Chronic blockade of sciatic nerve transmission by tetrodotoxin does not produce central changes in the dorsal horn of the spinal cord of the rat

Activity-dependent modulation of glutamatergic signaling in the developing rat dorsal horn by early tissue injury

Tissue injury in early life can produce distinctive effects on pain processing, but little is known about the underlying neural mechanisms. Neonatal inflammation modulates excitatory synapses in spinal nociceptive circuits, but it is unclear whether this results directly from altered afferent input. Here we investigate excitatory and inhibitory synaptic transmission in the rat superficial dorsal horn following neonatal hindlimb surgical incision using in vitro patch-clamp recordings and test the effect of blocking peripheral nerve activity on the injury-evoked changes. Surgical incision through the skin and muscle of the hindlimb at postnatal day 3 (P3) or P10 selectively increased the frequency, but not amplitude, of glutamatergic miniature excitatory postsynaptic currents (mEPSCs) recorded 2-3 days after injury, without altering miniature inhibitory postsynaptic current frequency or amplitude at this time point. Meanwhile, incision at P17 failed to affect excitatory or inhibitory synaptic function at 2-3 days postinjury. The elevated mEPSC frequency was accompanied by increased inward rectification of evoked alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR)-mediated currents, but no change in AMPAR/N-methyl-D-aspartate receptor ratios, and was followed by a persistent reduction in mEPSC frequency by 9-10 days postinjury. Prolonged blockade of primary afferent input from the time of injury was achieved by administration of bupivacaine hydroxide or tetrodotoxin to the sciatic nerve at P3. The increase in mEPSC frequency evoked by P3 incision was prevented by blocking sciatic nerve activity. These results demonstrate that increased afferent input associated with peripheral tissue injury selectively modulates excitatory synaptic drive onto developing spinal sensory neurons and that the enhanced glutamatergic signaling in the dorsal horn following neonatal surgical incision is activity dependent.

If substance P fails to fulfil the criteria as a neurotransmitter in somatosensory afferents, what might be its function?

In the first part of this paper, a series of examples are described where substance P content of afferent C fibres and responses which have been attributed to C fibre excitation vary independently. Thirteen sets of data fail to support the proposal that SP is an excitatory transmitter for noxious inputs. In the second part an alternative hypothesis is proposed in which C fibres would have functions in addition to impulse propagation. It is shown that C fibres are involved in establishing and maintaining the connection between afferent fibres and central cells and that transport mechanisms play a role in this connectivity control. Therefore it is proposed that the chemicals in C fibres should be examined for their possible action on regulatory mechanisms as well as for neurotransmitter action.

A microcapsule technique for long-term conduction block of the sciatic nerve by tetrodotoxin

Tetrodotoxin (TTX) is a selective blocker of voltage-gated Na+ channels that is used to block action potentials in vitro and in vivo. Maintaining a sufficiently high local concentration of TTX in vivo to block conduction in a peripheral nerve is technically demanding and carries a risk of systemic toxicity. We report that slow diffusion of TTX out of a microcapsule (glass capillary) inserted beneath the epineurium of the sciatic nerve, with a loose cuff around the nerve, combines high blocking efficacy with low systemic toxicity in rats and mice. The local anaesthesia and motor paralysis was stable for at least 4-6 weeks. The conduction block was reversible and did not cause any obvious nerve injury. Low cost and simple surgical implementation make this new system an interesting alternative to existing long-term drug delivery methods.

Dorsal Horn Plasticity Following Re-routeing of Peripheral Nerves: Evidence for Tissue-Specific Neurotrophic Influences from the Periphery

Some properties of primary sensory neurons change when they reinnervate new peripheral targets (McMahon et al., Neuroscience, 33, 67 - 75, 1989). We ask here if such influences can extend to the central connectivity of sensory neurons. In adult rats the nerve to the gastrocnemius muscle (GN) and the cutaneous sural nerve (SN) were self- and cross-anastomosed on left- and right-hand sides, respectively, so that they regenerated to either appropriate or inappropriate targets. Ten to 14 weeks later, the distribution and strength of spinal connections of the SN and GN were determined. The unmyelinated afferents in the GN innervating skin increased their connectivity to 286% of that seen for the GN innervating muscle (P < 0.005), and came to resemble normal cutaneous afferents. However, for the SN there was no significant difference between appropriately and inappropriately regenerated nerves by this measure. The ability of myelinated fibres to produce inhibitions and facilitations in dorsal horn cells was also assessed. The intact or self-anastomosed SN produced predominantly inhibitory effects, whilst the GN produced predominantly facilitatory effects. After the SN had regenerated to muscle its central effects became predominantly facilitatory, whilst those of the GN innervating skin became inhibitory. These changes were statistically significant. In conclusion, we have found that major changes in the physiology of central connections in the dorsal horn may occur following peripheral reinnervation of foreign targets. The changes that were seen were appropriate to the new target, and could not easily be explained by non-specific changes due to axotomy, or changes in A-fibre-mediated inhibitions. We suggest that these effects might arise because of trophic influences arising in and specific to different peripheral targets.

Regulation of afferent connectivity in the adult spinal cord by nerve growth factor

During development, nerve growth factor (NGF) regulates the density and character of peripheral target innervation (Barde, Neuron, 2, 1525 - 1534, 1989; Ritter et al., Soc. Neurosci. Abstr., 17, 546.2, 1991); its role in adult animals is less well defined. Here we have asked if the availability of growth factors such as NGF in peripheral tissues can influence the pattern of primary afferent connections in the CNS. Using osmotic minipumps, we raised the levels of NGF in rat skeletal muscle in vivo, a tissue where the levels of this factor are normally very low (Korsching and Thoenen, Proc. Natl. Acad. Sci. USA, 80, 3513 - 3516, 1983; Shelton and Reichardt, Proc. Natl. Acad. Sci. USA, 81, 7951 - 7955, 1984; Goedert et al., Mol. Brain Res., 1, 85 - 92, 1986). After 2 weeks of treatment we asked if the sensory neurons innervating this tissue showed an altered strength and distribution of connections with dorsal horn neurons. The contralateral (vehicle-treated) muscle, and totally untreated animals, served as controls. In normal and vehicle-treated animals, electrical stimulation of muscle afferents excited relatively few neurons in the dorsal horn, and these generally showed only weak responses. In contrast, on the NGF-treated side many more dorsal horn neurons in the lumbar enlargement of the spinal cord were excited by muscle afferents. The increased responsiveness could not be explained by a generalized increase in dorsal horn excitability, since spontaneous activity was not enhanced, nor by a change in A-fibre-mediated inhibitions from the treated afferents. Thus, these afferents appeared to establish new synaptic connections or strengthened previously weak ones as a result of increased neurotrophic factor availability. The data suggest that, in the adult rat, the levels of growth factors in peripheral targets may be used to regulate an appropriate degree of afferent connectivity within the central nervous system.

Does the right side know what the left is doing?

Following peripheral-nerve lesions there are well-documented events that affect the contralateral nonlesioned structures. These contralateral effects are qualitatively similar to those occurring at the ipsilateral side, but are usually smaller in magnitude and have a briefer time course. It is unclear whether the findings are an epiphenomenon or serve a biological purpose, but in either case the existence of these effects implies the presence of unrecognized signalling mechanisms that link the two sides of the body. Strong circumstantial evidence argues against a peripheral mechanism (for example, via circulating factors) and in favour of a central mechanism, in particular signalling via the system of commissural interneurons that is present in spinal cord and brainstem. While an altered pattern of activity in this system might underlie the phenomenon, there are several reasons for proposing that the changes depend upon chemical signals, possibly growth factors. Because of its relative easy access for experimental manipulation, the spinal cord could serve as a model system to study these transmedian signalling systems.

Interleukin-1 beta induces long-term increase of axonally transported opiate receptors and substance P

Interleukin-1 is known to exert pleiotropic effects in host defence mechanisms and in inflammation. Chronic pain, inflammation and interleukin-1 beta enhance the production of substance P. Recently, axonal transport of opiate receptors was found to increase in rat sciatic nerves in the model of Freund's adjuvant-induced arthritis. Here we show that a single intraplantar injection of interleukin-1 beta is able to enhance the axonal transport of mu and kappa opiate receptors and substance P. Indeed, their accumulation was markedly increased in the proximal part of ligated sciatic nerves, but only in the paw injected with interleukin-1. The time course revealed a delayed onset and, more importantly, a long-term increase lasting at least six days, which is in contrast with the short-term pyrogenic effect of interleukin-1. Pretreatment of rats with capsaicin or administration of dexamethasone completely prevented the interleukin-1 beta effect. The present results suggest that interleukin-1 beta may serve as a mediator to sensitize nociceptors in chronic inflammation and possibly in hyperalgesia through long-term changes in neuronal plasticity.

A surgically implantable nerve irrigation system for intermittent delivery of dissolved drugs: evaluation of long-term performance and histocompatibility in rats

A surgically implantable system designed to facilitate intermittent delivery of solutions of local anesthetic or other pharmacologically active substances to a segment of peripheral nerve was developed and its long-term performance and histocompatibility were tested in rats. Twenty-two systems, each comprising a subcutaneous injection port, a silicone conduit, and a membranous perineural sheath, were implanted in 20 animals. Of the systems, 12 could be used to perform repeated local anesthetic nerve blocks for periods lasting from several weeks to as long as 13 months. The system is suitable for use in studies of peripheral nerve pharmacology and, with improvements, could find clinical use in the management of peripheral neuralgia.

Quantitative analysis of peptide levels and neurogenic extravasation following regeneration of afferents to appropriate and inappropriate targets

We have studied quantitatively the levels of substance P and calcitonin gene-related peptide in nerves innervating skin and muscle of rats, and examined the effects of cross-anastomosing these nerves so that they regenerate to an inappropriate target. We have also compared the ability of nerves to induce neurogenic extravasation with their peptide content. Peptide was measured by radioimmunoassay in the proximal section of ligated peripheral nerves, and neurogenic oedema was measured by determination of Evans Blue extravasation induced by either systemic capsaicin treatment or topical mustard oil application. The levels of these peptides are higher in cutaneous nerves than muscle nerves. This cannot be explained by differences in the number of fibres in the nerves studied. The levels of peptides fall when cutaneous afferents reinnervate muscle, and rise when muscle afferents reinnervate skin. We suggest that these changes occur because of some tissue-specific trophic influence arising from the tissue innervated. The ability to produce extravasation in skin is highly correlated with the substance P and calcitonin gene-related peptide levels of its innervation, even when this occurs in inappropriate nerves which do not normally produce extravasation.

Plasticity of primary afferent acid phosphatase expression following rerouting of afferents from muscle to skin in the adult rat

We have examined the possibility that reinnervation of a new peripheral target by primary afferent neurones can alter the histochemical properties of those afferents in the adult rat. The hindlimb sural and gastrocnemius nerves largely supply skin and muscle, respectively. In adult animals these nerves were cut and rejoined to either their own distal stumps (self-anastomosis) or that of the other nerve (cross-anastomosis) and allowed to regenerate for 12-16 weeks to reinnervate an appropriate or inappropriate target. Fluoride-resistant acid phosphatase (FRAP) is a chemical marker found in many unmyelinated afferents. We have determined the FRAP expression in normal and regrown nerves and examined its distribution in the dorsal horn of animals with self- and cross-anastomosed nerves. While normal and self-anastomosed sural nerves stained heavily for FRAP, gastrocnemius nerves showed either no staining or only the occasional fibre. Cross-anastomosed gastrocnemius nerves, now innervating the skin, showed a significant increase in staining, in some cases approaching the levels normally seen in sural nerves. Conversely, cross-anastomosed sural nerves (innervating muscle) showed decreased FRAP staining. In the normal dorsal horn the terminals of FRAP containing afferents form a thin band extending throughout the mediolateral extent of lamina II (Devor and Claman: Brain Res. 190:17-28, '80). One week after axotomy of the sural nerve, FRAP is depleted from its terminals and a gap appears in the normal FRAP staining pattern in the lumbar enlargement of the spinal cord. The new expression of FRAP in cross-anastomosed nerves was also seen in their terminals in the dorsal horn.(ABSTRACT TRUNCATED AT 250 WORDS)

Regulatory mechanisms for substance P in the dorsal horn during a nociceptive stimulus: axoplasmic transport vs electrical activity

Substance P (SP) is believed to be a neuromediator of nociception in the dorsal horn of the spinal cord. SP precursor is synthesized in the dorsal root ganglia (DRG) and transported via axoplasmic transport to the nerve terminal where it is stored and released as SP. The chemical nociceptive stimulus, formalin, when injected into the hindpaw causes an increase in the level of SP in the dorsal horn. This increase in SP may be the result of increased electrical activity due to activation of free nerve endings or the transport of some chemical or trophic signal to the DRG or to the central terminal. This study investigates the mechanism of the SP increase during the formalin stimulus. Rats were anesthetized and a laminectomy performed. In some experiments the sciatic nerve was exposed. Agar gel pads containing either colchicine or tetrodotoxin (TTX) were applied to the dorsal root or sciatic nerve prior to the injection of 5% formalin or saline into the hindpaw. Electrical activity across the dorsal root distal to the gel pad was monitored to determine the effects of colchicine and TTX on the nerve. Sixty min after the injection into the hindpaw, the animal was perfused and the lumbar spinal cord removed. Ten-micron frozen sections were stained for SP. It was found that the formalin-evoked increase in SP could be partially blocked by either colchicine or TTX applied to the dorsal root and completely blocked by the application of both agents together. TTX or colchicine applied to the sciatic nerve completely blocked the formalin-evoked increase in SP.(ABSTRACT TRUNCATED AT 250 WORDS)