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Bouchatta O, Brodzki M, Manouze H, Carballo GB, Kindström E, de-Faria FM, Yu H, Kao AR, Thorell O, Liljencrantz J, Ng KKW, Frangos E, Ragnemalm B, Saade D, Bharucha-Goebel D, Szczot I, Moore W, Terejko K, Cole J, Bonnemann C, Luo W, Mahns DA, Larsson M, Gerling GJ, Marshall AG, Chesler AT, Olausson H, Nagi SS, Szczot M. PIEZO2-dependent rapid pain system in humans and mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.01.569650. [PMID: 38168273 PMCID: PMC10760115 DOI: 10.1101/2023.12.01.569650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The PIEZO2 ion channel is critical for transducing light touch into neural signals but is not considered necessary for transducing acute pain in humans. Here, we discovered an exception - a form of mechanical pain evoked by hair pulling. Based on observations in a rare group of individuals with PIEZO2 deficiency syndrome, we demonstrated that hair-pull pain is dependent on PIEZO2 transduction. Studies in control participants showed that hair-pull pain triggered a distinct nocifensive response, including a nociceptive reflex. Observations in rare Aβ deafferented individuals and nerve conduction block studies in control participants revealed that hair-pull pain perception is dependent on Aβ input. Single-unit axonal recordings revealed that a class of cooling-responsive myelinated nociceptors in human skin is selectively tuned to painful hair-pull stimuli. Further, we pharmacologically mapped these nociceptors to a specific transcriptomic class. Finally, using functional imaging in mice, we demonstrated that in a homologous nociceptor, Piezo2 is necessary for high-sensitivity, robust activation by hair-pull stimuli. Together, we have demonstrated that hair-pulling evokes a distinct type of pain with conserved behavioral, neural, and molecular features across humans and mice.
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Affiliation(s)
- Otmane Bouchatta
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- These authors contributed equally
| | - Marek Brodzki
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- These authors contributed equally
| | - Houria Manouze
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Gabriela B. Carballo
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Emma Kindström
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Felipe M. de-Faria
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Huasheng Yu
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Anika R. Kao
- School of Engineering and Applied Science, University of Virginia, Charlottesville, USA
| | - Oumie Thorell
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Jaquette Liljencrantz
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, USA
- Department of Anesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kevin K. W. Ng
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Eleni Frangos
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, USA
| | - Bengt Ragnemalm
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Dimah Saade
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, USA
| | - Diana Bharucha-Goebel
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, USA
| | - Ilona Szczot
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Warren Moore
- Institute of Life Course and Medical Sciences, University of Liverpool, UK
| | - Katarzyna Terejko
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- Biology of Astrocytes Research Group, Łukasiewicz Research Network - PORT Polish Center for Technology Development, Wroclaw, Poland
| | - Jonathan Cole
- University Hospitals, Dorset, and University of Bournemouth, UK
| | - Carsten Bonnemann
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, USA
| | - Wenquin Luo
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - David A. Mahns
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Max Larsson
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Gregory J. Gerling
- School of Engineering and Applied Science, University of Virginia, Charlottesville, USA
| | - Andrew G. Marshall
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- Institute of Life Course and Medical Sciences, University of Liverpool, UK
| | - Alexander T. Chesler
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, USA
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, USA
| | - Håkan Olausson
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Saad S. Nagi
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- School of Medicine, Western Sydney University, Sydney, Australia
- Senior author
| | - Marcin Szczot
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- Senior author
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Roza C, Bernal L. Electrophysiological characterization of ectopic spontaneous discharge in axotomized and intact fibers upon nerve transection: a role in spontaneous pain? Pflugers Arch 2022; 474:387-396. [PMID: 35088129 DOI: 10.1007/s00424-021-02655-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/14/2022]
Abstract
Many patients experience positive symptoms after traumatic nerve injury. Despite the increasing number of experimental studies in models of peripheral neuropathy and the knowledge acquired, most of these patients lack an effective treatment for their chronic pain. One possible explanation might be that most of the preclinical studies focused on the development of mechanical or thermal allodynia/hyperalgesia, neglecting that most of the patients with peripheral neuropathies complain mostly about spontaneous forms of pains. Here, we summarize the aberrant electrophysiological behavior of peripheral nerve fibers recorded in experimental models, the underlying pathophysiological mechanisms, and their relationship with the symptoms reported by patients. Upon nerve section, axotomized but also intact fibers develop ectopic spontaneous activity. Most interestingly, a proportion of axotomized fibers might present receptive fields in the skin far beyond the site of damage, indicative of a functional cross talk between neuromatose and intact fibers. All these features can be linked with some of the symptoms that neuropathic patients experience. Furthermore, we spotlight the consequence of primary afferents with different patterns of spontaneous discharge on the neural code and its relationship with chronic pain states. With this article, readers will be able to understand the pathophysiological mechanisms that might underlie some of the symptoms that experience neuropathic patients, with a special focus on spontaneous pain.
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Affiliation(s)
- Carolina Roza
- Dpto. Biología de Sistemas, Edificio de Medicina Universidad de Alcalá, 28871, Alcalá de Henares, Madrid, Spain.
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Lysophosphatidic acid activates nociceptors and causes pain or itch depending on the application mode in human skin. Pain 2021; 163:445-460. [PMID: 34166323 DOI: 10.1097/j.pain.0000000000002363] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/13/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Lysophosphatidic acid (LPA) is involved in the pathophysiology of cholestatic pruritus and neuropathic pain. Slowly conducting peripheral afferent C-nerve fibers are crucial in the sensations of itch and pain. In animal studies, specialized neurons ("pruriceptors") have been described, expressing specific receptors e.g. from the Mrgpr family. Human nerve fibers involved in pain signaling ("nociceptors") can elicit itch if activated by focalized stimuli such as cowhage spicules.In this study, we scrutinized the effects of LPA in humans by two different application modes on the level of psychophysics and single nerve fiber recordings (microneurography). In healthy human subjects, intracutaneous LPA microinjections elicited burning pain, whereas LPA application via inactivated cowhage spicules evoked a moderate itch sensation. LPA microinjections induced heat hyperalgesia and hypersensitivity to higher electrical stimulus frequencies. Pharmacological blockade of TRPA1 or TRPV1 reduced heat hyperalgesia but not acute chemical pain. Microneurography revealed an application mode-dependent differential activation of mechano-sensitive (CM) and mechano-insensitive (CMi) C-fibers. LPA microinjections activated a greater proportion of CMi and more strongly than CM fibers; spicule-application of LPA activated CM and CMi fibers to a similar extent but excited CM more and CMi fibers less intensely than microinjections.In conclusion, we show for the first time in humans that LPA can cause pain as well as itch dependent on the mode of application and activates afferent human C-fibers. Itch may arise from focal activation of few nerve fibers with distinct spatial contrast to unexcited surrounding afferents, and a specific combination of activated fiber subclasses might contribute.
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"Shooting pain" in lumbar radiculopathy and trigeminal neuralgia, and ideas concerning its neural substrates. Pain 2021; 161:308-318. [PMID: 31651576 DOI: 10.1097/j.pain.0000000000001729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patients with radicular low back pain (radicular LBP, sciatica) frequently describe their pain as "shooting" or "radiating." The dictionary meaning of these words implies rapid movement, and indeed, many sufferers report feeling pain moving rapidly from the lower back or buttock into the leg. But, others do not. Moreover, the sensation of movement is paradoxical; it is neither predicted nor accounted for by current ideas about the pathophysiology of radicular LBP. We have used a structured questionnaire to evaluate the sensory qualities associated with "shooting" and "radiating" in 155 patients, 98 with radicular LBP and 57 with trigeminal neuralgia, a second chronic pain condition in which shooting/radiating are experienced. Results indicated a spectrum of different sensations in different people. Although many sciatica patients reported rapid downward movement of their pain, even more reported downward expansion of the area of pain, some reported upward movement, and for some, there was no spatial dynamic at all. The velocity of movement or expansion was also variable. By cross-referencing sensations experienced in the sciatica and trigeminal neuralgia cohorts with known signal processing modes in the somatosensory system, we propose testable hypotheses concerning the pathophysiology of the various vectorial sensations reported, their direction and velocity, and the structures in which they are generated. Systematic evaluation of qualitative features of "shooting" and "radiating" pain at the time of diagnosis can shed light on the pain mechanism in the individual patient and perhaps contribute to a better therapeutic outcomes.
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Abstract
The endogenous metabolite methylglyoxal (MG) accumulates in diabetic patients with neuropathic pain. Methylglyoxal could be a mediator of diabetes-induced neuropathic pain through TRPA1 activation and sensitization of the voltage-gated sodium channel subtype 1.8. In this study, we tested the algogenic and sensitizing effect of MG in healthy human subjects using intracutaneous microinjections. The involvement of C fibers was assessed through selective A-fiber nerve block, axon-reflex-erythema, and through single nerve fiber recordings in humans (microneurography). Involvement of the transduction channels TRPA1 and TRPV1 in MG-induced pain sensation was investigated with specific ion channel blockers. We showed for the first time in healthy humans that MG induces pain, axon-reflex-erythema, and long-lasting hyperalgesia through the activation of C nociceptors. Predominantly, the subclass of mechano-insensitive C fibers is activated by MG. A fibers contribute only negligibly to the burning pain sensation. Selective pharmacological blockade of TRPA1 or TRPV1 showed that TRPA1 is crucially involved in MG-induced chemical pain sensation and heat hyperalgesia. In conclusion, the actions of MG through TRPA1 activation on predominantly mechano-insensitive C fibers might be involved in spontaneously perceived pain in diabetic neuropathy and hyperalgesia as well as allodynia.
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Chen L, Ilham SJ, Guo T, Emadi S, Feng B. In vitro multichannel single-unit recordings of action potentials from mouse sciatic nerve. Biomed Phys Eng Express 2017; 3:045020. [PMID: 29568573 PMCID: PMC5858727 DOI: 10.1088/2057-1976/aa7efa] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Electrode arrays interfacing with peripheral nerves are essential for neuromodulation devices targeting peripheral organs to relieve symptoms. To modulate (i.e., single-unit recording and stimulating) individual peripheral nerve axons remains a technical challenge. Here, we report an in vitro setup to allow simultaneous single-unit recordings from multiple mouse sciatic nerve axons. The sciatic nerve (~30 mm) was harvested and transferred to a tissue chamber, the ~5mm distal end pulled into an adjacent recording chamber filled with paraffin oil. A custom-built multi-wire electrode array was used to interface with split fine nerve filaments. Single-unit action potentials were evoked by electrical stimulation and recorded from 186 axons, of which 49.5% were classed A-type with conduction velocities (CV) greater than 1 m/s and 50.5% were C-type (CV < 1 m/s). The single-unit recordings had no apparent bias towards A- or C-type axons, were robust and repeatable for over 60 minutes, and thus an ideal opportunity to assess different neuromodulation strategies targeting peripheral nerves. For instance, ultrasonic modulation of action potential transmission was assessed using the setup, indicating increased nerve conduction velocity following ultrasound stimulus. This setup can also be used to objectively assess the design of next-generation electrode arrays interfacing with peripheral nerves.
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Affiliation(s)
- L Chen
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - S J Ilham
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - T Guo
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - S Emadi
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - B Feng
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
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Kleggetveit IP, Schmidt R, Namer B, Salter H, Helås T, Schmelz M, Jørum E. Pathological nociceptors in two patients with erythromelalgia-like symptoms and rare genetic Nav 1.9 variants. Brain Behav 2016; 6:e00528. [PMID: 27781142 PMCID: PMC5064340 DOI: 10.1002/brb3.528] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION The sodium channel Nav 1.9 is expressed in peripheral nociceptors and has recently been linked to human pain conditions, but the exact role of Nav 1.9 for human nociceptor excitability is still unclear. METHODS C-nociceptors from two patients with late onset of erythromelalgia-like pain, signs of small fiber neuropathy, and rare genetic variants of Nav 1.9 (N1169S, I1293V) were assessed by microneurography. RESULTS Compared with patients with comparable pain phenotypes (erythromelalgia-like pain without Nav-mutations and painful polyneuropathy), there was a tendency toward more activity-dependent slowing of conduction velocity in mechanoinsensitive C-nociceptors. Hyperexcitability to heating and electrical stimulation were seen in some nociceptors, and other unspecific signs of increased excitability, including spontaneous activity and mechanical sensitization, were also observed. CONCLUSIONS Although the functional roles of these genetic variants are still unknown, the microneurography findings may be compatible with increased C-nociceptor excitability based on increased Nav 1.9 function.
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Affiliation(s)
- Inge P. Kleggetveit
- Section of Clinical NeurophysiologyDepartment of NeurologyOslo University Hospital‐RikshospitaletOsloNorway
| | - Roland Schmidt
- Department of Clinical NeurophysiologyUppsala UniversityUppsalaSweden
| | - Barbara Namer
- Institute of Physiology and PathophysiologyFriedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Hugh Salter
- AstraZeneca Translational Science CentreDepartment of Clinical NeuroscienceKarolinska InstitutetSolnaSweden
| | - Tormod Helås
- Section of Clinical NeurophysiologyDepartment of NeurologyOslo University Hospital‐RikshospitaletOsloNorway
| | - Martin Schmelz
- Department of Anesthesiology MannheimHeidelberg UniversityMannheimGermany
| | - Ellen Jørum
- Section of Clinical NeurophysiologyDepartment of NeurologyOslo University Hospital‐RikshospitaletOsloNorway
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Ørstavik K, Kleggetveit IP, Jørum E. [Microneurography and research on peripheral neuropathic pain]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2013; 133:302-5. [PMID: 23381167 DOI: 10.4045/tidsskr.12.0098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Microneurography is a neurophysiological technique which enables recording from single peripheral nerve fibres in persons who are awake. The method is only used in research. We discuss how microneurography has been used to map nerve-fibre functions under normal circumstances and in chronic pain conditions. METHOD The article is based on a literature search in PubMed and on the authors' own knowledge and experience of the method from their research. RESULTS Microneurography has contributed to the understanding of pain under physiological conditions and in chronic pain conditions, in particular peripheral neuropathic pain. For example, signs of hyperexcitability have been found in peripheral nerve fibres in connection with neuropathies and peripheral neuropathic pain conditions, and the proportion of hyperexcitable nerve fibres has been shown to be greater in neuropathy patients with chronic pain than in neuropathy patients without pain. Findings indicate that so-called CMi nociceptors play an important role in chronic neuropathic pain. INTERPRETATION In the longer term we hope that research using microneurography will help to reveal mechanisms of direct importance for the development of targeted treatment of neuropathic pain.
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Affiliation(s)
- Kristin Ørstavik
- Nevrologisk avdeling, Klinisk nevrofysiologisk seksjon, Oslo Universitetssykehus, Rikshospitalet, Norway.
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Change in prostaglandin expression levels and synthesizing activities in dry eye disease. Ophthalmology 2012; 119:2211-9. [PMID: 22858125 DOI: 10.1016/j.ophtha.2012.05.038] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 05/23/2012] [Accepted: 05/23/2012] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate the expression level of prostaglandins (PGs) and their de novo synthesis in dry eye (DE) disease. DESIGN Cross-sectional case-control study and in vivo mouse experimental study. PARTICIPANTS Forty-six eyes from 23 DE patients and 33 eyes from 17 age- and sex-matched controls were studied. Also, DE-induced murine eyes were compared with control eyes. METHODS Patients completed a symptom questionnaire using a 100-mm visual analog scale (VAS). Nano-liquid chromatography tandem mass spectrometry was used for the quantification of PGE2 and PGD2. A DE disease environmental chamber was used to induce DE in mice. One week after induction, enzyme expressions of cyclooxygenase-1, cyclooxygenase-2 (COX-2), PG E synthase (PGES), and PG D synthase (PGDS) in the lacrimal glands, meibomian glands, and corneas were examined using immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR). MAIN OUTCOME MEASURES The mean PGE2 and PGD2 levels in the tears of DE patients were measured and compared with symptom severity scores. Immunohistochemistry staining patterns and qRT-PCR data of DE mice were quantified. RESULTS The mean PGE2 level in the tears of DE patients (2.72 ±3 .42 ng/ml) was significantly higher than that in the control group (0.88 ± 0.83 ng/ml; P = 0.003). However, the mean PGD2 level in the tears of DE patients (0.11 ± 0.22 ng/ml) was significantly lower (0.91 ± 3.28 ng/ml; P = 0.028). The mean PGE2-to-PGD2 ratio correlated strongly with VAS scoring (P = 0.008). In DE mice, COX-2 mRNA was significantly higher in ocular surface tissue and lacrimal glands. Furthermore, PGES mRNA was significantly higher in ocular surface tissue, whereas PGDS mRNA was decreased. Immunohistochemistry staining showed elevated COX-2 expression in the lacrimal glands, meibomian glands, corneas, and conjunctivas. Furthermore, PGES expression was found in periductal infiltrated cells of the lacrimal glands and conjunctival epithelium. Also, PGDS expression was decreased in meibomian glands and increased focally in the conjunctival epithelium. CONCLUSIONS A reciprocal change in PGE2 and PGD2 levels was found in the tears of DE patients, which correlated with patients' symptom scores. These clinical results were supported by increased COX-2 and PGES expression levels found in tear-producing tissues of DE mice.
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