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The Journal of Neuroscience, January 1, 2002, 22(1):93-102
Peripheral Inflammation Sensitizes P2X Receptor-Mediated
Responses in Rat Dorsal Root Ganglion Neurons
Guang-Yin
Xu1 and
Li-Yen Mae
Huang1, 2
1 Marine Biomedical Institute and
2 Department of Physiology and Biophysics, University of
Texas Medical Branch, Galveston, Texas 77555-1069
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ABSTRACT |
ATP-gated P2X receptors in nociceptive sensory neurons participate
in transmission of pain signals from the periphery to the spinal cord.
To determine the role of P2X receptors under injurious conditions, we
examined ATP-evoked responses in dorsal root ganglion (DRG) neurons
isolated from rats with peripheral inflammation, induced by injections
of complete Freund's adjuvant (CFA) into the hindpaw. Application of
ATP induced both fast- and slow-inactivating currents in control and
inflamed neurons. CFA treatment had no effect on the affinity of ATP
for its receptors or receptor phenotypes. On the other hand,
inflammation caused a twofold to threefold increase in both
ATP-activated currents, altered the voltage dependence of P2X
receptors, and enhanced the expression of P2X2 and P2X3 receptors. The
increase in ATP responses gave rise to large depolarizations that
exceeded the threshold of action potentials in inflamed DRG neurons.
Thus, P2X receptor upregulation could account for neuronal hypersensitivity and contribute to abnormal pain responses associated with inflammatory injuries. These results suggest that P2X receptors are useful targets for inflammatory pain therapy.
Key words:
dorsal root ganglion; ATP; P2X receptor; Western
blotting; peripheral inflammation; pain; electrophysiology
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INTRODUCTION |
In addition to being an
intracellular energy source, ATP is released from neuronal and
non-neuronal cells, acts on purinergic receptors, and regulates
activities of autonomic and sensory neurons, smooth muscle, and
endothelial cells (Jahr and Jessell, 1983 ; Cook and McCleskey, 2000 ;
North and Surprenant, 2000 ; Burnstock, 2001 ). In primary sensory dorsal
root ganglion (DRG) cells, ATP plays a prominent role in signaling. It
depolarizes DRG neurons by eliciting fast- and slow-inactivating inward
currents. The fast-inactivating ATP currents are mediated by homomeric
P2X3 receptors; the slow-desensitizing currents are mediated by
heteromeric P2X2/3 receptors (Bradbury et al., 1998 ; Virginio et al.,
1998 ; Burgard et al., 1999 ; Grubb and Evans, 1999 ). In addition, ATP modulates synaptic transmission at DRG and dorsal horn synapses (Bardoni et al., 1997 ; Li et al., 1998 ). It enhances spontaneous glutamate responses and elicits action potentials to evoke glutamate release (Gu and MacDermott, 1997 ; Nakatsuka and Gu, 2001 ). Studies of
P2X receptor distributions show that P2X2 and P2X3 receptor subtypes
are selectively expressed in structures associated with pain signal
processing, including small- and medium-sized DRG neurons, peripheral
and central sensory terminals, and superficial dorsal horns (Chen et
al., 1995 ; Lewis et al., 1995 ; Cook et al., 1997 ; Vulchanova et al.,
1998 ; Kanjhan et al., 1999 ). Behavioral experiments suggest that
applications of the P2X agonists ATP and  meATP to the rat hindpaw
decrease the tail-flick latency and produce flinching and writhing
behaviors (Cockayne et al., 2000 ; Souslova et al., 2000 ; Tsuda et al.,
2000 ). Thus, activation of P2X receptors in sensory neurons facilitates
transmission of nociceptive signals from the periphery to the spinal cord.
The consequences of nerve and tissue injuries on ATP responses have not
been thoroughly explored. Insults to afferent fibers and peripheral
tissues, such as neuropathy and inflammation, frequently give rise to
exaggerated responses to non-noxious and noxious stimuli (allodynia and
hyperalgesia). These pathological responses are thought to arise from
sensitization of DRG and dorsal horn neurons to external stimuli (Woolf
and Doubell, 1994 ; Xu et al., 2000 ). Stanfa et al. (2000) find that the
spinally administered P2X antagonists suramin and
pyridoxalphosphate-6-azophenyl-2',4'-disulfonic acid (PPADS)
reduce C-fiber-evoked discharges in deep dorsal horn neurons of rats
with inflammation but have no effect on those in normal or
nerve-ligated rats. Hamilton et al. (1999) show that high
concentrations of ATP ( 100 nmol) to the hindpaw of normal rats are
required to produce nocifensive behaviors (i.e., paw lifting, shaking,
and licking) and heat hyperalgesia. However, 1 nmol of ATP can evoke
these behaviors in rats inflamed with carrageenan. Furthermore,
ATP-evoked activity of C-mechanoheat or polymodal nociceptors is
greatly enhanced (Hamilton et al., 2001 ). P2X receptor activation is
therefore facilitated after inflammation. The mechanism underlying the
facilitation is unknown. Here we examine the ATP-evoked responses and
the expression of P2X receptors in DRG neurons isolated from rats with
peripheral inflammation. Our results show that inflammation produces a
large increase in P2X receptor currents.
Parts of this work have been published previously in abstract form (Xu
and Huang, 1999 ).
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MATERIALS AND METHODS |
Induction of peripheral inflammation. All experiments
were approved by the Institutional Animal Care and Use
Committee at the University of Texas Medical Branch and were in
accordance with the guidelines of the National Institutes of Health and
the International Association for the Study of Pain.
Sprague Dawley rats (27-37 d old) were used for the studies. Complete
Freund's adjuvant (CFA) (Mycobacterium butyricum; Difco, Detroit, MI)
emulsion (1:1 peanut oil/saline, 10 mg/ml Mycobacterium) was injected
into the ankle and plantar surface (100 µl each) of the left hindpaw (Gu and Huang, 2001 ). The injections produced localized inflammation characterized by redness, edema, and hyperalgesia in the hindpaw and ankle.
Dissociation of DRG neurons. Control rats (n = 42) and rats 3-14 d after CFA injection (n = 87)
were killed by cervical dislocation, followed by decapitation.
L4-L6 DRGs were then dissected out and put in an ice-cold, oxygenated
dissecting solution, containing (in mM): 130 NaCl, 5 KCl, 2 KH2PO4, 1.5 CaCl2, 6 MgCl2, 10 glucose, and 10 HEPES, pH 7.2 (osmolarity, 305 mOsm). After removal of the
connective tissue, the ganglia were transferred to a 10 ml dissecting
solution containing collagenase IV (1.0-1.5 mg/ml; Boehringer
Mannheim, Indianapolis, IN) and trypsin (1.0 mg/ml; Sigma, St.
Louis, MO) and incubated for 1 hr at 34.5°C. DRGs were then taken
from the enzyme solution, washed, and put in 3 ml of the dissecting
solution containing DNase (0.5 mg/ml; Sigma). Cells were subsequently
dissociated by trituration with fire-polished glass pipettes and placed
on acid-cleaned glass coverslips.
Perforated patch recording and application of drugs. Cells
were superfused (2 ml/min) at room temperature with an external solution containing (in mM): 130 NaCl, 5 KCl, 2 KH2PO4, 2.5 CaCl2, 1 MgCl2, 10 HEPES,
and 10 glucose, pH 7.2 (osmolarity, 295-300 mOsm). ATP-induced
currents and action potentials were recorded using the perforated
patch-clamp technique. The patch electrode had a resistance between 2.2 and 3.5 M . The pipette tip was initially filled with
amphotericin-free pipette solution, containing (in mM): 100 KmeSO3, 40 KCl,
and 10 HEPES, pH 7.25 adjusted with KOH (osmolarity, 290 mOsm). The
pipette was then backfilled with same pipette solution containing
amphotericin B (300 µg/ml). The currents were filtered at 2-5 kHz
and sampled at 50 or 100 µsec per point.
All chemicals were pressure delivered (1-2 psi) to the recorded cell
through two applicators (Dilger and Brett, 1990 ). Each applicator was
connected to a solenoid valve, which was controlled by computer pulses
to start and stop the solution flow. To determine the rate of solution
exchange, a depolarized pulse to 10 mV was used to activate a delayed
rectifying K+ current in DRG neurons. When
the current reached a steady state, the external KCl concentration was
switched from 5 to 30 mM. This resulted in a change in
K+ currents. The time constant
for the current change through the open
K+ channels, an indicator of the solution
exchange rate, was 2.0 msec. The exchange rate was fast and would not
limit peak ATP responses. ATP,  meATP, suramin, PPADS, and TTX
were purchased from Sigma, and
2',3'-O-(2',4',6')-trinitrophenyl-ATP (TNP-ATP) was from
Molecular Probes (Eugene, OR).
Western blotting. L4-L6 DRGs from control rats or the DRGs
ipsilateral to the CFA-injected paw of CFA-treated rats were dissected out and lyzed in 100 µl of radioimmunoprecipitation assay
buffer containing 1% NP-40, 0.5%Na deoxycholate, 0.1% SDS, PMSF (10 µl/ml), and aprotinin (30 µl/ml; Sigma). The cell lysates were then
microfuged at 15,000 × g for 25 min at 4°C. The
concentration of protein in homogenate was determined using a BCA
reagent (Pierce, Rockford, IL). Ten micrograms of proteins for P2X1 and
P2X2 studies or 5 µg of proteins for P2X3 studies were loaded onto a
10% Tris-HCl SDS-PAGE gel (Bio-Rad, Hercules, CA). After
electrophoresis, the proteins were electrotransferred onto
polyvinylidene difluoride membranes (Bio-Rad) overnight at 4°C. The
membranes were incubated in 25 ml of blocking buffer (1× TBS with 5%
w/v fat-free dry milk) for 2 hr at room temperature. The membranes were
then incubated with the primary antibodies for 1.5 hr at room
temperature. Primary antibodies used were rabbit anti-P2X3 (1:3000;
Neuromics Inc., Minneapolis, MN), rabbit anti-P2X1 and -P2X2 (1:200;
Alomone Labs, Jerusalem, Israel), and mouse anti-actin (1:1000;
Chemicon, Temecula, CA). After incubation, the membranes were washed
with TBST (1× TBS and 1% Tween 20) three times for 30 min each and
incubated with anti-rabbit peroxidase-conjugated secondary antibody (1: 2000; Santa Cruz Biotechnology, Santa Cruz, CA) or anti-mouse HRP-conjugated secondary antibody (1:400; Chemicon) for 1 hr at room
temperature. The membrane was then washed with TBST three times for 30 min each. The immunoreactive proteins were detected by enhanced
chemiluminescence (ECL kit; Amersham Biosciences, Arlington
Heights, IL). The bands recognized by primary antibody were visualized
by exposure of the membrane onto an x-ray film.
Data analyses. Rise times
(Ta) of ATP responses were obtained by
measuring the activation time between 10 and 90% of the peak value.
The time constants of current inactivation
( in) were obtained by fitting the decay phase
of the currents with exponential functions using the
Levenberg-Marquardt algorithm.
Membrane conductance (G) at each holding
potential (V) was calculated according to the
equation G = I/(V Vrev), where I is the ATP
current, and Vrev is the reversal
potential. The G-V curve was fitted with the Boltzmann
equation G = Gmax/(1 + exp(A)), where A = (V V0.5) * (ZFV/RT).
Gmax is the maximal conductance, V0.5 is the potential at which
G/Gmax = 0.5, V
is the membrane potential, R is the gas constant,
T is the absolute temperature, Z is the charge
factor, and F is the Faraday constant.
Dose-response curves for ATP activation were fit with the Hill
equation I = Imax *
([ATP]n)/([ATP]n + (EC50)n), where
I is the measured current,
Imax is the maximal response, EC50 is the ATP concentration used to obtain 50%
of the maximal response, and n is the Hill coefficient.
Data are expressed as mean ± SEM or as percentage.
Student's t or 2 test was
used to assess the significance of changes after CFA treatment.
p < 0.05 was considered significant.
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RESULTS |
Potentiation of ATP-activated currents after inflammation
To determine the effect of inflammation on ATP-activated currents,
the properties of the currents in neurons from control and CFA-treated
rats were examined under voltage-clamp conditions. Peripheral
inflammation was induced by injecting CFA into the ankle and plantar
surface of the rat left hindpaw. L4-L6 DRGs were isolated 3-14 d
after the CFA injection, a period of peak hyperalgesic conditions. We
chose small to medium diameter (15-40 µm) DRG neurons for the study
because they mediate transmission of nociceptive signals (Willis and
Coggeshall, 1991 ).
Applications of ATP (20 µM) evoked large inward currents
at 60 mV holding potential in control DRG neurons. Based on the time
course of the responses, they were categorized as fast, slow, and mixed
responses. The fast ATP-evoked currents were rapidly activating and
inactivating (Fig. 1A).
The rise times of the fast responses were short
(Ta = 6.5 ± 1.1 msec;
n = 18). The currents reduced to <5.0 ± 0.5% of
their peak amplitudes within 2 sec of ATP applications. The
inactivating phase of the currents was best fitted with a sum of two
exponentals ( 1in = 38.1 ± 7.7 msec, A1 = 605.3 ± 171.2 pA,
2in = 477.3 ± 177.2 msec,
A2 = 120.2 ± 20.6 pA;
n = 11). Once inactivated, the fast ATP responses
recovered very slowly. The original peak amplitude would not be
restored unless there was a 10-15 min wait between consecutive ATP
applications.

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Figure 1.
Inflammation potentiates ATP-activated currents.
A, Examples of currents evoked by ATP application in
control rats (CON). ATP (20 µM) activated fast-inactivating (left) and
slow-inactivating (right) currents in DRG neurons. The
membrane was held at 60 mV. Results were obtained from two different
cells. The solid line above each trace
indicates the period of ATP application. B, Examples of
currents evoked by ATP application in rats injected with CFA. Under
similar conditions as in A, ATP also evoked
fast-inactivating (left) and slow-inactivating
(right) currents in DRG cells. The amplitudes of both
types of currents were much larger than those obtained in control rats.
C, Mean fast and slow current densities from control and
CFA rats. The mean peak fast-inactivating
(Fast_P) current density measured in CFA
rats was 2.7 times larger than that measured in control rats
(Fast_P: control, 0.30 ± 0.05 pA/µm2, n = 29; CFA, 0.82 ± 0.13 pA/µm2, n = 48;
*p < 0.01). The mean peak slow-inactivating
(Slow_P) current density in CFA rats was
2.8 times larger (Slow_P: control,
0.24 ± 0.05 pA/µm2, n = 25; CFA, 0.68 ± 0.09 pA/µm2,
n = 38), and the mean steady-state slow
(Slow_SS) current density was 3.0 times
larger than those obtained in control rats
(Slow_SS: control, 0.10 ± 0.02 pA/µm2, n = 25; CFA, 0.30 ± 0.05 pA/µm2, n = 38;
*p < 0.01).
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The slow ATP responses in control neurons were characterized by
relatively slow rise times (Ta = 38.5 ± 5.97 msec; n = 10). The inactivation
kinetics varied among cells. In a small percentage (~8%) of cells,
slow ATP responses showed very little inactivation during the ATP
application. A majority of slow responses, however, showed
inactivation. The decay kinetics could be fit with one exponential. The
average inactivation time constant ( in) was 2007.5 ± 200.4 msec (n = 10), which was ~4-50
times slower than those of the fast ATP responses. Unlike the fast ATP
responses, the slow ATP responses recovered rather quickly. The peak
response returned to its original size within 1 min after an ATP application.
ATP also evoked inward currents in a large number of neurons isolated
from CFA rats. Similar to control cells, ATP evoked fast and slow
responses in inflamed neurons. The most prominent change was the large
enhancement of current amplitudes (Fig. 1B). The
average peak current density of the fast responses in inflamed neurons
was 2.7-fold larger (control, 0.30 ± 0.05 pA/µm2, n = 29; CFA,
0.82 ± 0.13 pA/µm2,
n = 48). The kinetic characteristics of the fast ATP
responses of inflamed neurons were similar to those obtained from
control neurons (Table 1). The fast ATP
responses in inflamed neurons activated rapidly
(Ta = 6.3 ± 0.78 msec,
n = 19) and desensitized in two phases
( 1in = 49.4 ± 7.9 msec,
A1 = 1352.7 ± 237.1 pA; 2in = 292.7 ± 30.4 msec,
A2 = 325.5 ± 58.4 pA;
n = 19). The currents were desensitized completely
during the 2 sec ATP application.
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Table 1.
Kinetics of ATP-induced fast and slow currents in dorsal
root ganglion neurons isolated from control (CON) and CFA-treated rats
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ATP also evoked slow responses in inflamed neurons. The amplitudes of
slow responses were also greatly potentiated. The average peak current
density of the slow-inactivating currents was increased by 2.8-fold
(control, peak 0.24 ± 0.05 pA/µm2,
n = 25; CFA, peak 0.68 ± 0.09 pA/µm2, n = 38); the
average steady-state current density of the slow responses was
increased by 3.0-fold (control, 0.10 ± 0.02 pA/µm2, n = 25; CFA,
0.30 ± 0.05 pA/µm2,
n = 38) (Fig. 1C). The kinetic properties of
slow responses in inflamed neurons were not significantly different
from those of control neurons (Table 1). The slow ATP responses of
inflamed neurons had a mean rise time
(Ta) of 52.0 ± 8.2 msec
(n = 16), and a mean decayed time constant of
in = 2318.4 ± 379.5 msec (n = 16).
We also observed ATP currents with mixed fast and slow characteristics
in both control and inflamed (data not shown). Like the fast ATP
responses, the mixed ATP responses were characterized by a fast rise
time and a distinct two-phase inactivation. The fast inactivation phase
had a time constant similar to the 1in of the
fast ATP responses. However, the slow inactivation phase had a time
constant that was much slower than the 2in of
the fast ATP responses. Thus, a substantial portion of the current remained at the end of the 2 sec ATP application, a characteristic feature of the slow ATP responses. To simplify our analyses, the mixed
ATP responses, which occurred in 8.5% of ATP responding control
neurons (12 of 141 cells tested) and 11.6% of responding CFA neurons
(32 of 276 cells), were not included in this study.
Cell distribution of ATP responses
We then analyzed the cell types that displayed either fast or slow
ATP responses. ATP-induced responses were observed in 89.4% of all
recorded DRG neurons (n = 141) isolated from control
rats and in 93.8% of DRG neurons (n = 276) isolated
from CFA-injected rats. Thus, the percentages of neurons responding to
ATP remained unchanged after CFA treatment (p > 0.05). Analyses of the types of ATP responses in control neurons
indicated that 33.3% of recorded neurons (n = 47)
exhibited fast-inactivating ATP currents, and 47.5% of cells exhibited
slow-inactivating ATP currents (n = 67). After
inflammation, 42.8% of neurons (n = 118) exhibited
fast ATP responses, and 39.5% of cells (n = 109)
exhibited slow ATP responses. Therefore, two types of responses
occurred with approximately equal frequencies in control and
CFA-treated rats (p > 0.05) (Fig. 2A).

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Figure 2.
Inflammation does not change the percentages and
the size distributions of neurons responding to ATP. A,
Percentages of responding cells. The percentage of the total number of
cells (Total) responding to ATP was 89.4%
(n = 141) in control rats
(CON) and 93.8% (n = 276) in
CFA rats. The change was not significant ( 2 test;
p > 0.05). The percentages of cells with
fast-inactivating ATP responses (Fast) (control, 33.3%,
n = 47; CFA, 42.8%, n = 118)
and the percentages of cells with slow-inactivating ATP responses
(Slow) (control, 47.5%, n = 67;
CFA, 39.5%, n = 109) were not altered by
inflammation. B, Cell size distributions for ATP
responses. Distributions of cell diameter were expressed in cumulative
histograms, i.e., percentages of cells that responded with either fast
or slow ATP responses versus cell diameters that were smaller than the
indicated values. In control rats, 50% of cells responding to ATP with
fast-inactivating currents (13 of 27 cells tested) had diameters <26
µm; 50% of the cells responding to ATP with slow-inactivating
currents (23 of 46 cells tested) had diameters <33 µm. The size
difference was significant (p < 0.05;
Kolmogorov-Smirnov test). In CFA rats, 50% of the cells responding to
ATP with fast-inactivating currents had diameters <26 µm (32 of 65 cells tested); 50% of the cells responding to ATP with
slow-inactivating currents had diameters <31 µm (28 of 56 cells
tested). CFA treatment did not change the size distribution of cells
responding to ATP with either the fast- or slow-inactivating
currents.
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Cell size distribution of fast- and slow-inactivating ATP responses was
also obtained using cumulative distribution analyses. The percentages
of cells exhibiting ATP responses versus cell diameters smaller than
the indicated values were plotted (Fig. 2B). We found
that 50% of cells responding to ATP with fast-inactivating currents
had diameters <26 µm in both control and CFA rat groups. Cells
responding to ATP with slow-inactivating currents for both rat groups
were significantly larger (i.e., 50% of cells responding with slow
currents had diameters <33 µm in control rats and <31 µm in CFA
rats). Because the cell size distributions for both ATP responses are
the same for normal and inflamed rats, inflammation does not appear to
alter the types of DRG cells expressed P2X receptors.
P2X receptor phenotypes
ATP activates more than one subtype of P2X receptors in control
DRG neurons (Vulchanova et al., 1997 ; North and Surprenant, 2000 ). It
is of interest to determine whether the same P2X receptor subtypes are
expressed in DRGs after inflammation. Antagonists were first used to
identify P2X receptors in DRGs. Suramin (30 µM) and PPADS
(50 µM) completely blocked fast and slow ATP-evoked currents in control (n = 20) and inflamed
(n = 25) neurons (Fig. 3A, left and
middle). These two antagonists, at tens of micromolar concentrations, are known to block homomeric P2X1, P2X2, P2X3, and P2X5
and heteromeric P2X2/3 receptors without significantly affecting
homomeric P2X4, P2X6, and P2X7 receptors (North and Barnard, 1997 ;
North and Surprenant, 2000 ). Thus, P2X4, P2X6, and P2X7 were not
present in either control or inflamed DRGs. We then used the antagonist
TNP-ATP to determine whether homomeric P2X2 receptors were present in
our DRG neurons (Fig. 3A, right). TNP-ATP is
500-fold more sensitive to homomeric P2X1 and P2X3 and heteromeric
P2X2/3 receptors than to homomeric P2X2 receptors (Thomas et al.,
1998 ). High concentrations ( 1 µM) of TNP-ATP should block P2X1, P2X3, and P2X2/3 receptor-mediated responses but
leaves most homomeric P2X2 receptor-mediated responses intact (Thomas
et al., 1998 ; Virginio et al., 1998 ; North and Surprenant, 2000 ). At 1 µM, TNP-ATP blocked all fast ATP currents and
reduced slow ATP currents by 98% in control (n = 18)
and inflamed (n = 24) neurons (Fig. 3A,
right). Thus, the responses mediated by homomeric P2X2
receptors, if present in our cells, would be small.

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Figure 3.
Inflammation does not change the receptor
phenotypes. A, Effects of P2X receptor antagonists. In
inflamed neurons, the antagonists of P2X receptors suramin
(Sur; 30 µM) and PPADS (50 µM) completely blocked both fast- and slow-inactivating
currents. TNP-ATP (1 µM) inhibited the fast ATP responses
completely and inhibited the slow ATP responses by 98%. Current traces
obtained from ATP plus and minus an antagonist were superimposed.
B, Effects of the P2X receptor agonist  meATP. At
saturated concentrations, ATP (100 µM) and  meATP
(100 µM) elicited similar responses, suggesting minimal
contributions of homomeric P2X2, P2X5 receptor-mediated responses to
the observed currents. CFA treatment did not alter the effect of
 meATP. CON, Control.
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We then used the P2X receptor agonist  meATP to further identify
P2X receptor types in control and inflamed neurons. Unlike ATP,
 meATP has low affinity for homomeric P2X2 and P2X5 receptors (North and Surprenant, 2000 ). If P2X2 and/or P2X5 receptors were present in significant quantities, a saturated concentration of ATP
(100 µM) or  meATP (100 µM) should
evoke different responses. This was not observed. ATP and  meATP
activated currents of similar amplitudes in control (n = 9) and inflamed (n = 12) neurons (Fig. 3B). Homomeric P2X2 and P2X5 receptors, therefore, were not
present in sufficient amount to contribute to ATP responses in either control or inflamed DRGs. The expression of P2X1 receptor in control and inflamed neurons has not been studied in detail. Preliminary Western blot analyses showed that the P2X1 receptor immunoreactivity was low in both control and inflamed neurons, suggesting that P2X1 was
not the major receptor type in DRGs (data not shown). From these
experiments, we conclude that homomeric P2X3 and heteromeric P2X2/3
receptors are the main receptor types in inflamed DRGs and that
inflammation does not elicit significant changes in P2X receptor phenotypes.
Affinity of ATP for P2X receptors
To determine whether the increase in ATP responses in inflamed
neurons arises from changes in the affinity of ATP for P2X receptors,
dose-response curves for ATP in control and inflamed rat groups were
studied (Fig. 4). ATP, at 100
µM, elicited both maximal fast and slow ATP responses.
The maximal fast response was 2.5-fold larger and the maximal slow
response was 2.3-fold larger in inflamed neurons. Dose-response curves
for both fast and slow ATP responses were fit with the Hill equation.
The EC50 for fast ATP responses was 1.7 ± 0.9 µM in control and 2.0 ± 0.69 µM
in inflamed neurons (Fig. 4A). The
EC50 for slow ATP responses was 5.7 ± 1.4 µM in control and 3.6 ± 1.2 µM in inflamed neurons (Fig.
4B). The changes in ATP affinities for P2X receptors
in inflamed DRG neurons were not significant.

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Figure 4.
CFA treatment has no effect on the affinity of ATP
for P2X receptors. A, Dose-response curves for
ATP-evoked fast responses. The peak fast-inactivating ATP responses
evoked in control and inflamed neurons were plotted as a function of
ATP concentration. The dose-response curves were fit by the Hill
equation. For control cells (CON),
Imax = 0.38 ± 0.04 pA/µm2, EC50 = 1.70 ± 0.90 µM, and Hill coefficient = 1. For inflamed cells,
Imax = 0.95 ± 0.06 pA/µm2, EC50 = 2.00 ± 0.69 µM, and Hill coefficient = 1. The data points were
obtained from 3-18 cells. B, Dose-response curves for
ATP-evoked slow responses. For control cells,
Imax = 0.29 ± 0.02 pA/µm2, EC50 = 5.70 ± 1.40 µM, and Hill coefficient = 1. For inflamed cells,
Imax = 0.68 ± 0.14 pA/µm2, EC50 = 3.60 ± 1.20 µM, and Hill coefficient = 1. The data points were
obtained from two to eight cells. Therefore, inflammation did not alter
the ATP affinities for P2X receptors, although it greatly enhanced the
maximal ATP responses.
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Leftward shift of conductance-voltage curves
The voltage dependence of ATP responses was also determined.
Currents in response to ATP applications were measured at different holding potentials. The peak currents versus voltage
(I-V) curves were plotted. Both fast and slow ATP
currents reversed at near +10 mV in control cells (Fig.
5A), and CFA treatment did not
change the reversal potentials of ATP responses (Fig. 5). Therefore, inflammation had no significant effect on the permeation properties of
P2X3 and P2X2/3 receptors.

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Figure 5.
ATP currents in control and inflamed neurons
exhibit steep voltage dependence. Examples of current-voltage
(I-V) relationships of peak fast
(left) and slow (right) ATP currents in
control (CON) (A) and CFA
(B) neurons. The currents were measured at
different holding potentials. The current traces were shown in the
inset of each I-V curve. The reversal
potentials of the currents did not change after CFA treatment. Data
were obtained from four different cells.
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Both fast- and slow-inactivating ATP currents showed inward
rectification (Fig. 5). The conductance-voltage
(G-V) relationships of both types of currents were
fit with the Boltzmann equation (Fig. 6).
The G-V curves obtained for the fast ATP responses in control neurons had a Z = 0.97 ± 0.07, Gmax = 4.4 ± 0.7 pS/µm2, and
V0.5 = 35.6 ± 2.9 mV
(n = 10). CFA treatment did not significantly change
the Z (0.91 ± 0.08; n = 12) of the
G-V curve. As expected from the current data (Fig. 1), the
Gmax of inflamed neurons was 2.9-fold
larger, i.e., Gmax = 12.9 ± 1.4 pS/µm2 (n = 12). Furthermore, the
V0.5 shifted significantly in the hyperpolarized direction (Fig. 6)
(V0.5 = 49.5 ± 2.3 mV;
n = 12).

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Figure 6.
CFA alters the conductance-voltage curves.
A, Examples of conductance-voltage
(G-V) curves. The data were calculated according
to the procedure described in Materials and Methods, Data analyses. The
solid lines were the theoretical fit of the Boltzmann
equation using the following parameter values. Fast responses: control
(CON), Gmax = 5.6 pS/µm2, Z = 1.1, and
V0.5 = 31.5 mV; CFA,
Gmax = 13.4 pS/µm2, Z = 1.2, and
V0.5 = 51.4 mV. Slow responses:
control, Gmax = 6.9 pS/µm2, Z = 0.9, and
V0.5 = 19.0 mV; CFA,
Gmax = 18.5 pS/µm2, Z = 1.1, and
V0.5 = 39.0 mV. B,
Mean parameters obtained from all of the cells tested. Fast responses:
control, Gmax = 4.4 ± 0.7 pS/µm2, Z = 0.97 ± 0.07, and V0.5 = 35.6 ± 2.9 mV
(n = 10); CFA, Gmax = 12.9 ± 1.4 pS/µm2, Z = 0.91 ± 0.01, and V0.5 = 49.5 ± 2.3 mV (n = 12). Slow responses:
control, Gmax = 5.0 ± 0.9 pS/µm2, Z = 0.92 ± 0.09, and V0.5 = 25.4 ± 4.8 mV
(n = 6); CFA, Gmax = 11.0 ± 0.1 pA/µm2, Z = 0.95 ± 0.01, and V0.5 = 43.5 ± 2.8 mV (n = 12). Inflammation
increased Gmax (*p < 0.05; top), shifted the G-V curves in
the hyperpolarized direction (*p < 0.05;
middle), and did not change the Z
(p > 0.05; bottom).
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The G-V of the slow-inactivating ATP currents in control
neurons had a Z = 0.92 ± 0.09, Gmax = 5.0 ± 0.9 pS/µm2, and
V0.5 = 25.0 ± 4.8 mV
(n = 6). Compared with the fast ATP currents, the slow
ATP responses inactivated at a more depolarized potential. Inflammation
did not affect Z (0.95 ± 0.06; n = 12), but it increased the Gmax
(11.0 ± 1.4 pS/µm2;
n = 12) of slow ATP responses by 2.2-fold and shifted
G-V curves in the hyperpolarized direction
(V0.5 = 43.5 ± 2.8 mV;
n = 12). Thus, in addition to increasing the maximal
conductances, inflammation causes both types of ATP responses to
inactivate at more hyperpolarized potentials.
Increased membrane depolarization
We then compared the effect of ATP on the membrane depolarization
of DRG neurons in control and CFA neurons under current-clamp conditions. The average resting membrane potential of DRG neurons recorded from CFA-treated rats was 49.9 ± 0.7 mV
(n = 104), which was not significantly different from
the resting membrane potential of neurons recorded from control rats
( 50.8 ± 1.2 mV; n = 54). In control rats,
application of ATP (20 µM) produced
depolarizations of membrane potentials in 18 of 22 cells tested (Fig.
7A). Most of the
depolarizations were subthreshold (Fig.
7A,B, top left). After
CFA treatment, ATP induced depolarization in 30 of 34 neurons. All of
the depolarizations were large enough to evoke action potentials (Fig.
7A,B, bottom right).
Because Na+ channels are upregulated in
the inflammatory state (Gould et al., 1998 ; Gold, 1999 ) and could
affect changes in the firing properties of inflamed neurons, their
contribution to the depolarization has to be eliminated. We therefore
isolated the depolarization attributable to P2X receptor
activation by using TTX to block TTX-sensitive
Na+ channels and a depolarized prepulse to
inactivate both TTX-sensitive and -resistant
Na+ channels (Ogata and Tatebayashi, 1993 ;
Rush et al., 1998 ). TTX (2 µM) could block cell
firings in ~50% of the DRG cells isolated from control and CFA rats.
In the other 50% of the cells tested, TTX had little effect on the
spike generation. The ATP-evoked depolarizations in TTX-sensitive and
-resistant neurons were evaluated separately. In TTX-sensitive neurons
isolated from control rats (Fig. 7A, top), the
average size of the depolarization was 12.4 ± 3.7 mV
(n = 4) before TTX and 11.8 ± 4.1 mV
(n = 4) after TTX. To inactivate TTX-resistant
Na+ channels that might also be present in
these cells, an 8 sec depolarized prepulse to 10 or 15 mV was
applied before ATP application. ATP-evoked depolarization, after the
prepulse, was 11.3 ± 3.6 mV (n = 4). The sizes of
depolarizations under the various experimental conditions were not
significantly different. We then examined ATP-evoked depolarizations in
neurons isolated from inflamed rats. ATP evoked cell firings in all of
the TTX-sensitive inflamed neurons (Fig. 7A,
bottom). The depolarization evoked by ATP was 30.9 ± 1.4 (n = 6) with TTX and 30.8 ± 1.5 mV
(n = 6) with both TTX and the prepulse. Thus, ATP
evoked a substantially larger depolarization after inflammation (Fig.
7B).

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Figure 7.
Inflammation increases ATP-evoked depolarizations
in DRG cells. A, ATP-evoked depolarizations in
TTX-sensitive neurons. Top, In control neurons
(CON), ATP (20 µM) produced subthreshold
depolarizations in most responsive cells. In the cell shown, ATP-evoked
depolarization was 13.5 mV before TTX (2 µM) and 13.3 mV
after TTX. To inactivate TTX-resistant Na channels, a prepulse
depolarized to 15 mV for a period of 8 sec was applied before the
application of ATP. With the prepulse, ATP produced a 12.6 mV
depolarization. Resting potential was 49 mV. Bottom,
In the CFA neuron, ATP evoked an action potential that was blocked by
TTX. In the presence of TTX, ATP evoked a depolarization of 36.0 mV
without the prepulse and 36.2 mV with the prepulse. Resting potential
was 48 mV. Solid lines under current
traces indicate the period of ATP applications.
B, A bar graph summarizes the data obtained from
TTX-sensitive neurons isolated from control and CFA rats. The average
ATP-evoked depolarization was 12.4 ± 3.7 mV
(n = 4) in control and 30.8 ± 1.5 mV
(n = 6) in CFA neurons with both TTX and the
prepulse. C, ATP-evoked depolarizations in TTX-resistant
neurons. Top, In a control neuron, ATP evoked
subthreshold depolarizations of 15.2 mV before TTX and of 14.1 mV after
TTX. In the presence of TTX, the depolarized prepulse elicited an
action potential that subsided as TTX-resistant channels inactivated.
ATP after the prepulse produced a 13.5 mV depolarization. Resting
potential was 53 mV. Bottom, After inflammation, ATP
evoked an action potential that was insensitive to TTX. With the
prepulse, ATP evoked 36.9 mV depolarization in this cell. Resting
potential was 52 mV. D, The average depolarization
produced by ATP in CFA neurons (32.4 ± 1.5 mV) was significantly
larger than that produced in control neurons (15.6 ± 1.7 mV).
Data were obtained from four different neurons. *p < 0.01.
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The same experiments were repeated in TTX-resistant neurons. ATP did
not evoke cell firings in most TTX-resistant neurons isolated from
control rats (Fig. 7C, top). The average
ATP-evoked depolarization in these cells was 15.7 ± 1.6 mV
(n = 4) before TTX and 15.9 ± 1.7 mV
(n = 4) after TTX. When a depolarized prepulse was
applied to this cell group, action potentials were often evoked at the
beginning of the prepulse, even in the presence of TTX. The firing then
subsided as the TTX-resistant Na+ channels
became inactivated during the prepulse. The depolarization evoked by
ATP applied after the prepulse was 15.6 ± 1.7 mV
(n = 4). The contribution of
Na+ channel activation to ATP
depolarization was not significant. ATP invariably evoked cell firing
in responsive TTX-resistant neurons isolated from CFA-treated rats
(Fig. 7B, bottom traces). These spikes could not
be blocked by TTX but were inactivated by the depolarized prepulse. The
average ATP-induced depolarization after the depolarized prepulse was
32.4 ± 1.5 mV (n = 4), which again is much larger
than that obtained in control neurons (Fig. 7D).
We then examined threshold voltages of action potentials in both
control and inflamed neurons. The threshold voltage was 24 ± 2.4 mV (n = 9) in control neurons and 25.5 ± 1.3 mV (n = 25) in inflamed neurons. CFA treatment did
not change the threshold voltage significantly. Thus, in both
TTX-sensitive and -resistant neurons isolated from control rats,
ATP-evoked depolarizations are subthreshold. In contrast, ATP
evoked-depolarizations in both types of neurons isolated from CFA rats
are large and exceed the firing threshold of the neurons.
Enhanced P2X receptor expression
To determine whether the expression of P2X receptors indeed
increases in DRG after inflammation, Western blotting assays were performed on DRGs in control rats and in inflamed rats ipsilateral to
the CFA-injected paw. Proteins were isolated from L4-L6 DRGs of
control rats and rats treated with CFA for 5 d. After separating the proteins by electrophoresis under denaturing conditions, they were
transferred to nylon membranes and probed with anti-P2X2 and anti-P2X3.
Anti-P2X2 antibody labeled a ~64 kDa molecular weight protein, and
anti-P2X3 labeled a ~57 kDa protein. After CFA treatment, the
molecular weight of the proteins did not change. However, the level of
expression of both P2X2 and P2X3 receptors was increased significantly
(Fig. 8) (P2X2, CFA/control = 1.81; P2X3, CFA/control = 1.82). Thus, inflammation upregulates the P2X2
and P2X3 receptor expression in DRGs.

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Figure 8.
CFA treatment enhances P2X2 and P2X3 receptor
expression. A, Western blots for P2X2 and P2X3 receptors
from ganglia of control rats (CON) and rats
5 d after CFA treatment. Actin control for each sample was given.
B, Mean density relative to control rats for P2X2 and
P2X3 receptors. After inflammation, the relative density of P2X2 and
P2X3 receptors were increased by 81 and 82%, respectively
(n = 3-5 rats; *p < 0.05;
Student's t test).
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 |
DISCUSSION |
We show here that ATP responses in DRG neurons are altered by
inflammation. The most prominent change is a twofold to threefold increase in the current density of both fast and slow ATP responses (Fig. 1). Because the EC50 of the dose-response
curve for ATP does not change in inflamed neurons (Fig. 4), the
increase cannot be attributed to an increase in the affinity of ATP for
its receptors. Possible mechanisms for the potentiation of ATP currents
include an increase in single-channel conductance, enhancement of
channel opening probability, and/or upregulation of P2X receptor
expression. Although single ATP receptor channel properties in inflamed
neurons have yet to be studied, an increase in the opening probability of ATP channels is not likely because the kinetic properties of both
fast and slow ATP currents remain unchanged after CFA treatment (Table
1). Because CFA produces a significant increase in P2X2 and P2X3
proteins (Fig. 8), upregulation of P2X receptor expression is a major
cause for the large increase in ATP responses after the development of inflammation.
The current-voltage curves of both slow and fast ATP-evoked currents
show inward rectification in control and CFA-treated rats (Fig. 5). The
steepness of the rectification is similar to those reported by others
in normal rats (Krishtal et al., 1983 , 1988 ). The inward rectification
characteristics of ATP responses are thought to arise from
voltage-dependent blocking of intracellular cations (Krishtal et al.,
1988 ) and/or fast voltage-dependent gating of ATP-activated channels
(Bean, 1990 ; Bean et al., 1990 ). Our analyses of the voltage dependence
of ATP responses show that the G-V curves of both fast and
slow ATP responses shift in the hyperpolarized direction after
inflammation (Fig. 6). The mean V0.5
of fast ATP current shifts from 35.6 to 49.5 mV; the mean V0.5 of slow responses shifts from
25.4 to 43.5 mV. The mechanism underlying the shift is yet unclear.
Changes in the phosphorylating state of P2X receptors after
inflammation could be a contributing factor (Paukert et al., 2001 ). One
physiological consequence of the inward rectification of ATP currents
is regulation of action potential generation. A large inward ATP
current generated below the firing threshold (less than 25 mV) will
depolarize cells quickly and thus activate voltage-dependent ion
channels. As the membrane potential depolarizes, the inward ATP current
will get smaller. When the membrane potential becomes positive, the
outward ATP current is nearly blocked. Thus, activation of P2X
receptors will facilitate the generation of action potential without
shunting it at positive potentials. When the G-V curves of
ATP responses shift to hyperpolarized potentials after CFA treatment,
the depolarizing effects of P2X receptor activation would be dampened
because a smaller fraction of P2X receptors are activated at the
resting potential. In our case, the relative conductance
(G/Gmax) of the fast ATP
response at 50 mV is 0.59 in control cells but becomes 0.51 in CFA
neurons. A 2.9-fold increase in Gmax
after the development of inflammation would give a 2.5-fold increase in
conductance at 50 mV. Thus, despite curtailing the conductance
increase by the leftward shift of the G-V curve, the
increase in conductance in inflamed neurons is still large.
We also compared the ATP-induced depolarizations in control and CFA
neurons. To eliminate the contribution of depolarizations attributable
to activation of voltage-dependent Na channels, TTX and a depolarized
prepulse are used to block and inactivate Na channels (Ogata and
Tatebayashi, 1993 ; Rush et al., 1998 ). Under such conditions, we found
that, in contrast to ATP-induced subthreshold depolarizations in
control neurons, ATP evokes large (>30 mV) depolarizations that exceed
the action potential threshold. The suprathreshold depolarization
induced by ATP after inflammation is compelling evidence that
upregulation of P2X receptors may lead to enhanced firing activity in
inflamed neurons.
Different types of sensory neurons have been shown to process distinct
pain signals from the periphery to the spinal cord (Willis and
Coggeshall, 1991 ). High percentages of cells are found to respond to
ATP in in vitro studies of P2X receptors in
normal DRGs (Fig. 2) (Krishtal et al., 1988 ; Bean, 1990 ; Burgard et
al., 1999 ; Grubb and Evans, 1999 ). Inflammation does not change the percentage of total cells responding to ATP (control, 89.4%; CFA, 93.8%), nor does it change the percentage of cells exhibiting fast and
slow ATP currents (Fig. 2A). Because of the same
pharmacological profiles of ATP responses between control and inflamed
neurons (Fig. 3), P2X receptor phenotypes expressed in DRGs are not
altered by inflammation. Thus, the homomeric P2X3 receptors are likely to mediate the fast-inactivating ATP currents and heteromeric P2X2/3
receptors are likely to mediate the slow-inactivating ATP currents in
inflamed neurons. We and others also show that, in normal rats, the
diameters of cells responding to ATP with fast responses are in general
smaller than those of cells responding to ATP with slow responses (Fig.
2B) (Tsuda et al., 1999 , 2000 ; Ueno et al., 1999 ).
Behavioral studies suggest that fast-desensitizing ATP responses from
small capsaicin-sensitive neurons signal heat and nocifensive
behaviors, and slow-desensitizing ATP responses from medium
capsaicin-insensitive neurons signal mechanical allodynia (Tsuda et
al., 2000 ). Because the cell size distribution for fast or slow ATP
responses remains unchanged after CFA treatment (Fig. 2B), various pain signals are likely to be processed
differentially by homomeric P2X3 and heteromeric P2X2/3 receptors in
distinct populations of inflamed DRG neurons.
All of our studies were conducted in the somata of DRGs in
vitro. The roles of P2X receptors on peripheral and central
terminals in nociception are therefore inferred. Although the
percentage of cells responding to ATP in intact DRG of control rats is
much lower (Stebbing et al., 1998 ), it seems reasonable to assume that upregulation of P2X receptors in the soma would lead to an increase in
P2X receptor expression at both terminals. Activation of P2X receptors
at central terminals has been shown to enhance the release of glutamate
at synapses in the spinal cord (Li and Perl, 1995 ; Labrakakis et al.,
2000 ; Nakatsuka and Gu, 2001 ). The proposed mechanisms underlying the
synaptic action of P2X receptor include Ca2+ influx through activated P2X
receptors (Robertson et al., 2001 ) and activation of voltage-dependent
Ca2+channels activated by P2X
receptor-evoked action potentials (Cook and McCleskey, 1997 ; Gu and
MacDermott, 1997 ). Our results suggest that ATP-evoked action potential
generation is not likely to occur in control neurons. However, it may
underlie the action of P2X receptors in inflamed neurons (Fig. 7). In
addition to activation of P2X receptors, ATP is rapidly metabolized to
adenosine during its release (Li and Perl, 1995 ; Nakatsuka and Gu,
2001 ; Robertson et al., 2001 ). Subsequent activation of A1 receptors by
adenosine is found to inhibit the release of glutamate from central
terminals of DRG neurons (Li and Perl, 1994 ). Therefore, P2X and
adenosine receptors exert opposite effects at glutamatergic synapses in the spinal dorsal horn. An increase in P2X receptor expression at
central terminals in the inflammatory state would increase the
influence of P2X receptor-mediated responses, thus potentiating the
synaptic transmission in the dorsal horn. This possibility is
consistent with the observation that intrathecally applied P2X receptor
antagonists become more effective in blocking C-fiber-evoked responses
in dorsal horn neurons after inflammation (Stanfa et al., 2000 ).
Peripheral P2X receptors at peripheral terminals are known to
participate in the transmission of nociceptive and non-nociceptive responses (Cockayne et al., 2000 ; Hamilton and McMahon, 2000 ; Hamilton
et al., 2000 , 2001 ; Souslova et al., 2000 ; Tsuda et al., 2000 ). An
increased ATP-evoked depolarization as the result of enhanced P2X
receptor expression at peripheral terminals could result in
sensitization in sensory afferents. This possibility is consistent with
the recent studies of pain behaviors in rats. The concentrations of ATP
and  meATP used in the behavioral studies in normal rats are 100
nmol, a range that is too high to be attained endogenously (Hamilton et
al., 1999 ; Tsuda et al., 2000 ). After inflammation, ATP concentrations
required to elicit pain behaviors are reduced 100-fold (Hamilton et
al., 1999 ). The proposed mechanisms for the increase in the ATP
effectiveness in nociceptive signaling include large leakage of ATP
from injured cells, sensitization of P2X receptors elicited by enhanced
release of neuropeptides or H+ from
inflamed tissue, and changes in the second-messenger levels (Hamilton
et al., 1999 , 2001 ; Paukert et al., 2001 ). Although these possibilities
cannot be dismissed, our results suggest that upregulation of P2X
receptors and enhanced ATP responses are the primary reasons for
increased behavioral sensitivity in the inflammatory state. With a
twofold to threefold increase in ATP responses after inflammation, a
small amount of ATP release would evoke depolarizations large enough to
elicit action potentials in DRG neurons (Fig. 7). It is therefore
conceivable that endogenous ATP release does not produce pain in normal
rats. The same ATP release after inflammation, however, will sensitize
neurons and produce abnormal nociceptive responses. Therefore, the
profound changes in P2X3 and P2X2/3 receptor expression and in ATP
responses observed here may be critical for the induction of pain
hypersensitivity after the development of inflammation.
 |
FOOTNOTES |
Received May 22, 2001; revised Sept. 18, 2001; accepted Oct. 16, 2001.
This work was supported by National Institutes of Health Grant NS 30045 (to L.-Y.M.H.). We thank Dr. C. Wang for advice on Western blotting
analyses, Drs. Y. Gu and R. Coggeshall for comments on this manuscript,
and S. Y. Wong for technical assistance.
Correspondence should be addressed to Dr. Li-Yen Mae Huang, Marine
Biomedical Institute, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1069. E-mail:
lmhuang{at}utmb.edu.
 |
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