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Inflammatory pain hypersensitivity mediated by phenotypic switch in myelinated primary sensory neurons.

机译:表型转换介导的髓鞘初级感觉神经元的炎症性疼痛超敏反应。

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摘要

Pain is normally evoked only by stimuli that are sufficiently intense to activate high-threshold A(delta) and C sensory fibres, which relay the signal to the spinal cord. Peripheral inflammation leads to profoundly increased pain sensitivity: noxious stimuli generate a greater response and stimuli that are normally innocuous elicit pain. Inflammation increases the sensitivity of the peripheral terminals of A(delta) and C fibres at the site of inflammation. It also increases the excitability of spinal cord neurons, which now amplify all sensory inputs including the normally innocuous tactile stimuli that are conveyed by low-threshold A(beta) fibres. This central sensitization has been attributed to the enhanced activity of C fibres, which increase the excitability of their postsynaptic targets by releasing glutamate and the neuropeptide substance P. Here we show that inflammation results in A(beta) fibres also acquiring the capacity to increase the excitability of spinal cord neurons. This is due to a phenotypic switch in a subpopulation of these fibres so that they, like C-fibres, now express substance P. A(beta) fibres thus appear to contribute to inflammatory hypersensitivity by switching their phenotype to one resembling pain fibres, thereby enhancing synaptic transmission in the spinal cord and exaggerating the central response to innocuous stimuli.
机译:通常只有足够强烈的刺激来激活高阈值A(delta)和C感觉纤维,从而将信号传递到脊髓,从而引起疼痛。周围炎症导致疼痛敏感性大大提高:有害刺激会产生更大的反应,而刺激通常是无害的,会引起疼痛。炎症会增加炎症部位Aδ和C纤维外围末端的敏感性。它也增加了脊髓神经元的兴奋性,这现在可以放大所有的感觉输入,包括由低阈值Aβ纤维传递的通常无害的触觉刺激。这种中央敏化作用归因于C纤维活性增强,C纤维通过释放谷氨酸盐和神经肽物质P来增加其突触后靶标的兴奋性。脊髓神经元的兴奋性。这是由于这些纤维的亚群中的表型转换,因此它们现在像C纤维一样表达物质P。因此,Aβ纤维似乎通过将其表型切换为一种类似疼痛的纤维来促进炎症性超敏反应,从而增强脊髓中的突触传递并夸大对无害刺激的中枢反应。

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