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Ma LT, Bai Y, Cao P, Ren KX, Chen J, Zhang T, Fan BY, Qiao Y, Yan HY, Wang JJ, Li YQ, Zheng J. The analgesic effects of β-elemene in rats with neuropathic pain by inhibition of spinal astrocytic ERK activation. Mol Pain 2022; 18:17448069221121562. [PMID: 35976914 PMCID: PMC9393702 DOI: 10.1177/17448069221121562] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Neuropathic pain takes a heavy toll on individual well-being, while current therapy is far from desirable. Herein, we assessed the analgesic effect of β-elemene, a chief component in the traditional Chinese medicine Curcuma wenyujin, and explored the underlying mechanisms at the level of spinal dorsal horn (SDH) under neuropathic pain. A spared nerve injury (SNI)-induced neuropathic pain model was established in rats. Intraperitoneal injection (i.p.) of β-elemene was administered for 21 consecutive days. Mechanical allodynia was explored by von Frey filaments. The activation of the mitogen-activated protein kinase (MAPK) family (including ERK, p38, and JNK) in spinal neurons, astrocytes, and microglia was evaluated using immunostaining 29 days after SNI surgery. The expression of GFAP, Iba-1, p-ERK, p-JNK, and p-p38 within the SDH was measured using immunoblotting. The levels of proinflammatory cytokines (including TNF-α, IL-1β, and IL-6) were measured with ELISA. The levels of oxidative stress indicators (including MDA, SOD, and GSH-PX) were detected using biochemical tests. Consecutive i.p. administration of β-elemene relieved SNI-induced mechanical allodynia (with an EC50 of 16.40 mg/kg). SNI significantly increased the expression of p-ERK in spinal astrocytes but not microglia on day 29. β-elemene reversed spinal astrocytic ERK activation and subsequent upregulation of proinflammatory cytokines in SNI rats, with no effect on the expression of p38 and JNK in spinal glia. β-elemene also exerted antioxidative effects by increasing the levels of SOD and GSH-PX and decreasing the level of MDA. Our results suggest that SNI induces robust astrocytic ERK activation within the SDH in the late phase of neuropathic pain. β-elemene exerts remarkable analgesic effects on neuropathic pain, possibly by inhibiting spinal astrocytic ERK activation and subsequent neuroinflammatory processes. Our findings suggest that β-elemene might be a promising analgesic for the treatment of chronic pain.
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Affiliation(s)
- Li-Tian Ma
- Department of Traditional Chinese Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, China.,Department of Gastroenterology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Yang Bai
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Peng Cao
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Kai-Xi Ren
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Jing Chen
- Department of Anatomy, Histology and Embryology, Preclinical School of Medicine, Air Force Medical University, Xi'an, China
| | - Ting Zhang
- Department of Anatomy, Histology and Embryology, Preclinical School of Medicine, Air Force Medical University, Xi'an, China
| | - Bo-Yuan Fan
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University, Xi'an, China
| | - Yu Qiao
- Laser Medical Center, Hainan Hospital, PLA General Hospital, Sanya, China
| | - Hong-Yu Yan
- 36674The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jing-Jie Wang
- Department of Gastroenterology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Yun-Qing Li
- Department of Anatomy, Histology and Embryology, Preclinical School of Medicine, Air Force Medical University, Xi'an, China.,Department of Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China.,Department of Anatomy, College of Basic Medicine, Dali University, Dali, China
| | - Jin Zheng
- Department of Traditional Chinese Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, China
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Ren D, Li JN, Qiu XT, Wan FP, Wu ZY, Fan BY, Zhang MM, Chen T, Li H, Bai Y, Li YQ. Anterior Cingulate Cortex Mediates Hyperalgesia and Anxiety Induced by Chronic Pancreatitis in Rats. Neurosci Bull 2021; 38:342-358. [PMID: 34907496 PMCID: PMC9068840 DOI: 10.1007/s12264-021-00800-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/29/2021] [Indexed: 12/18/2022] Open
Abstract
Central sensitization is essential in maintaining chronic pain induced by chronic pancreatitis (CP), but cortical modulation of painful CP remains elusive. Here, we examined the role of the anterior cingulate cortex (ACC) in the pathogenesis of abdominal hyperalgesia in a rat model of CP induced by intraductal administration of trinitrobenzene sulfonic acid (TNBS). TNBS treatment resulted in long-term abdominal hyperalgesia and anxiety in rats. Morphological data indicated that painful CP induced a significant increase in FOS-expressing neurons in the nucleus tractus solitarii (NTS) and ACC, and some FOS-expressing neurons in the NTS projected to the ACC. In addition, a larger portion of ascending fibers from the NTS innervated pyramidal neurons, the neural subpopulation primarily expressing FOS under the condition of painful CP, rather than GABAergic neurons within the ACC. CP rats showed increased expression of vesicular glutamate transporter 1, and increased membrane trafficking and phosphorylation of the N-methyl-D-aspartate receptor (NMDAR) subunit NR2B and the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) subunit GluR1 within the ACC. Microinjection of NMDAR and AMPAR antagonists into the ACC to block excitatory synaptic transmission significantly attenuated abdominal hyperalgesia in CP rats, which was similar to the analgesic effect of endomorphins injected into the ACC. Specifically inhibiting the excitability of ACC pyramidal cells via chemogenetics reduced both hyperalgesia and comorbid anxiety, whereas activating these neurons via optogenetics failed to aggravate hyperalgesia and anxiety in CP rats. Taken together, these findings provide neurocircuit, biochemical, and behavioral evidence for involvement of the ACC in hyperalgesia and anxiety in CP rats, as well as novel insights into the cortical modulation of painful CP, and highlights the ACC as a potential target for neuromodulatory interventions in the treatment of painful CP.
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Affiliation(s)
- Dan Ren
- Department of Anatomy, Guangxi Medical University, Nanning, 510000, China.,Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Jia-Ni Li
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Xin-Tong Qiu
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Fa-Ping Wan
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China.,Department of Anatomy, Xuzhou Medical University, Xuzhou, 221004, China
| | - Zhen-Yu Wu
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Bo-Yuan Fan
- Department of Cardiology, The Second Affiliated Hospital of Xian Jiaotong University, Xi'an, 710004, China
| | - Ming-Ming Zhang
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Tao Chen
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Hui Li
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Yang Bai
- Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China. .,Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, 110016, China.
| | - Yun-Qing Li
- Department of Anatomy, Guangxi Medical University, Nanning, 510000, China. .,Department of Anatomy, Histology and Embryology and K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China. .,Key Laboratory of Brain Science Research and Transformation in Tropical Environment of Hainan Province, Haikou, 570216, China. .,Department of Human Anatomy, College of Basic Medicine, Dali University, Dali, 671000, China.
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Abstract
This paper is the fortieth consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2017 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, CUNY, 65-30 Kissena Blvd., Flushing, NY, 11367, United States.
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Bai Y, Chen YB, Qiu XT, Chen YB, Ma LT, Li YQ, Sun HK, Zhang MM, Zhang T, Chen T, Fan BY, Li H, Li YQ. Nucleus tractus solitarius mediates hyperalgesia induced by chronic pancreatitis in rats. World J Gastroenterol 2019; 25:6077-6093. [PMID: 31686764 PMCID: PMC6824279 DOI: 10.3748/wjg.v25.i40.6077] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Central sensitization plays a pivotal role in the maintenance of chronic pain induced by chronic pancreatitis (CP). We hypothesized that the nucleus tractus solitarius (NTS), a primary central site that integrates pancreatic afferents apart from the thoracic spinal dorsal horn, plays a key role in the pathogenesis of visceral hypersensitivity in a rat model of CP.
AIM To investigate the role of the NTS in the visceral hypersensitivity induced by chronic pancreatitis.
METHODS CP was induced by the intraductal injection of trinitrobenzene sulfonic acid (TNBS) in rats. Pancreatic hyperalgesia was assessed by referred somatic pain via von Frey filament assay. Neural activation of the NTS was indicated by immunohistochemical staining for Fos. Basic synaptic transmission within the NTS was assessed by electrophysiological recordings. Expression of vesicular glutamate transporters (VGluTs), N-methyl-D-aspartate receptor subtype 2B (NR2B), and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor subtype 1 (GluR1) was analyzed by immunoblotting. Membrane insertion of NR2B and GluR1 was evaluated by electron microscopy. The regulatory role of the NTS in visceral hypersensitivity was detected via pharmacological approach and chemogenetics in CP rats.
RESULTS TNBS treatment significantly increased the number of Fos-expressing neurons within the caudal NTS. The excitatory synaptic transmission was substantially potentiated within the caudal NTS in CP rats (frequency: 5.87 ± 1.12 Hz in CP rats vs 2.55 ± 0.44 Hz in sham rats, P < 0.01; amplitude: 19.60 ± 1.39 pA in CP rats vs 14.71 ± 1.07 pA in sham rats; P < 0.01). CP rats showed upregulated expression of VGluT2, and increased phosphorylation and postsynaptic trafficking of NR2B and GluR1 within the caudal NTS. Blocking excitatory synaptic transmission via the AMPAR antagonist CNQX and the NMDAR antagonist AP-5 microinjection reversed visceral hypersensitivity in CP rats (abdominal withdraw threshold: 7.00 ± 1.02 g in CNQX group, 8.00 ± 0.81 g in AP-5 group and 1.10 ± 0.27 g in saline group, P < 0.001). Inhibiting the excitability of NTS neurons via chemogenetics also significantly attenuated pancreatic hyperalgesia (abdominal withdraw threshold: 13.67 ± 2.55 g in Gi group, 2.00 ± 1.37 g in Gq group, and 2.36 ± 0.67 g in mCherry group, P < 0.01).
CONCLUSION Our findings suggest that enhanced excitatory transmission within the caudal NTS contributes to pancreatic pain and emphasize the NTS as a pivotal hub for the processing of pancreatic afferents, which provide novel insights into the central sensitization of painful CP.
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Affiliation(s)
- Yang Bai
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Ying-Biao Chen
- Department of Anatomy, Fujian Health College, Fuzhou 350101, Fujian Province, China
| | - Xin-Tong Qiu
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Yan-Bing Chen
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Li-Tian Ma
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Ying-Qi Li
- Department of Cardiology, The Second Affiliated Hospital of Xian Jiaotong University, Xian Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Hong-Ke Sun
- Department of Cardiology, The Second Affiliated Hospital of Xian Jiaotong University, Xian Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Ming-Ming Zhang
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Ting Zhang
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Tao Chen
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Bo-Yuan Fan
- Department of Cardiology, The Second Affiliated Hospital of Xian Jiaotong University, Xian Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Hui Li
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
| | - Yun-Qing Li
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
- Joint Laboratory of Neuroscience at Hainan Medical University and Fourth Military Medical University, Hainan Medical University, Haikou 571199, Hainan Province, China
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Bai Y, Ma LT, Chen YB, Ren D, Chen YB, Li YQ, Sun HK, Qiu XT, Zhang T, Zhang MM, Yi XN, Chen T, Li H, Fan BY, Li YQ. Anterior insular cortex mediates hyperalgesia induced by chronic pancreatitis in rats. Mol Brain 2019; 12:76. [PMID: 31484535 PMCID: PMC6727343 DOI: 10.1186/s13041-019-0497-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/23/2019] [Indexed: 12/11/2022] Open
Abstract
Central sensitization plays a pivotal role in the maintenance of chronic pain induced by chronic pancreatitis (CP), but cortical modulation of painful CP remains elusive. This study was designed to examine the role of anterior insular cortex (aIC) in the pathogenesis of hyperalgesia in a rat model of CP. CP was induced by intraductal administration of trinitrobenzene sulfonic acid (TNBS). Abdomen hyperalgesia and anxiety were assessed by von Frey filament and open field tests, respectively. Two weeks after surgery, the activation of aIC was indicated by FOS immunohistochemical staining and electrophysiological recordings. Expressions of VGluT1, NMDAR subunit NR2B and AMPAR subunit GluR1 were analyzed by immunoblottings. The regulatory roles of aIC in hyperalgesia and pain-related anxiety were detected via pharmacological approach and chemogenetics in CP rats. Our results showed that TNBS treatment resulted in long-term hyperalgesia and anxiety-like behavior in rats. CP rats exhibited increased FOS expression and potentiated excitatory synaptic transmission within aIC. CP rats also showed up-regulated expression of VGluT1, and increased membrane trafficking and phosphorylation of NR2B and GluR1 within aIC. Blocking excitatory synaptic transmission significantly attenuated abdomen mechanical hyperalgesia. Specifically inhibiting the excitability of insular pyramidal cells reduced both abdomen hyperalgesia and pain-related anxiety. In conclusion, our findings emphasize a key role for aIC in hyperalgesia and anxiety of painful CP, providing a novel insight into cortical modulation of painful CP and shedding light on aIC as a potential target for neuromodulation interventions in the treatment of CP.
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Affiliation(s)
- Yang Bai
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, No. 169, West Chang-le Road, Xi'an, 710032, China
| | - Li-Tian Ma
- Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Yan-Bing Chen
- Department of Anatomy, Fujian Medical University, Fuzhou, 350108, China
| | - Dan Ren
- Department of Anatomy, Guangxi Medical University, Nanning, 530021, China
| | - Ying-Biao Chen
- Department of Anatomy, Fujian Health College, Fuzhou, 350101, China
| | - Ying-Qi Li
- Department of Cardiology, The Second Affiliated Hospital of Xian Jiaotong University, Xian Jiaotong University, Xi'an, 710004, China
| | - Hong-Ke Sun
- Department of Cardiology, The Second Affiliated Hospital of Xian Jiaotong University, Xian Jiaotong University, Xi'an, 710004, China
| | - Xin-Tong Qiu
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, No. 169, West Chang-le Road, Xi'an, 710032, China
| | - Ting Zhang
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, No. 169, West Chang-le Road, Xi'an, 710032, China
| | - Ming-Ming Zhang
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, No. 169, West Chang-le Road, Xi'an, 710032, China
| | - Xi-Nan Yi
- Joint Laboratory of Neuroscience at Hainan Medical University and Fourth Military Medical University, Hainan Medical University, Haikou, 571199, China
| | - Tao Chen
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, No. 169, West Chang-le Road, Xi'an, 710032, China
| | - Hui Li
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, No. 169, West Chang-le Road, Xi'an, 710032, China
| | - Bo-Yuan Fan
- Department of Cardiology, The Second Affiliated Hospital of Xian Jiaotong University, Xian Jiaotong University, Xi'an, 710004, China.
| | - Yun-Qing Li
- Department of Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Fourth Military Medical University, No. 169, West Chang-le Road, Xi'an, 710032, China. .,Joint Laboratory of Neuroscience at Hainan Medical University and Fourth Military Medical University, Hainan Medical University, Haikou, 571199, China.
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Yu T, Li L, Liu H, Li H, Liu Z, Li Z. KCNQ2/3/5 channels in dorsal root ganglion neurons can be therapeutic targets of neuropathic pain in diabetic rats. Mol Pain 2018; 14:1744806918793229. [PMID: 30027794 PMCID: PMC6088482 DOI: 10.1177/1744806918793229] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Diabetic neuropathic pain is poorly controlled by analgesics, and the precise molecular mechanisms underlying hyperalgesia remain unclear. The KCNQ2/3/5 channels expressed in dorsal root ganglion neurons are important in pain transmission. The expression and activity of KCNQ2/3/5 channels in dorsal root ganglion neurons in rats with diabetic neuropathic pain were investigated in this study. Methods The mRNA levels of KCNQ2/3/5 channels were analyzed by real-time polymerase chain reaction. The protein levels of KCNQ2/3/5 channels were evaluated by Western blot assay. KCNQ2/3/5 channel expression in situ in dorsal root ganglion neurons was detected by double fluorescent labeling technique. M current (IM) density and neuronal excitability were determined by whole-cell voltage and current clamp recordings. Mechanical allodynia and thermal hyperalgesia were assessed by von Frey filaments and plantar analgesia tester, respectively. Results The mRNA and protein levels of KCNQ2/3/5 channels significantly decreased, followed by the reduction of IM density and elevation of neuronal excitability of dorsal root ganglion neurons from diabetic rats. Activation of KCNQ channels with retigabine reduced the hyperexcitability and inhibition of KCNQ channels with XE991 enhanced the hyperexcitability. Administration of retigabine alleviated both mechanical allodynia and thermal hyperalgesia, while XE991 augmented both mechanical allodynia and thermal hyperalgesia in diabetic neuropathic pain in rats. Conclusion The findings elucidate the mechanisms by which downregulation of the expression and reduction of the activity of KCNQ2/3/5 channels in diabetic rat dorsal root ganglion neurons contribute to neuronal hyperexcitability, which results in hyperalgesia. These data provide intriguing evidence that activation of KCNQ2/3/5 channels might be the potential new targets for alleviating diabetic neuropathic pain symptoms.
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Affiliation(s)
- Ting Yu
- 1 Department of Anatomy, School of Basic Medical Sciences, Shandong University, Jinan, China.,2 Department of Physiology, Jining Medical University, Jining, China
| | - Lei Li
- 3 Department of Diagnosis, Jining Medical University, Jining, China
| | - Huaxiang Liu
- 4 Department of Rheumatology, Shandong University Qilu Hospital, Jinan, China
| | - Hao Li
- 5 Department of Orthopaedics, Shandong University Qilu Hospital, Jinan, China
| | - Zhen Liu
- 1 Department of Anatomy, School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Zhenzhong Li
- 1 Department of Anatomy, School of Basic Medical Sciences, Shandong University, Jinan, China
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