced polyarthritis (21 d). In acute inflammatory pain there
is ongoing release of substance P (SP) as measured by SPR
internalization in lamina I neurons at both 8 and 60 min after formalin
injection. Although there is no tonic release of SP in short-term
inflammatory pain, at 3 hr after carrageenan injection, SP is released
in response to both noxious and non-noxious somatosensory stimulation
with SPR internalization being observed in neurons located in both
laminae I and III-IV. In long-term inflammatory pain models (CFA and
polyarthritis) the same pattern of SP release and SPR activation occurs
as is observed in short-term inflammation with the addition that there
is a significant upregulation of the SPR in lamina I neurons. These
results suggest that SPR internalization might serve as a marker of the
contribution of ongoing primary afferent input in acute and persistent
pain states. These stereotypical neurochemical changes suggest that
there are unique neurochemical signatures for acute, short-term, and
long-term inflammatory pain.
Key words:
carrageenan; complete Freund adjuvant; formalin; inflammation; internalization; pain; spinal cord; substance P
receptor
 |
INTRODUCTION |
Chronic inflammation is responsible
for a variety of persistent pain states including arthritis, back pain,
and temporomandibular joint disorder. Although significant progress has
been made in understanding the peripheral inflammatory response, the
neurochemical changes within the spinal cord that are involved in the
generation and maintenance of chronic inflammatory pain are poorly
understood. In response to persistent inflammatory pain, normally
innocuous sensory stimuli are perceived as painful (allodynia), and
mildly noxious sensory stimuli are perceived as highly painful
(hyperalgesia). Both hyperalgesia and allodynia are thought to arise
from a sensitization of peripheral nociceptors (peripheral
sensitization) and spinal dorsal horn neurons (central sensitization)
(Treede et al., 1992 ).
Peripheral sensitization is believed to result from the release of
proinflammatory substances at the site of injury, including bradykinin,
prostaglandins, serotonin, ATP, and protons (Beck and Handwerker, 1974 ;
Schaible and Schmidt, 1988 ; Thayer et al., 1988 ; Steen et al., 1992 ;
Bevan and Geppetti, 1994 ; for review, see Dray, 1994 ). These substances
can directly activate and/or sensitize the peripheral nociceptors and
are at least partly responsible for the sensitization of primary
afferent neurons and the resulting hyperalgesia and allodynia (for
review, see Dray, 1995 ).
The sustained activity of primary afferent fibers that occurs after
peripheral sensitization also induces an increase in the efficacy of
synaptic transmission between primary afferent fibers and dorsal horn
neurons, a process referred to as central sensitization (Mendell, 1966 ;
Woolf, 1983 , 1994 ; see references in Dickenson, 1990 , 1995 ). The
detailed mechanisms that underlie central sensitization are not fully
understood; however several in vitro and in vivo pharmacological studies have implicated a cooperation between substance
P (SP) and NMDA-mediated events in the development and maintenance of inflammation-induced central sensitization (Chizh et
al., 1995 ; Cumberbatch et al., 1995 ; see references in Urban et al.,
1994 ).
In an effort to understand the mechanisms involved in the peripheral
and central sensitization associated with inflammatory pain, we
explored the expression and internalization of the substance P receptor
(SPR) in the spinal dorsal horn in four well-characterized and widely
used experimental models of inflammatory pain in the rat. These were
produced by unilateral subcutaneous injection of formalin, carrageenan,
or complete Freund's adjuvant (CFA) into the hindpaw. In addition, we
examined the neurochemical changes in an animal model of polyarthritis
induced by CFA injection into the base of the tail. Each of these
inflammatory models is characterized by a different onset and time
course of nociceptive inputs and responses. Using this approach, we
compared the previous electrophysiological and behavioral data with the
alterations in the amount and/or site of release of SP from primary
afferent neurons, the number and location of SPR-expressing spinal
neurons that are activated by this released SP, and the populations of
neurons showing upregulation of the SPR. Together, these data suggest
that each type of inflammatory pain (acute, short-term, and long-term)
is characterized by a unique neurochemical signature within the spinal
cord.
 |
MATERIALS AND METHODS |
Experimental animals. Experiments were performed on
124 adult male Sprague Dawley rats (Harlan, Madison, WI), weighing
225-250 gm. Rats were kept in a vivarium, maintained at 22°C, with a
12 hr alternating light/dark cycle and were given food and water ad libitum. All procedures were approved by the Animal Care
Committees at the Veterans Affairs Medical Center and the University of Minnesota.
All subcutaneous injections in the rat hindpaw were performed
under anesthesia (50 mg/kg sodium pentobarbital, i.p.). In addition to
a group of naive rats used as normal controls, each experimental group
(formalin, carrageenan, CFA, and polyarthritis) had an associated control group receiving an injection of saline (formalin, carrageenan, and CFA controls) or mineral oil (polyarthritis controls) and surviving
the same amount of time.
The formalin model. Formalin injection (Dubuisson and
Dennis, 1977 ; for review, see Tjolsen et al., 1992 ) induces a biphasic stereotypical nocifensive behavior and corresponding
electrophysiological (Dickenson and Sullivan, 1987a ,b ) responses. These
responses are divided into an early and short-lasting first phase
(0-10 min) caused by a primary afferent discharge produced by the
stimulus, followed by a quiescent period, and then a second, prolonged
phase (15-60 min) of tonic pain. In the present study, rats received formalin (5%, pH 6.9, in saline, 50 µl, s.c.; Sigma, St. Louis, MO)
in the plantar surface of the hindpaw and were allowed to survive 8 min
(n = 8) or 1 hr (n = 8; controls
received saline, 50 µl, n = 6 and n = 6, respectively). The extent of peripheral edema was expressed as
percent of the control values, i.e., the diameters of both paw (site of
injection) and ankle (edema diffusion) were measured immediately before
perfusion using a caliper square. Because of the high number of spinal
internalized SPR-positive neurons after formalin injection, the effects
of additional stimulation in formalin-injected animals were not examined.
The carrageenan model. Injection of -carrageenan (Winter
et al., 1962 ) in the rat hindpaw produces an acute, restricted
inflammation associated with thermal and mechanical hyperalgesia and
allodynia that peak 3 hr after carrageenan injection (Kayser and
Guilbaud, 1987 ; Hargreaves et al., 1988 ; Kayser et al., 1991 ). In the
present study, rats received carrageenan (2%, pH 6.8, in saline, 100 µl, s.c.; Sigma) in the plantar surface of the hindpaw and survived 3 hr (n = 11; controls received saline, 100 µl,
n = 7). The acute effects of carrageenan injection were
evaluated by perfusing rats 10 min after carrageenan injection
(n = 3). As in the formalin model, extent of peripheral
edema was measured. In addition, the changes in spinal SPR expression
and internalization during inflammation-induced allodynia and
hyperalgesia were studied by evaluating the effects of non-noxious and
noxious mechanical stimulation in carrageenan- and saline-injected rats
(see below).
The CFA model. Injection of CFA (Millan et al., 1988 ) in the
rat hindpaw produces a long-lasting pain syndrome, peaking at 3 d
and associated with thermal and mechanical hyperalgesia and allodynia
(Ma and Woolf, 1996 ). In the present study, rats received CFA (50%, pH
7.0, in saline, 100 µl, s.c.; Sigma) in the plantar surface of the
hindpaw and were allowed to survive 3 d (n = 11; controls received saline, 100 µl, n = 7). The acute
effects of CFA injection were evaluated by perfusing rats 10 min after
CFA injection (n = 3). As in the formalin model, extent
of peripheral edema was measured. In addition, the changes in spinal
SPR expression and activation during inflammation-induced allodynia and
hyperalgesia were studied by evaluating the effects of non-noxious and
noxious mechanical stimulation in CFA- and saline-injected rats (see below).
The polyarthritis model. Injection of Mycobacterium
butirycum into the base of the rat tail (Pearson and Wood, 1959 )
results in an initial inflammatory response within hours; in addition, significant physiological, behavioral, and electrophysiological changes
appear 10 d after the injection and last several weeks, peaking at
3-4 weeks (Colpaert et al., 1980 ; De Castro Costa et al., 1981 ;
Colpaert and Van den Hoogen, 1982 ; Menetrey and Besson, 1982 ; see
references in Besson and Guilbaud, 1988 ). In the present study,
polyarthritis was induced by subcutaneous injection of heat-killed
Mycobacterium butirycum into the base of the tail (performed
at the breeding center, 10 mg/ml, 100 µl, Charles River, Saint Aubin
Les Elbeuf, France). Rats were kept for 3 weeks after inoculation (n = 10; controls received vehicle alone,
n = 10). As in the formalin model, extent of peripheral
edema was measured. To reduce discomfort, animals were housed three per
large cage with food directly available on the cage floor. Because of
their general impairment and the bilateral nature of the inflammation, the effects of additional mechanical stimulation were not evaluated.
Mechanical stimulation. Under pentobarbital anesthesia,
carrageenan (3 hr; n = 4)-, CFA (3 d; n = 4)-, and saline-injected (3 hr and 3 d; n = 4/group) rats were stimulated with a non-noxious mechanical stimulus
(light stroking of the dorsal hindpaw every second for 2 min using the
wooden handle of a brush applying a pressure approximately equivalent
to 3.6 × g or with a noxious mechanical stimulation (a
noxious pressure was applied for 30 sec with a hemostat placed on the
distal part of the hindpaw between the footpads). Rats were perfused 5 min after the end of the mechanical stimulation.
Immunohistochemistry. At the appropriate time point (8 and
60 min after formalin, 10 min and 3 hr after carrageenan, 10 min and
3 d after CFA, 21 d after the inoculation of polyarthritis and 5 min after acute mechanical stimulation) the animals were deeply
anesthetized with pentobarbital (50 mg/kg, i.p.) and perfused intracardially with 200 ml of 0.1 M PBS followed by
500 ml of a solution of 4% formaldehyde and 12.5% picric acid in 0.1 M PBS. The spinal cord was then removed and post-fixed for
16 hr in the same fixative and cryoprotected for 24 hr in 30% sucrose
in 0.1 M phosphate buffer. Serial frozen sections,
60-µm-thick, were cut with a microtome and collected in PBS to be
processed immunohistochemically as free-floating sections.
The tissue sections were incubated for 30 min at room temperature in a
blocking solution of 1% normal goat serum in PBS with 0.3% Triton
X-100 and were then incubated overnight (SPR antibody) or for 4 hr (SP
antibody) at room temperature in the primary antiserum. SPR was
detected with a polyclonal rabbit anti-SPR antibody (1:5000, raised in
our laboratory). SP was detected with a polyclonal guinea pig anti-SP
antibody (1:1000, a kind gift from J. Maggio). The incubated sections
were washed three times for 10 min in PBS and incubated in the
secondary antibody solution for 3 hr at room temperature. Secondary
antibodies conjugated to fluorescent markers Cy3 (used with SPR) and
FITC (used with SP) were used at 1:600 and 1:150, respectively.
Finally, the sections were washed three times for 10 min in PBS,
mounted on gelatin-coated slides, air-dried, dehydrated via an alcohol
gradient (70, 90, and 100%), cleared in Xylene, and coverslipped. To
confirm the specificity of the primary antibody, controls were
performed; preabsorption with the corresponding synthetic peptide (see
Fig. 2A) or omission of any stage in the protocol
abolished the staining. Because staining intensity might vary between
experiments, control sections were included in each run of staining.
Quantification of immunofluorescence levels and SPR
internalization. Sections from the lumbar spinal cord were
analyzed by fluorescent and confocal microscopy to characterize SPR and
SP immunofluorescence and SPR internalization, using an MRC-1024 confocal imaging system (Bio-Rad, Hercules, CA) and an Olympus BH-2
microscope equipped for epifluorescence (Mantyh et al., 1995 ; Allen et
al., 1997 ).
In all cases, immunofluorescence levels for SP and SPR and the
percentage of SPR immunoreactive (SPR-IR) neurons demonstrating internalization were determined. Because an increase in SPR
immunofluorescence could be explained by an increase in the number of
SPR-IR neurons, the number of SPR-IR neurons was also counted. Analyses
were performed at the lumbar level (L4), the main projection site for
the primary afferent fibers innervating the hindpaws (Molander et al.,
1984 ; Molander and Grant, 1985 ; LaMotte et al., 1991 ), in laminae I-II and III-IV of the dorsal horn, ipsilateral and contralateral to the
stimulation. Sagittal sections were viewed through a 1 cm2 eyepiece grid divided into 100 1 × 1 mm units. In cell bodies that do not contain internalized SPR, the
SPR immunoreactivity is uniformly distributed on the cell surface; in
contrast, in the neurons that have internalized the SPR, the cytoplasm
contained bright, immunofluorescent endosomes. An endosome was defined
as an intense SPR-immunoreactive intracellular organelle between 0.1 and 0.7 µm in diameter that was clearly not part of the external plasma membrane. Unstimulated cells contained less than five endosomes per cell. In the present study, neurons containing 20 or more endosomes
were considered to be internalized. Importantly, because neurons with
<20 endosomes were not counted, it is possible that subtle changes in
the magnitude of internalization were missed.
Immunofluorescence intensities were obtained with a confocal
fluorescent imaging system and analyzed using NIH Image 1.7. These
results were confirmed using a 12 bit SPOT2 digital camera (Diagnostic
Instruments, Sterling Heights, MI) on an Olympus BX-60 fluorescence
microscope with Image Pro Plus version 3.0 software (mediaCybernetics,
Silver Spring, MD). The response of the digital camera was measured
using 540/560 nm Inspeck fluorescent bead standards (Molecular Probes,
Eugene, OR). A ratio was established between the output of the camera
and a given relative fluorescence of the beads. The camera response was
determined to be linear, thus establishing that a doubling of the
camera grayscale output represents a doubling of label present in the tissue.
Statistical tests. Student's t test was used to
compare immunohistochemical measures in each inflammatory model with
its respective control. For the effects of mechanical stimulation in
carrageenan- or CFA-injected animals on SPR internalization and the
development of peripheral edema, a one-way ANOVA was used. To evaluate
the correlation between the extent of peripheral edema and SPR
internalization at the spinal level, a Pearson's correlation
coefficient was performed. For multiple comparisons, the Fisher's
Protected Least Significant Difference (PLSD) post hoc test
was used; significance at p < 0.05. In all cases, the
investigator responsible for plotting and counting the SPR-IR neurons
was blind to the experimental situation of each animal.
 |
RESULTS |
Distribution of SPR immunoreactivity in the spinal segment L4
Under normal or unstimulated experimental conditions, a distinct
pattern of spinal SPR immunoreactivity is observed. The densest SPR
staining is found in lamina I (Fig.
1A), and SPR
immunoreactivity covers almost the entire dendritic and somatic surface
of each neuron that expresses the receptor (Fig.
2B). In contrast,
lamina II contains almost no SPR-IR cell bodies (Fig.
1A), but is traversed by SPR-IR dendrites originating
from SPR-IR neurons located, in part, in laminae III-IV (Fig.
1B). SPR immunoreactivity is also observed in spinal
neurons localized in laminae V and VI and around the central canal
(lamina X). In all these regions, the SPR immunoreactivity is
predominantly associated with the plasma membrane, with few SPR-IR
endosomes present in the cytoplasm. In the present study, SPR staining
was evaluated in all the spinal regions, but the results are reported
for laminae I-IV because changes were only observed in these
laminae.

View larger version (118K):
[in this window]
[in a new window]
|
Figure 1.
Laminar distribution of SPR immunoreactivity in
the spinal cord and upregulation of SPR expression in lamina I in
long-term inflammatory pain state. Confocal image illustrating the
laminar distribution of SPR immunoreactivity in a coronal section of
the L4 spinal segment, 3 d after a unilateral CFA injection
(A). This image is from 60-µm-thick tissue
section acquired with a 10× lens. Scale bar, 200 µm. Confocal images
of lamina III SPR-IR neurons contralateral (B)
and ipsilateral (C) to CFA injection. The densest
SPR staining is found in lamina I. In contrast, lamina II contains
almost no SPR-IR neuronal cell bodies, but is traversed by SPR-IR
dendrites originating from SPR-IR neurons located in laminae III-V. SPR
immunoreactivity is also observed in laminae V-VI and around the
central canal. In long-term inflammation, upregulation of the SPR
appears confined to lamina I neurons (see box in
A and arrow pointing at a lamina I SPR-IR
neurons in C). These images, obtained from 60-µm-thick
tissue sections, are projected from 25 optical sections acquired at 0.8 µm intervals with a 60× lens. Scale bar, 20 µm.
|
|

View larger version (140K):
[in this window]
[in a new window]
|
Figure 2.
Normally innocuous mechanical stimulation induces
SPR internalization in lamina I SPR-expressing neurons in carrageenan-
and CFA-induced inflammatory pain but not in saline-injected animals.
Confocal images of lamina I SPR-IR neurons ipsilateral to the injection
of (B) saline, (D)
carrageenan (3 hr), and (F) CFA (3 d), observed
after innocuous mechanical stimulation. A is a
preabsorbed control for SPR primary antibody, showing the specificity
of the primary antibody against SPR. C and
E present the basal SPR immunoreactivity observed after
carrageenan (3 hr) and CFA (3 d) injections, respectively. Note that
innocuous mechanical stimulation does not induce any SPR
internalization in saline-injected animals, whereas this same stimulus
induces SPR internalization in CFA- (F) and
carrageenan-injected (D) rats. Note also the
increase in immunofluorescence level in lamina I neurons after CFA
injection (E), whereas no changes are observed
after carrageenan injection. These images, obtained from 60-µm-thick
tissue sections, are projected from 18 optical sections acquired at 0.8 µm intervals with a 60× lens. Scale bar, 5 µm.
|
|
Acute inflammation: ongoing release of SP
Formalin injection induced a unilateral peripheral edema
observable at 1 hr after the injection (115 ± 1% and 109 ± 2% of saline control values for the paw and ankle diameters,
respectively; p < 0.0001), edema was not detectable at
an earlier time point (8 min; 99 ± 1% and 100 ± 1% of
saline control values, respectively). Neither spinal SPR nor SP
immunofluorescence levels changed when comparing: (1) formalin-injected
rats to their respective saline controls or (2) the ipsilateral and
contralateral sides in formalin-injected animals (see Fig. 4). SPR
internalization was not observed in saline control animals. In
contrast, SPR internalization was observed in laminae I-II but not in
laminae III-IV (Figs. 3A,
4), ipsilateral to the formalin
injection. Eight minutes after formalin, 70-75% of laminae I-II
SPR-IR neurons showed internalization. Furthermore, at 1 hr after
formalin, 55-60% of laminae I-II SPR-IR neurons were still containing
internalized SPR. For laminae III-IV neurons, SPR-IR endosomes were
observed in their dorsally directed dendrites located in laminae I and
II (Fig. 3A), but not in their cell bodies.

View larger version (193K):
[in this window]
[in a new window]
|
Figure 3.
SPR internalization in acute inflammation and SPR
upregulation in long-term inflammation are confined to lamina I spinal
neurons. Confocal images of lamina III SPR-IR neurons observed 1 hr
after formalin injection (A) and 21 d after
induction of polyarthritis (B). SPR
internalization in laminae I and II and in dorsally directed dendrites
of lamina III neurons characterizes the neurochemical signature of
acute inflammatory pain, whereas SPR upregulation in lamina I neurons
is observed in long-term inflammatory pain. As in CFA, the SPR
upregulation observed in polyarthritis is confined to neurons located
in lamina I of the dorsal horn and is not observed in lamina III SPR-IR
neurons. These images, obtained from 60-µm-thick tissue sections, are
projected from 25 optical sections acquired at 0.8 µm intervals with
a 60× lens. Scale bar, 20 µm.
|
|

View larger version (47K):
[in this window]
[in a new window]
|
Figure 4.
Quantification of SPR internalization and levels
of SPR immunoreactivity in short- and long-term inflammatory pain
states. Results are expressed as percent increase compared to
respective saline control values for SPR immunofluorescence levels in
spinal lamina I (mean ± SEM) and percent of internalized SPR-IR
lamina I neurons in saline-injected animals (saline), 8 min (Form 8 min), and 1 hr (Form 1 hr)
after formalin injection, 10 min (Carra 10 min) and 3 hr
(Carra 3 hr) after carrageenan injection, 10 min
(CFA 10 min) and 3 d (CFA 3 d) after
CFA injection and in CFA-induced polyarthritic rats (Poly
21d). Student's t test,
***p < 0.001 compared to respective
controls.
|
|
In addition, no change in the number of SPR-IR neurons was observed in
laminae I-II (8.2 ± 1.7 and 7.8 ± 0.8 neurons per section compared to 7.4 ± 0.8 and 7.5 ± 0.4 in respective saline
controls) and III-IV (3.7 ± 0.4 and 3.8 ± 0.4 neurons per
section compared to 3.8 ± 0.1 and 4.2 ± 0.3 in respective
saline controls).
Short-term inflammation: alteration of SPR internalization in
response to non-noxious and noxious mechanical stimulations
Ten minutes after carrageenan injection, we observed a small
degree of SPR internalization in the spinal dorsal horn, mainly localized in dendrites and in few cell bodies of lamina I neurons (Fig.
4).
Three hours after carrageenan injection, we detected an extended
unilateral peripheral edema in both paw and ankle of the injected
hindpaw (increase of 50 ± 1% and 39 ± 2% compared to saline control values, respectively; p < 0.0001).
Spinal SPR or SP immunofluorescence levels remained unchanged when
comparing: (1) carrageenan-injected rats to their respective saline
controls (Figs. 2C, 4) and (2) the ipsilateral and
contralateral sides in carrageenan-injected rats. In addition, no
alteration in the number of SPR-IR neurons in laminae I-II (8.8 ± 1.2 neurons per section compared to 8.5 ± 0.8 in saline controls)
and III-IV (5.5 ± 0.9 neurons per section compared to 5.4 ± 0.4 in saline controls), and no SPR internalization in laminae I-II
(Fig. 2C) or laminae III-IV was observed in saline- or
carrageenan-injected animals.
Non-noxious mechanical stimulation did not induce spinal SPR
internalization in saline-injected rats (Fig. 2B). In
contrast, this normally non-noxious stimulus induced SPR
internalization in SPR-IR lamina I neurons in carrageenan-injected rats
(Fig. 2D). SPR internalization was observed in both
the dendrites and cell body of SPR-IR neurons localized throughout the
lumbar enlargement (L1-L6), ipsilateral to the stimulation. After
non-noxious stimulation, 57 ± 3% of the SPR-IR lamina I neurons
showed SPR internalization (Fig. 5;
p < 0.0001 compared to saline control values). No SPR internalization was detected in laminae III-IV.

View larger version (39K):
[in this window]
[in a new window]
|
Figure 5.
Quantification of SPR internalization in cell
bodies of laminae I and III-IV SPR-IR neurons after innocuous and
noxious stimulation in carrageenan- and CFA-induced inflammatory pain
states. Results are expressed as percent of internalized SPR-IR neurons
in laminae I and III after innocuous mechanical stimulation and in
laminae I, III, and IV after noxious mechanical stimulation, in
saline-, carrageenan-, and CFA-treated rats. Note that there is greater
SPR internalization in lamina I in carrageenan-injected rats after
innocuous stimulation compared to CFA-injected rats
(p < 0.01) and that this difference is also
observed in lamina III neurons after noxious stimulation
(p < 0.0001). In addition, SPR
internalization in lamina IV is only observed in carrageenan-injected
animals. In contrast, noxious mechanical stimulation induces a maximal
SPR internalization in lamina I neurons in both carrageenan- and
CFA-injected rats. No SPR internalization is observed in lamina III-IV
after non-noxious stimulation in any of the inflammatory pain states
examined. One-way ANOVA and Fisher PLSD, **p < 0.01, ***p < 0.001 compared to the saline-injected
group.
|
|
In saline control rats, noxious mechanical stimulation induced SPR
internalization in 76 ± 6% of the SPR-IR neurons in lamina I
(Fig. 5). In addition, in carrageenan-injected animals, noxious mechanical stimulation induced a maximum SPR internalization in lamina
I (100% of SPR+ neurons show internalization, p < 0.01 compared to control values). In laminae III-IV spinal neurons, noxious mechanical stimulation did not induce any SPR internalization in control rats (Figs. 5,
6A). In contrast, this
noxious stimulation induced SPR internalization in SPR-IR lamina III
neurons in carrageenan-injected animals (Fig. 5). After noxious
stimulation, 63 ± 2% of the SPR-IR lamina III neurons
(p < 0.0001 compared to saline control values, 2 ± 1%) and 45 ± 5% of the SPR-IR lamina IV neurons
(p < 0.0001 compared to saline control values,
0 ± 0%) showed SPR internalization in carrageenan-injected
animals (Fig. 5), ipsilaterally to the stimulation.

View larger version (150K):
[in this window]
[in a new window]
|
Figure 6.
Noxious mechanical stimulation induces SPR
internalization in lamina III neurons in long-term inflammatory pain
states. Confocal images of lamina III SPR-IR neurons ipsilateral to the
injection of (A) saline and
(B) CFA after noxious mechanical stimulation.
Note that after noxious mechanical stimulation in saline-treated rats,
SPR internalization is observed in cell bodies and dendrites located in
lamina I and II. In contrast, in CFA-inflamed rats, the same
stimulation induces a significant SPR internalization in laminae I and
II as well as in the cell bodies and dendrites of lamina III neurons.
These images, obtained from 60-µm-thick tissue sections, are
projected from 25 optical sections acquired at 0.8 µm intervals with
a 60× lens. Scale bar, 20 µm.
|
|
Long-term inflammation: increase in spinal SPR immunofluorescence
and alteration of SPR internalization in response to non-noxious and
noxious mechanical stimulations
Ten minutes after CFA injection, we observed a small degree of SPR
internalization in the spinal dorsal horn, mainly localized in
dendrites and in few cell bodies of lamina I neurons (Fig. 4).
Three days after CFA injection, we detected a unilateral peripheral
edema, smaller than observed after carrageenan injection (increase of
30 ± 1% and 18 ± 1% compared to saline control values for
the paw and ankle diameters, respectively; p < 0.0001). Consistent with our previous results using this model at this
time point, spinal SPR immunofluorescence levels were significantly
increased in laminae I-II (Figs. 1A,C,
2E), ipsilateral to the CFA injection (Fig. 4;
Abbadie et al., 1996 ). No significant change in SP immunofluorescence levels in laminae I-II was detected. In laminae I-II, SPR
immunofluorescence levels were increased by 94%
(p < 0.0001 compared to saline controls) and by
76% (p < 0.0001 compared to the contralateral
side of CFA-injected rats). In contrast, no change in SPR
immunofluorescence was observed in laminae III-IV (Fig.
1A,C). In addition, in the absence of superimposed
stimulation, no SPR internalization was detected in the inflamed
animals (Figs. 1C, 2E, 4).
It is important to note that the number of lamina I SPR-IR neurons
remained the same after CFA injection, ruling this out as a possible
explanation for the increase in SPR immunofluorescence observed in
lamina I. The total number of SPR-IR neurons per section in laminae
I-II was 7.8 ± 0.5 (compared to 8.1 ± 0.1 in saline controls) and in laminae III-IV 3.5 ± 0.6 (compared to 4.3 ± 0.5 in saline controls).
Non-noxious mechanical stimulation induced SPR internalization in
SPR-IR lamina I neurons in CFA-injected animals (Fig.
2F). SPR internalization was mainly observed in
dendrites and in a few cell bodies of SPR-IR neurons in lumbar segments
(L3-L5), ipsilateral to the stimulation. After non-noxious
stimulation, 32 ± 7% of the SPR-IR lamina I neurons showed SPR
internalization in CFA-injected animals, (Fig. 5; p < 0.003 compared to saline control values). Interestingly, the number of
SPR-IR neurons showing SPR internalization in lamina I was
significantly lower than in carrageenan-injected animals
(p < 0.007). In addition, there was a positive
correlation between the number of SPR-internalized lamina I neurons and
the size of the peripheral edema as measured at both the paw and ankle
(r = 0.95; p < 0.0001). The
correlation between edema magnitude and degree of SPR internalization
observed after non-noxious stimulation in inflammatory conditions
suggest that SPR internalization is at least partly caused by
peripheral sensitization present in inflammatory states. Finally, SPR
internalization was not detected in laminae III-IV SPR-IR.
In CFA-injected animals, noxious mechanical stimulation induced a
maximum SPR internalization in lamina I (97 ± 2% of SPR-IR neurons are internalized; p < 0.01 compared to saline
control values 76 ± 6%, no difference between CFA- and
carrageenan-injected groups). In laminae III-IV spinal neurons, noxious
mechanical stimulation did not induce any SPR internalization in saline
control rats (Figs. 5, 6A). In contrast, noxious
stimulation induced SPR internalization in SPR-IR lamina III neurons in
CFA-injected animals (Figs. 5, 6B). After noxious
stimulation, 32 ± 5% of the SPR-IR lamina III neurons showed SPR
internalization in CFA-injected animals, (Fig. 5; p < 0.001 compared to saline control values, 2 ± 1%), and the number
of SPR-IR neurons showing SPR internalization in lamina III was
significantly lower than in carrageenan-injected animals
(p < 0.001). There was a positive correlation
between the number of SPR internalized lamina III neurons and the
magnitude of the peripheral edema as measured at both the paw and ankle (r = 0.96; p < 0.0001). The
correlation between edema magnitude and degree of SPR internalization
observed after noxious stimulation in inflammatory conditions suggests
once again that SPR internalization is at least partly caused by
peripheral sensitization present in inflammatory states inducing an
increased release of SP and subsequently a larger diffusion of SP. In
contrast to carrageenan inflammation, SPR internalization was not
observed in lamina IV neurons after noxious mechanical stimulation in
CFA-injected rats.
Long-term inflammation: bilateral increase in SPR
immunofluorescence in polyarthritic rats
Three weeks after the inoculation with CFA, a generalized
inflammatory reaction developed (polyarthritis), inducing a wide spread
peripheral edema that was evident in both hindpaws (increase of 53 ± 1% and 51 ± 1% compared to control values for the paw and
ankle diameters, respectively; p < 0.0001). No
significant change in spinal SP immunofluorescence levels was observed.
However, in the same spinal cord sections, SPR immunofluorescence
levels increased bilaterally, by 29% (p < 0.0001) and 31% (p < 0.0001) in laminae I-II,
for each side of the dorsal horn, compared with control rats. In
contrast, no change in SPR immunofluorescence levels was observed in
laminae III-IV (Fig. 3B). In addition, no SPR
internalization was observed in resting, nonstimulated animals (Fig.
4).
As in CFA rats, no modification in the number of SPR-IR neurons was
observed. The total number of SPR-IR neurons per section was 7.2 ± 0.9 in laminae I-II (compared to 8.2 ± 0.4 in controls) and
4.6 ± 0.3 in laminae III-IV (compared to 4.7 ± 0.6 in controls).
To further determine which cells were the origin of the upregulation of
the SPR in lamina I, SPR immunofluorescence levels in cell bodies of
laminae I and III neurons and in the dendrites of lamina III neurons,
extending to lamina I or localized in lamina III were measured. In
control rats as well as in inflamed rats, there were no differences in
SPR immunofluorescence levels originating from lamina III neurons, but
we observed an increase in SPR immunofluorescence levels in lamina I
neurons in inflamed animals, suggesting that the increase in SPR
immunofluorescence in lamina I in long-term inflammation is primarily
caused by an increase in SPR immunofluorescence in cell bodies and
dendrites of lamina I SPR-IR neurons.
 |
DISCUSSION |
Acute inflammatory pain
Formalin induces a stereotypical biphasic response, consisting of
an early short-lasting painful response followed by a prolonged period
of tonic/persistent pain (Dubuisson and Dennis, 1977 ; Dickenson and
Sullivan, 1987a ,b ). Although it is generally agreed that the first
phase results from a direct action of formalin on nociceptive primary
afferent fibers, the factors contributing to the second phase have not
been fully defined. In the present report, we observed a significant
SPR internalization in lamina I of the spinal dorsal horn at the end of
the first phase (8 min), a time where there is almost no detectable
peripheral edema. At 60 min after the initial injection of formalin,
SPR internalization was still observed in a majority of lamina I SPR-IR
neurons, at which time significant peripheral edema has developed.
It is of interest to compare this pattern of internalization with that
produced by a single injection of capsaicin (Mantyh et al., 1995 ).
Capsaicin induces a rapid, marked SPR internalization that is confined
to lamina I neurons, and this SPR internalization is largely resolved
60 min after capsaicin injection. In contrast, 60 min after formalin
injection there remains a significant SPR internalization in lamina I
neurons, suggesting that there is an ongoing release of SP from primary
afferent terminals. These results suggest that during both the first
and second phases of the formalin response there is ongoing primary
afferent input from C fibers and release of SP in the spinal cord.
These data are in accord with previous reports demonstrating that SPR
antagonists could block both the first and second phases of the
formalin response in spinal neurons (Chapman and Dickenson, 1993 ) and
that peripheral injection of local anesthetics after the end of the
first phase reduces electrophysiological, behavioral, and anatomical
correlates of the second phase (Dickenson and Sullivan, 1987a ; Taylor
et al., 1995 ; Puig and Sorkin, 1996 ; Abbadie et al., 1997a ). These results provide further evidence that a major component of the second
phase of the formalin response is caused by ongoing activity of primary
afferent neurons. Together these results suggest that the neurochemical
signature of acute inflammation is very similar, although with a longer
time course, to what is produced by a brief chemical noxious stimulus,
i.e., a stimulus that produces acute pain under nonpathological conditions.
Short-term inflammatory pain
Within 3 hr after carrageenan injection, peripheral edema,
allodynia, and hyperalgesia had fully developed. In this condition, SPR
internalization was observed early, i.e., 10 min after carrageenan injection, in dendrites and in a few lamina I SPR-IR neurons. This
indicates that SP release occurs in the early stage of carrageenan inflammation. However, there is a major difference between
carrageenan-induced inflammation (short-term) and formalin-induced
inflammation (acute). Specifically, we found that formalin injection
induced SPR internalization in lamina I neurons even at 1 hr after
injection, whereas there was no evidence of ongoing SPR internalization
at 3 hr after carrageenan injection. This lack of ongoing SPR
internalization suggests either that there is no significant release of
SP (using SP-induced SPR internalization as an assay of SP release)
from primary afferents, even though a significant edema has developed
at this time point, or that the system had desensitized, i.e., the
receptor no longer responds. This absence of ongoing SPR
internalization agrees with the observation that there is no
spontaneous activity of dorsal horn neurons 3 hr after carrageenan
injection (Stanfa et al., 1992 ; see however, Kocher et al., 1987 ),
although a large number of spinal neurons express the Fos protein in
both laminae I-II and III-IV 3 hr after carrageenan injection (Honore
et al., 1995 ). If spinal Fos induction is a reflection of neuronal
activation (Hunt et al., 1987 ; Munglani and Hunt, 1995 ; Doyle and Hunt,
1999 ), it seems reasonable to conclude that there must be maintained nociceptive input from the periphery to the spinal cord during the
development of carrageenan inflammation. Whether this is caused by SP,
released immediately after carrageenan injection (the Fos protein
half-life is ~2 hr), or other neurotransmitters such as excitatory
amino acids is unclear.
What is apparent at 3 hr after carrageenan injection is that normally
non-noxious mechanical stimulation of the carrageenan-inflamed hindpaw,
which does not induce SPR internalization in normal animals, now
induces massive SPR internalization in lamina I neurons. Furthermore, noxious mechanical stimulation, which only induces SPR internalization in lamina I in normal animals, now induces SPR internalization in
neurons located in laminae I-II and III-IV.
A key question raised by these observations is whether the activation
of these laminae III-IV SPR-IR neurons is caused by increased release
and/or diffusion of SP from terminals that reside in laminae I-II or
from de novo synthesis and release of SP from primary
afferent neurons that terminate in laminae III-IV. After peripheral
inflammation, an increase in SP synthesis by small DRG neurons that
normally synthesize SP (Donnerer et al., 1993 ; Galeazza et al., 1995 ;
Abbadie et al., 1996 ) as well as SP synthesis by large DRG neurons has
been reported (Neumann et al., 1996 ). Release of SP by A fibers
could explain the SPR internalization observed in laminae III-IV after
non-noxious stimulation in long-term inflammatory pain (Abbadie et al.,
1997b ). However, 3 hr after carrageenan injection, there would appear
to be insufficient time for de novo synthesis and transport
of SP from primary afferent cell body to the terminals in the spinal
cord. These data suggest that the SPR internalization that is observed
in lamina I after normally innocuous stimulation and the increased SPR
internalization that is observed in laminae I-II and III-IV neurons
after noxious stimulation is caused primarily by peripheral
sensitization that manifests itself as a greater release and diffusion
of SP from primary afferent neurons that already expressed SP. This
increase in SP release from primary afferent fibers could thus lead to SP diffusing significantly greater distances, resulting in a switch from primarily synaptic to volume neurotransmission (Agnati et al.,
1995 ; Zoli et al., 1998 ). Because SP would diffuse and interact with
SPRs at both synaptic and extrasynaptic sites this increased release of
SP from primary afferent fibers could also explain why there is
significantly greater SPR internalization in lamina I SPR neurons after
noxious stimulation under inflammatory conditions. Based on these
observations, we suggest that this neurochemical signature of
short-term inflammation is characterized by a lack of spontaneous SP
release from primary afferents as reflected by the lack of ongoing SPR
internalization, a lack of SPR upregulation, and a switch from synaptic
to volume transmission so that there is an increase in both the number
and the location of SPR-IR spinal neurons that are activated in
response to innocuous or noxious stimuli.
Long-term inflammatory pain
CFA-induced unilateral inflammation and adjuvant-induced
polyarthritis are two of the most commonly used models of long-term inflammatory pain. They elicit peak symptoms at 3 and 21 d,
respectively. Similarities in the neurochemical signature of short- and
long-term inflammatory pain include the lack of ongoing SPR
internalization in basal unstimulated condition and an increase in the
number and location of the spinal neurons that showed SPR
internalization in response to either normally non-noxious or noxious stimuli.
The major difference in the spinal cords of animals with short- versus
long-term inflammation is that in long-, but not short-term inflammation, there is a significant upregulation of the SPR on neurons
in lamina I of the spinal cord. The increase in SPR mRNA observed in
the spinal cord several days after peripheral inflammation has been
reported to be blocked by morphine or SPR antagonists (Noguchi et al.,
1988 ; McCarson and Krause, 1994 , 1995 , 1996 ), suggesting that SP
release and/or SPR activation is necessary for SPR upregulation.
However, in both chronic inflammatory pain, which is associated with an
increase in SP in primary afferents (Lembeck et al., 1981 ; Donaldson et
al., 1992 ), and in nerve injury, which is associated with a decrease in
SP in primary afferents (Noguchi et al., 1989 ; Garrison et al., 1993 ),
there is an increase in SPR immunoreactivity in lamina I of the spinal
dorsal horn (Abbadie et al., 1996 ). Additionally, whereas cAMP has been
reported to be involved in the regulation of SPR expression, SPR
activation leads to the production of inositol phosphates, suggesting
that SP is not the major regulator of SPR expression. These findings suggest that while SP could contribute to SPR upregulation, other neurotransmitters, acting directly on SPR-IR neurons or indirectly via
the release of yet unknown factors, must be involved.
If there is a significant upregulation of the SPR in lamina I neurons
in long-term inflammation, does it alter the response properties of
these neurons? Several electrophysiological studies have shown that the
response of spinal cord neurons to peripheral stimuli increases in an
inflammatory pain state (Hylden et al., 1989 ; Haley et al., 1990 ;
Simone et al., 1991 ; Dougherty et al., 1992 ; Stanfa et al., 1992 ; Urban
et al., 1993 ; Neugebauer et al., 1994 ). This increased responsiveness
is hypothesized to be largely mediated by a facilitated transmission
through the NMDA receptor. SPR activation leads to the generation of
diacyl glycerol and inositol triphosphate, inducing an increase in
intracellular calcium and a synergistic facilitation of the activity of
the protein kinase C. In turn, protein kinase C induces phosphorylation
of the NMDA receptors, counteracting the magnesium block and allowing NMDA receptors to operate at a more negative potentials (for review, see Urban et al., 1994 ; Yaksh et al., 1995 ; Urban and Gebhart, 1998 ;
Millan, 1999 ). These data suggest that SPR activation enhances NMDA
receptor-mediated events and that the co-joint activation of SPR and
NMDA receptors leads to increased neuronal excitability. The SPR
upregulation observed in long-term inflammatory pain states may
therefore contribute to the central sensitization observed in long-term
inflammatory pain.
Conclusions
Previous experimental and clinical studies have suggested that
there are distinctive differences between acute and chronic pain,
including the shift from the sensitization of primary afferent neurons
to a sensitization of spinal cord neurons. What is unique about the
present approach is the ability to visualize and quantify neurochemical
changes at the single and intracellular level as a pain "moves"
from the acute to the long-term state. These results suggest that SPR
internalization might serve as a marker of the contribution of ongoing
primary afferent input to acute/persistent pain states. Using a similar
approach to understand the changes that other neurotransmitter/receptor
systems undergo as a pain moves from the acute to the chronic state
should provide significant insight into the mechanisms involved in the
generation and maintenance of chronic pain and may lead to novel
therapies to control different pain states.
 |
FOOTNOTES |
Received March 24, 1999; revised June 11, 1999; accepted June 15, 1999.
This study was supported by the National Institutes of Health, National
Institute of Neurological Diseases and Stroke Grant 23970, National Institute on Drug Abuse Grant 11986, National Institutes of Health Training Grant DE07288, a Department of Veterans Affairs Merit Review, the Spinal Cord Society, and the Association Francaise pour la Recherche Therapeutique.
Correspondence should be addressed to Dr. Patrick W. Mantyh,
Neurosystems Center, 18-208 Moos Tower, 515 Delaware Street, Minneapolis, MN 55455.
 |
REFERENCES |
-
Abbadie C,
Brown JL,
Mantyh PW,
Basbaum AI
(1996)
Spinal cord substance P receptor immunoreactivity increases in both inflammatory and nerve injury models of persistent pain.
Neuroscience
70:201-209[Web of Science][Medline].
-
Abbadie C,
Taylor BK,
Peterson MA,
Basbaum AI
(1997a)
Differential contribution of the two phases of the formalin test to the pattern of c-fos expression in the rat spinal cord: studies with remifentanil and lidocaine.
Pain
69:101-110[Web of Science][Medline].
-
Abbadie C,
Trafton J,
Liu H,
Mantyh PW,
Basbaum AI
(1997b)
Inflammation increases the distribution of dorsal horn neurons that internalize the neurokinin-1 receptor in response to noxious and non-noxious stimulation.
J Neurosci
17:8049-8060[Abstract/Free Full Text].
-
Agnati LF,
Zoli M,
Stromberg I,
Fuxe K
(1995)
Intercellular communication in the brain: wiring versus volume transmission.
Neuroscience
69:711-726[Web of Science][Medline].
-
Allen BJ,
Rogers SD,
Ghilardi JR,
Menning PM,
Kuskowski MA,
Basbaum AI,
Simone DA,
Mantyh PW
(1997)
Noxious cutaneous thermal stimuli induce a graded release of endogenous substance P in the spinal cord: imaging peptide action in vivo.
J Neurosci
17:5921-5927[Abstract/Free Full Text].
-
Beck PW,
Handwerker HO
(1974)
Bradykinin and serotonin effects on various types of cutaneous nerve fibres.
Pflügers Arch
347:209-222[Web of Science][Medline].
-
Besson JM,
Guilbaud G
(1988)
In: The arthritic rat as a model of clinical pain? (Besson JM, Guilbaud G, eds). Amsterdam: Elsevier Science.
-
Bevan S,
Geppetti P
(1994)
Protons: small stimulants of capsaicin-sensitive sensory nerves.
Trends Neurosci
17:509-12[Web of Science][Medline].
-
Chapman V,
Dickenson AH
(1993)
The effect of intrathecal administration of RP67580, a potent neurokinin 1 antagonist on nociceptive transmission in the rat spinal cord.
Neurosci Lett
157:149-152[Web of Science][Medline].
-
Chizh BA,
Cumberbatch MJ,
Birch PJ,
Headley PM
(1995)
Endogenous modulation of excitatory amino acid responsiveness by tachykinin NK1 and NK2 receptors in the rat spinal cord.
Br J Pharmacol
115:1013-1019[Web of Science][Medline].
-
Colpaert FC,
De Witte P,
Maroli AN,
Awouters F,
Niemegeers CJE,
Janssen PA
(1980)
Self-administration of the analgesic suprofen in arthritic rats: evidence of mycobacterium butyricum-induced arthritis as an experimental model of chronic pain.
Life Sci
27:921-928[Web of Science][Medline].
-
Colpaert FC,
Van den Hoogen RHWM
(1982)
Ventilatory response to adjuvant arthritis in the rat.
Life Sci
31:957-963[Web of Science][Medline].
-
Cumberbatch MJ,
Chizh BA,
Headley PM
(1995)
Modulation of excitatory amino acid responses by tachykinins and selective tachykinin receptor agonists in the rat spinal cord.
Br J Pharmacol
115:1005-1012[Web of Science][Medline].
-
De Castro Costa M,
De Sutter P,
Gybels J,
Van Hees J
(1981)
Adjuvant-induced arthritis in rats: a possible animal model of chronic pain.
Pain
10:173-185[Web of Science][Medline].
-
Dickenson AH
(1990)
A cure for wind up: NMDA receptor antagonists as potential analgesics.
Trends Pharmacol
11:307-309[Medline].
-
Dickenson AH
(1995)
Central acute pain mechanisms.
Ann Med
27:223-227[Web of Science][Medline].
-
Dickenson AH,
Sullivan AF
(1987a)
Peripheral origins and central modulation of subcutaneous formalin-induced activity of rat dorsal horn neurons.
Neurosci Lett
83:207-211[Web of Science][Medline].
-
Dickenson AH,
Sullivan AF
(1987b)
Subcutaneous formalin-induced activity of dorsal horn neurones in the rat: differential response to an intrathecal opiate administered pre or post formalin.
Pain
30:349-360[Web of Science][Medline].
-
Donaldson LF,
Harmar AJ,
McQueen DS,
Seckl JR
(1992)
Increased expression of preprotachykinin, calcitonin gene-related peptide, but not vasoactive intestinal peptide messenger RNA in dorsal root ganglia during the development of adjuvant monoarthritis in the rat.
Brain Res Mol Brain Res
16:143-149[Medline].
-
Donnerer J,
Schuligoi R,
Stein C,
Amann R
(1993)
Upregulation, release and axonal transport of substance P and calcitonin gene-related peptide in adjuvant inflammation and regulatory function of nerve growth factor.
Regul Peptides
46:150-154[Web of Science][Medline].
-
Dougherty PM,
Sluka KA,
Sorkin LS,
Westlund KN,
Willis WD
(1992)
Enhanced responses of spinothalamic tract neurons to excitatory amino acids parallel the generation of acute arthritis in the monkey.
Brain Res
17:1-13.
-
Doyle CA,
Hunt SP
(1999)
Substance P receptor (neurokinin-1)-expressing neurons in lamina I of the spinal cord encode for the intensity of noxious stimulation: a c-Fos study in rat.
Neuroscience
89:17-28[Web of Science][Medline].
-
Dray A
(1994)
Tasting the inflammatory soup: the role of peripheral neurones.
Pain Rev
1:153-171.
-
Dray A
(1995)
Inflammatory mediators of pain.
Br J Anaesth
75:125-131[Abstract/Free Full Text].
-
Dubuisson D,
Dennis SG
(1977)
The formalin test: a quantitative study of the analgesic effects of morphine, meperidine, and brain stem stimulation in rats and cats.
Pain
4:161-174[Web of Science][Medline].
-
Galeazza MT,
Garry MG,
Yost HJ,
Strait KA,
Hargreaves KM,
Seybold VS
(1995)
Plasticity in the synthesis and storage of substance P and calcitonin gene-related peptide in primary afferent neurons during peripheral inflammation.
Neuroscience
66:443-458[Web of Science][Medline].
-
Garrison CJ,
Dougherty PM,
Carlton SM
(1993)
Quantitative analysis of substance P and calcitonin gene-related peptide immunohistochemical staining in the dorsal horn of neuropathic MK-801-treated rats.
Brain Res
607:205-214[Web of Science][Medline].
-
Haley JE,
Sullivan AF,
Dickenson AH
(1990)
Evidence for spinal N-methyl-D-aspartate receptor involvement in prolonged chemical nociception in the rat.
Brain Res
518:218-226[Web of Science][Medline].
-
Hargreaves K,
Dubner R,
Brown F,
Flores C,
Joris J
(1988)
A new and sensitive method for measuring thermal nociception in cutaneous hyperalgesia.
Pain
32:77-88[Web of Science][Medline].
-
Honore P,
Buritova J,
Besson JM
(1995)
Carrageenin-evoked c-Fos expression in rat lumbar spinal cord: the effects of indomethacin.
Eur J Pharmacol
272:249-259[Web of Science][Medline].
-
Hunt SP,
Pini A,
Evan G
(1987)
Induction of c-fos-like protein in spinal cord neurons following sensory stimulation.
Nature
328:632-634[Medline].
-
Hylden JLK,
Nahin RL,
Traub RJ,
Dubner R
(1989)
Expansion of receptive fields of spinal lamina I projection neurons in rats with unilateral adjuvant-induced inflammation: the contribution of dorsal horn mechanisms.
Pain
37:229-243[Web of Science][Medline].
-
Kayser V,
Guilbaud G
(1987)
Local and remote modifications of nociceptive sensitivity during carrageenan-induced inflammation in the rat.
Pain
28:99-107[Web of Science][Medline].
-
Kayser V,
Chen YL,
Guilbaud G
(1991)
Behavioural evidence for a peripheral component in the enhanced antinociceptive effect of a low dose of systemic morphine in carrageenan-induced hyperalgesia rats.
Brain Res
560:237-244[Medline].
-
Kocher L,
Anton F,
Reeh PW,
Handwerker HO
(1987)
The effect of carrageenan-induced inflammation on the sensitivity of unmyelinated skin nociceptors in the rat.
Pain
29:363-373[Web of Science][Medline].
-
LaMotte C,
Kapadia SE,
Shapiro CM
(1991)
Central projections of the sciatic, saphenous, median, and ulnar nerves of the rat demonstrated by transganglionic transport of choleragenoid-HRP (B-HRP) and wheat germ agglutinin-HRP (WGA-HRP).
J Comp Neurol
311:546-562[Web of Science][Medline].
-
Lembeck F,
Donnerer J,
Colpaert FC
(1981)
Increase of substance P in primary afferent nerves during chronic pain.
Neuropeptides
1:175-180.
-
Ma QP,
Woolf CJ
(1996)
Progressive tactile hypersensitivity: an inflammation-induced incremental increase in the excitability of the spinal cord [see comments].
Pain
67:97-106[Web of Science][Medline].
-
Mantyh PW,
Allen CJ,
Ghilardi JR,
Rogers SD,
Mantyh CR,
Liu H,
Basbaum AI,
Vigna SR,
Maggio JE
(1995)
Rapid endocytosis of a G protein-coupled receptor: substance P evoked internalization of its receptor in the rat striatum in vivo.
Proc Natl Acad Sci USA
92:2622-2626[Abstract/Free Full Text].
-
McCarson KE,
Krause JE
(1994)
NK-1 and NK-3 type tachykinin receptor mRNA expression in the rat spinal cord dorsal horn is increased during adjuvant or formalin-induced nociception.
J Neurosci
14:712-720[Abstract].
-
McCarson KE,
Krause JE
(1995)
The formalin-induced expression of tachykinin peptide and neurokinin receptor messenger RNAs in rat sensory ganglia and spinal cord is modulated by opiate preadministration.
Neuroscience
64:729-739[Web of Science][Medline].
-
McCarson KE,
Krause JE
(1996)
The neurokinin-1 receptor antagonist LY306,740 blocks nociception-induced increases in dorsal horn neurokinin-1 receptor gene expression.
Mol Pharmacol
50:1189-1199[Abstract].
-
Mendell LM
(1966)
Physiological properties of unmyelinated fibre projection to the spinal cord.
Exp Neurol
16:316-332[Web of Science][Medline].
-
Menetrey D,
Besson JM
(1982)
Electrophysiological characteristics of dorsal horn cells in rats with cutaneous inflammation resulting from chronic arthritis.
Pain
13:343-364[Web of Science][Medline].
-
Millan MJ
(1999)
The induction of pain: an integrative review.
Prog Neurobiol
57:1-164[Web of Science][Medline].
-
Millan MJ,
Czlonkowski A,
Morris B,
Stein C,
Arendt R,
Huber A,
Hollt V,
Herz A
(1988)
Inflammation of the hind limb as a model of unilateral, localized pain: influence on multiple opioid systems in the spinal cord of the rat.
Pain
35:299-312[Web of Science][Medline].
-
Molander C,
Grant G
(1985)
Cutaneous projections from the rat hindlimb foot to the substantia gelatinosa of the spinal cord studied by transganglionic transport of WGA-HRP conjugate.
J Comp Neurol
237:476-484[Web of Science][Medline].
-
Molander C,
Xu Q,
Grant G
(1984)
The cytoarchitectonic organization of the spinal cord in the rat: I. The lower thoracic and lumbosacral cord.
J Comp Neurol
230:133-141[Web of Science][Medline].
-
Munglani R,
Hunt SP
(1995)
Molecular biology of pain.
Br J Anaesth
75:186-192[Abstract/Free Full Text].
-
Neugebauer V,
Lucke T,
Grubb B,
Schaible HG
(1994)
The involvement of N-methyl-D-aspartate (NMDA) and non-NMDA receptors in the responsiveness of rat spinal neurons with input from the chronically inflamed ankle.
Neuroscience Lett
170:237-240[Web of Science][Medline].
-
Neumann S,
Doubell TP,
Leslie T,
Woolf CJ
(1996)
Inflammatory pain hypersensitivity mediated by phenotypic switch in myelinated primary sensory neurons.
Nature
384:360-364[Medline].
-
Noguchi K,
Morita Y,
Kiyama H,
Ono K,
Tohyama M
(1988)
A noxious stimulus induces the preprotachykinin-A gene expression in the rat dorsal root ganglion: a quantitative study using in situ hybridization histochemistry.
Brain Res
464:31-35[Medline].
-
Noguchi K,
Senba E,
Morita Y,
Sato M,
Tohyama M
(1989)
Prepro-VIP and preprotachykinin mRNAs in the rat dorsal root ganglion cells following peripheral axotomy.
Brain Res Mol Brain Res
6:327-330[Medline].
-
Pearson CM,
Wood FD
(1959)
Studies of polyarthritis and other lesions induced in rats by injection of mycobacterial adjuvant. I. General clinical and pathologic characteristics and some modifying factors.
Arthritis Rheum
2:440-459[Web of Science].
-
Puig S,
Sorkin LS
(1996)
Formalin-evoked activity in identified primary afferent fibers: systemic lidocaine suppresses phase-2 activity.
Pain
64:345-355[Web of Science][Medline].
-
Schaible HG,
Schmidt RF
(1988)
Excitation and sensitization of fine articular afferents from cat's knee joint by prostaglandin E2.
J Physiol (Lond)
403:91-104[Abstract/Free Full Text].
-
Simone DA,
Sorkin LS,
Oh U,
Chung JM,
Owens C,
LaMotte RH,
Willis WD
(1991)
Neurogenic hyperalgesia: central neural correlates in responses of spinothalamic tract neurons.
J Neurophysiol
66:228-246[Abstract/Free Full Text].
-
Stanfa LC,
Sullivan AF,
Dickenson AH
(1992)
Alterations in neuronal excitability and the potency of spinal µ,
and opioids after carrageenan-induced inflammation.
Pain
50:345-354[Web of Science][Medline]. -
Steen KH,
Reeh PW,
Anton F,
Handwerker HO
(1992)
Protons selectively induce lasting excitation and sensitization to mechanical stimulation of nociceptors in rat skin, in vitro.
J Neurosci
12:86-95[Abstract].
-
Taylor BK,
Peterson MA,
Basbaum AI
(1995)
Persistent cardiovascular and behavioral nociceptive responses to subcutaneous formalin require peripheral nerve input.
J Neurosci
15:7575-7584[Abstract].
-
Thayer SA,
Perney TM,
Miller RJ
(1988)
Regulation of calcium homeostasis in sensory neurons by bradykinin.
J Neurosci
8:4089-4097[Abstract].
-
Tjolsen A,
Berge O-G,
Hunskaar S,
Rosland JH,
Hole K
(1992)
The formalin test: an evaluation of the method.
Pain
51:5-17[Web of Science][Medline].
-
Treede RD,
Meyer RA,
Raja SN,
Campbell JN
(1992)
Peripheral and central mechanisms of cutaneous hyperalgesia.
Prog Neurobiol
38:397-421[Web of Science][Medline].
-
Urban L,
Dray A,
Nagy I,
Maggi CA
(1993)
The effects of NK-1 and NK-2 receptor antagonists on the capsaicin evoked synaptic response in the rat spinal cord in vitro.
Regul Peptides
46:413-414[Medline].
-
Urban L,
Thompson SWN,
Dray A
(1994)
Modulation of spinal excitability: co-operation between neurokinin and excitatory amino acid neurotransmitters.
Trends Neurosci
17:432-438[Web of Science][Medline].
-
Urban MO,
Gebhart GF
(1998)
The glutamate synapse: a target in the pharmacological management of hyperalgesic pain states.
Prog Brain Res
116:407-420[Web of Science][Medline].
-
Winter CA,
Risley EA,
Nuss GW
(1962)
Carrageenan-induced edema in hind paw of the rat as an assay for antiinflammatory drugs.
Proc Soc Exp Biol Med
111:544-547.
-
Woolf CJ
(1983)
Evidence for a central component of post-injury pain hypersensitivity.
Nature
306:686-688[Medline].
-
Woolf CJ
(1994)
A new strategy for the treatment of inflammatory pain. Prevention or elimination of central sensitization.
Drugs
47:1-9[Medline].
-
Yaksh TL,
Chaplan SR,
Malmberg AB
(1995)
Future directions in the pharmacological management of hyperalgesic and allodynic pain states: the NMDA receptor.
NIDA Research Monograph
147:84-103[Medline].
-
Zoli M,
Torri C,
Ferrari R,
Jansson A,
Zini I,
Fuxe K,
Agnati LF
(1998)
The emergence of the volume transmission concept.
Brain Res Brain Res Rev
26:136-147[Medline].
Copyright © 1999 Society for Neuroscience 0270-6474/99/19177670-09$05.00/0
This article has been cited by other articles:

|
 |

|
 |
 
L. S. Miraucourt, X. Moisset, R. Dallel, and D. L. Voisin
Glycine Inhibitory Dysfunction Induces a Selectively Dynamic, Morphine-Resistant, and Neurokinin 1 Receptor- Independent Mechanical Allodynia
J. Neurosci.,
February 25, 2009;
29(8):
2519 - 2527.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Biswal, D. L. Resnick, J. M. Hoffman, and S. S. Gambhir
Molecular Imaging: Integration of Molecular Imaging into the Musculoskeletal Imaging Practice
Radiology,
September 1, 2007;
244(3):
651 - 671.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. E. Haley and F. W. Flynn
Tachykinin NK3 receptor contribution to systemic release of vasopressin and oxytocin in response to osmotic and hypotensive challenge
Am J Physiol Regulatory Integrative Comp Physiol,
August 1, 2007;
293(2):
R931 - R937.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Scherrer, P. Tryoen-Toth, D. Filliol, A. Matifas, D. Laustriat, Y. Q. Cao, A. I. Basbaum, A. Dierich, J.-L. Vonesh, C. Gaveriaux-Ruff, et al.
Knockin mice expressing fluorescent {delta}-opioid receptors uncover G protein-coupled receptor dynamics in vivo
PNAS,
June 20, 2006;
103(25):
9691 - 9696.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. W. Allen, P. W. Mantyh, K. Horais, N. Tozier, S. D. Rogers, J. R. Ghilardi, D. Cizkova, M. R. Grafe, P. Richter, D. A. Lappi, et al.
Safety Evaluation of Intrathecal Substance P-Saporin, a Targeted Neurotoxin, in Dogs
Toxicol. Sci.,
May 1, 2006;
91(1):
286 - 298.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. E. Haley and F. W. Flynn
Agonist and hypertonic saline-induced trafficking of the NK3-receptors on vasopressin neurons within the paraventricular nucleus of the hypothalamus
Am J Physiol Regulatory Integrative Comp Physiol,
May 1, 2006;
290(5):
R1242 - R1250.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. K. Winter and K. E. McCarson
G-Protein Activation by Neurokinin-1 Receptors Is Dynamically Regulated during Persistent Nociception
J. Pharmacol. Exp. Ther.,
October 1, 2005;
315(1):
214 - 221.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
I. Kondo, J. C. G. Marvizon, B. Song, F. Salgado, S. Codeluppi, X.-Y. Hua, and T. L. Yaksh
Inhibition by Spinal {micro}- and {delta}-Opioid Agonists of Afferent-Evoked Substance P Release
J. Neurosci.,
April 6, 2005;
25(14):
3651 - 3660.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
F. Brocard, C. Bardy, and R. Dubuc
Modulatory Effect of Substance P to the Brain Stem Locomotor Command in Lampreys
J Neurophysiol,
April 1, 2005;
93(4):
2127 - 2141.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
B. Song and J. C. G. Marvizon
Dorsal Horn Neurons Firing at High Frequency, But Not Primary Afferents, Release Opioid Peptides that Produce {micro}-Opioid Receptor Internalization in the Rat Spinal Cord
J. Neurosci.,
October 8, 2003;
23(27):
9171 - 9184.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
V. S. Seybold, K. E. McCarson, P. G. Mermelstein, R. D. Groth, and L. G. Abrahams
Calcitonin Gene-Related Peptide Regulates Expression of Neurokinin1 Receptors by Rat Spinal Neurons
J. Neurosci.,
March 1, 2003;
23(5):
1816 - 1824.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
B. Song and J. C. G. Marvizon
Peptidases Prevent {micro}-Opioid Receptor Internalization in Dorsal Horn Neurons by Endogenously Released Opioids
J. Neurosci.,
March 1, 2003;
23(5):
1847 - 1858.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. A. C. Sabino, J. R. Ghilardi, J. L. M. Jongen, C. P. Keyser, N. M. Luger, D. B. Mach, C. M. Peters, S. D. Rogers, M. J. Schwei, C. de Felipe, et al.
Simultaneous Reduction in Cancer Pain, Bone Destruction, and Tumor Growth by Selective Inhibition of Cyclooxygenase-2
Cancer Res.,
December 15, 2002;
62(24):
7343 - 7349.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Murakami, B. Fleischmann, C. De Felipe, M. Freichel, C. Trost, A. Ludwig, U. Wissenbach, H. Schwegler, F. Hofmann, J. Hescheler, et al.
Pain Perception in Mice Lacking the beta 3 Subunit of Voltage-activated Calcium Channels
J. Biol. Chem.,
October 18, 2002;
277(43):
40342 - 40351.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. G. Khasabov, S. D. Rogers, J. R. Ghilardi, C. M. Peters, P. W. Mantyh, and D. A. Simone
Spinal Neurons that Possess the Substance P Receptor Are Required for the Development of Central Sensitization
J. Neurosci.,
October 15, 2002;
22(20):
9086 - 9098.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M.-C. Ma, H.-S. Huang, M.-S. Wu, C.-T. Chien, and C.-F. Chen
Impaired Renal Sensory Responses after Renal Ischemia in the Rat
J. Am. Soc. Nephrol.,
July 1, 2002;
13(7):
1872 - 1883.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R.-R. Ji, K. Befort, G. J. Brenner, and C. J. Woolf
ERK MAP Kinase Activation in Superficial Spinal Cord Neurons Induces Prodynorphin and NK-1 Upregulation and Contributes to Persistent Inflammatory Pain Hypersensitivity
J. Neurosci.,
January 15, 2002;
22(2):
478 - 485.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. Marchetti and A. Nistri
Neuronal Bursting Induced by NK3 Receptor Activation in the Neonatal Rat Spinal Cord In Vitro
J Neurophysiol,
December 1, 2001;
86(6):
2939 - 2950.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. H. Kamp, D. R. Beck, and G. F. Gebhart
Combinations of Neurokinin Receptor Antagonists Reduce Visceral Hyperalgesia
J. Pharmacol. Exp. Ther.,
October 1, 2001;
299(1):
105 - 113.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. D. Crown and J. W. Grau
Preserving and Restoring Behavioral Potential Within the Spinal Cord Using an Instrumental Training Paradigm
J Neurophysiol,
August 1, 2001;
86(2):
845 - 855.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. M. Luger, P. Honore, M. A. C. Sabino, M. J. Schwei, S. D. Rogers, D. B. Mach, D. R. Clohisy, and P. W. Mantyh
Osteoprotegerin Diminishes Advanced Bone Cancer Pain
Cancer Res.,
May 1, 2001;
61(10):
4038 - 4047.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
M. Barbieri and A. Nistri
Depression of Windup of Spinal Neurons in the Neonatal Rat Spinal Cord In Vitro by an NK3 Tachykinin Receptor Antagonist
J Neurophysiol,
April 1, 2001;
85(4):
1502 - 1511.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Qian, G. Yehia, C. A. Molina, A. Fernandes, R. J. Donnelly, D. J. Anjaria, P. Gascon, and P. Rameshwar
Cloning of Human Preprotachykinin-I Promoter and the Role of Cyclic Adenosine 5'-Monophosphate Response Elements in Its Expression by IL-1 and Stem Cell Factor
J. Immunol.,
February 15, 2001;
166(4):
2553 - 2561.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. A. Trafton, C. Abbadie, K. Marek, and A. I. Basbaum
Postsynaptic Signaling via the {micro}-Opioid Receptor: Responses of Dorsal Horn Neurons to Exogenous Opioids and Noxious Stimulation
J. Neurosci.,
December 1, 2000;
20(23):
8578 - 8584.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. C. Petruska, J. Napaporn, R. D. Johnson, J. G. Gu, and B. Y. Cooper
Subclassified Acutely Dissociated Cells of Rat DRG: Histochemistry and Patterns of Capsaicin-, Proton-, and ATP-Activated Currents
J Neurophysiol,
November 1, 2000;
84(5):
2365 - 2379.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G.-Y. Xu, L.-Y. M. Huang, and Z.-Q. Zhao
Activation of silent mechanoreceptive cat C and A{delta} sensory neurons and their substance P expression following peripheral inflammation
J. Physiol.,
October 15, 2000;
528(2):
339 - 348.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J. Schwei, P. Honore, S. D. Rogers, J. L. Salak-Johnson, M. P. Finke, M. L. Ramnaraine, D. R. Clohisy, and P. W. Mantyh
Neurochemical and Cellular Reorganization of the Spinal Cord in a Murine Model of Bone Cancer Pain
J. Neurosci.,
December 15, 1999;
19(24):
10886 - 10897.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|