Lobo, Marlene E Da Vitoria;
Weir, Nick;
Hardowar, Lydia;
Al Ojaimi, Yara;
Madden, Ryan;
Gibson, Alex;
Bestall, Samuel M;
... Hulse, Richard Philip; + view all
(2022)
Hypoxia-induced carbonic anhydrase mediated dorsal horn neuron activation and induction of neuropathic pain.
Pain
, 163
(11)
pp. 2264-2279.
10.1097/j.pain.0000000000002627.
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Abstract
Neuropathic pain, such as that seen in diabetes mellitus, results in part from central sensitisation in the dorsal horn. However, the mechanisms responsible for such sensitisation remain unclear. There is evidence that disturbances in the integrity of the spinal vascular network can be causative factors in the development of neuropathic pain. Here we show that reduced blood flow and vascularity of the dorsal horn leads to the onset of neuropathic pain. Using rodent models (type 1 diabetes and an inducible endothelial-specific vascular endothelial growth factor receptor 2 knockout mouse) that result in degeneration of the endothelium in the dorsal horn, we show that spinal cord vasculopathy results in nociceptive behavioural hypersensitivity. This also results in increased hypoxia in dorsal horn neurons, depicted by increased expression of hypoxia markers such as hypoxia inducible factor 1α, glucose transporter 3, and carbonic anhydrase 7. Furthermore, inducing hypoxia through intrathecal delivery of dimethyloxalylglycine leads to the activation of dorsal horn neurons as well as mechanical and thermal hypersensitivity. This shows that hypoxic signalling induced by reduced vascularity results in increased hypersensitivity and pain. Inhibition of carbonic anhydrase activity, through intraperitoneal injection of acetazolamide, inhibited hypoxia-induced pain behaviours. This investigation demonstrates that induction of a hypoxic microenvironment in the dorsal horn, as occurs in diabetes, is an integral process by which neurons are activated to initiate neuropathic pain states. This leads to the conjecture that reversing hypoxia by improving spinal cord microvascular blood flow could reverse or prevent neuropathic pain.
| Type: | Article |
|---|---|
| Title: | Hypoxia-induced carbonic anhydrase mediated dorsal horn neuron activation and induction of neuropathic pain |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/j.pain.0000000000002627 |
| Publisher version: | http://dx.doi.org/10.1097/j.pain.0000000000002627 ... |
| Language: | English |
| Additional information: | Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain. This is an open access article distributed under the terms of the Creative Commons Attribution-Non CommercialNo Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Anesthesiology, Clinical Neurology, Neurosciences, Neurosciences & Neurology, Pain, Neuron, Endothelial, Spinal cord, Hypoxia, Diabetes, VEGF, SPINAL-CORD, CHLORIDE DYSREGULATION, IN-VIVO, INHIBITION, HYPERSENSITIVITY, DISINHIBITION, NOCICEPTION, SENSITIVITY, PLASTICITY |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10170884 |
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