A microchannel neuroprosthesis for bladder control after spinal cord injury in rat

A severe complication of spinal cord injury is loss of bladder function (neurogenic bladder), which is characterized by loss of bladder sensation and voluntary control of micturition (urination), and spontaneous hyperreflexive voiding against a closed sphincter (detrusor-sphincter dyssynergia). A sacral anterior root stimulator at low frequency can drive volitional bladder voiding, but surgical rhizotomy of the lumbosacral dorsal roots is needed to prevent spontaneous voiding and dyssynergia. However, rhizotomy is irreversible and eliminates sexual function, and the stimulator gives no information on bladder fullness. We designed a closed-loop neuroprosthetic interface that measures bladder fullness and prevents spontaneous voiding episodes without the need for dorsal rhizotomy in a rat model. To obtain bladder sensory information, we implanted teased dorsal roots (rootlets) within the rat vertebral column into microchannel electrodes, which provided signal amplification and noise suppression. As long as they were attached to the spinal cord, these rootlets survived for up to 3 months and contained axons and blood vessels. Electrophysiological recordings showed that half of the rootlets propagated action potentials, with firing frequency correlated to bladder fullness. When the bladder became full enough to initiate spontaneous voiding, high-frequency/amplitude sensory activity was detected. Voiding was abolished using a high-frequency depolarizing block to the ventral roots. A ventral root stimulator initiated bladder emptying at low frequency and prevented unwanted contraction at high frequency. These data suggest that sensory information from the dorsal root together with a ventral root stimulator could form the basis for a closed-loop bladder neuroprosthetic. Copyright © 2013, American Association for the Advancement of Science

Cox-dependent fatty acid metabolites cause pain through activation of the irritant receptor TRPA1.

Prostaglandins (PG) are known to induce pain perception indirectly by sensitizing nociceptors. Accordingly, the analgesic action of nonsteroidal anti-inflammatory drugs (NSAIDs) results from inhibition of cyclooxygenases and blockade of PG biosynthesis. Cyclopentenone PGs, 15-d-PGJ(2), PGA(2), and PGA(1), formed by dehydration of their respective parent PGs, PGD(2), PGE(2), and PGE(1), possess a highly reactive alpha,beta-unsaturated carbonyl group that has been proposed to gate the irritant transient receptor potential A1 (TRPA1) channel. Here, by using TRPA1 wild-type (TRPA1(+/+)) or deficient (TRPA1(-/-)) mice, we show that cyclopentenone PGs produce pain by direct stimulation of nociceptors via TRPA1 activation. Cyclopentenone PGs caused a robust calcium response in dorsal root ganglion (DRG) neurons of TRPA1(+/+), but not of TRPA1(-/-) mice, and a calcium-dependent release of sensory neuropeptides from the rat dorsal spinal cord. Intraplantar injection of cyclopentenone PGs stimulated c-fos expression in spinal neurons of the dorsal horn and evoked an instantaneous, robust, and transient nociceptive response in TRPA1(+/+) but not in TRPA1(-/-) mice. The classical proalgesic PG, PGE(2), caused a slight calcium response in DRG neurons, increased c-fos expression in spinal neurons, and induced a delayed and sustained nociceptive response in both TRPA1(+/+) and TRPA1(-/-) mice. These results expand the mechanism of NSAID analgesia from blockade of indirect nociceptor sensitization by classical PGs to inhibition of direct TRPA1-dependent nociceptor activation by cyclopentenone PGs. Thus, TRPA1 antagonism may contribute to suppress pain evoked by PG metabolites without the adverse effects of inhibiting cyclooxygenases.

Hydrogen sulfide inhibits Cav3.2 T-type Ca2+ channels

The importance of H2S as a physiological signaling molecule continues to develop, and ion channels are emerging as a major family of target proteins through which H2S exerts many actions. The purpose of the present study was to investigate its effects on T-type Ca2+ channels. Using patch-clamp electrophysiology, we demonstrate that the H2S donor, NaHS (10 μM-1 mM) selectively inhibits Cav3.2 T-type channels heterologously expressed in HEK293 cells, whereas Cav3.1 and Cav3.3 channels were unaffected. The sensitivity of Cav3.2 channels to H2S required the presence of the redox-sensitive extracellular residue H191, which is also required for tonic binding of Zn2+ to this channel. Chelation of Zn2+ with N,N,N',N'-tetra-2-picolylethylenediamine prevented channel inhibition by H2S and also reversed H2S inhibition when applied after H2S exposure, suggesting that H2S may act via increasing the affinity of the channel for extracellular Zn2+ binding. Inhibition of native T-type channels in 3 cell lines correlated with expression of Cav3.2 and not Cav3.1 channels. Notably, H2S also inhibited native T-type (primarily Cav3.2) channels in sensory dorsal root ganglion neurons. Our data demonstrate a novel target for H2S regulation, the T-type Ca2+ channel Cav3.2, and suggest that such modulation cannot account for the pronociceptive effects of this gasotransmitter.

Neural mobilization reverses behavioral and cellular changes that characterize neuropathic pain in rats

Background: The neural mobilization technique is a noninvasive method that has proved clinically effective in reducing pain sensitivity and consequently in improving quality of life after neuropathic pain. The present study examined the effects of neural mobilization (NM) on pain sensitivity induced by chronic constriction injury (CCI) in rats. The CCI was performed on adult male rats, submitted thereafter to 10 sessions of NM, each other day, starting 14 days after the CCI injury. Over the treatment period, animals were evaluated for nociception using behavioral tests, such as tests for allodynia and thermal and mechanical hyperalgesia. At the end of the sessions, the dorsal root ganglion (DRG) and spinal cord were analyzed using immunohistochemistry and Western blot assays for neural growth factor (NGF) and glial fibrillary acidic protein (GFAP). Results: The NM treatment induced an early reduction (from the second session) of the hyperalgesia and allodynia in CCI-injured rats, which persisted until the end of the treatment. On the other hand, only after the 4th session we observed a blockade of thermal sensitivity. Regarding cellular changes, we observed a decrease of GFAP and NGF expression after NM in the ipsilateral DRG (68% and 111%, respectively) and the decrease of only GFAP expression after NM in the lumbar spinal cord (L3-L6) (108%). Conclusions: These data provide evidence that NM treatment reverses pain symptoms in CCI-injured rats and suggest the involvement of glial cells and NGF in such an effect.

Stimulation of peripheral Kappa opioid receptors inhibits inflammatory hyperalgesia via activation of the PI3K gamma/AKT/nNOS/NO signaling pathway

Background: In addition to their central effects, opioids cause peripheral analgesia. There is evidence showing that peripheral activation of kappa opioid receptors (KORs) inhibits inflammatory pain. Moreover, peripheral mu-opioid receptor (MOR) activation are able to direct block PGE(2)-induced ongoing hyperalgesia However, this effect was not tested for KOR selective activation. In the present study, the effect of the peripheral activation of KORs on PGE(2)-induced ongoing hyperalgesia was investigated. The mechanisms involved were also evaluated. Results: Local (paw) administration of U50488 (a selective KOR agonist) directly blocked, PGE(2)-induced mechanical hyperalgesia in both rats and mice. This effect was reversed by treating animals with L-NMMA or N-propyl-L-arginine (a selective inhibitor of neuronal nitric oxide synthase, nNOS), suggesting involvement of the nNOS/NO pathway. U50488 peripheral effect was also dependent on stimulation of PI3K gamma/AKT because inhibitors of these kinases also reduced peripheral antinociception induced by U50488. Furthermore, U50488 lost its peripheral analgesic effect in PI3K gamma null mice. Observations made in vivo were confirmed after incubation of dorsal root ganglion cultured neurons with U50488 produced an increase in the activation of AKT as evaluated by western blot analyses of its phosphorylated form. Finally, immunofluorescence of DRG neurons revealed that KOR-expressing neurons also express PI3K gamma (congruent to 43%). Conclusions: The present study indicates that activation of peripheral KORs directly blocks inflammatory hyperalgesia through stimulation of the nNOS/NO signaling pathway which is probably stimulated by PI3K gamma/AKT signaling. This study extends a previously study of our group suggesting that PI3K gamma/AKT/nNOS/NO is an important analgesic pathway in primary nociceptive neurons.

Cytokine inhibition and time-related influence of inflammatory stimuli on the hyperalgesia induced by the nucleus pulposus

The symptoms of lumbar disc herniation, such as low back pain and sciatica, have been associated with local release of cytokines following the inflammatory process induced by the contact of the nucleus pulposus (NP) with the spinal nerve. Using an animal experimental model of intervertebral disc herniation and behavioral tests to evaluate mechanical (electronic von Frey test) and thermal (Hargreaves Plantar test) hyperalgesia in the hind paw of rats submitted to the surgical model, this study aimed to detect in normal intervertebral disc the cytokines known to be involved in the mechanisms of inflammatory hyperalgesia, to observe if previous exposure of the intervertebral disc tissue to specific antibodies could affect the pain behavior (mechanical and thermal hyperalgesia) induced by the NP, and to observe the influence of the time of contact of the NP with the fifth lumbar dorsal root ganglion (L5-DRG) in the mechanical and thermal hyperalgesia. The cytokines present at highest concentrations in the rat NP were TNF-alpha, IL-1 beta and CINC-1. Rats submitted to the disc herniation experimental model, in which a NP from the sacrococcygeal region is deposited over the right L5-DRG, showed increased mechanical and thermal hyperalgesia that lasted at least 7 weeks. When the autologous NP was treated with antibodies against the three cytokines found at highest concentrations in the NP (TNF-alpha, IL-1 beta and CINC-1), there was decrease in both mechanical and thermal hyperalgesia in different time points, suggesting that each cytokine may be important for the hyperalgesia in different steps of the inflammatory process. The surgical remotion of the NP from herniated rats 1 week after the implantation reduced the hyperalgesia to the level similar to the control group. This reduction in the hyperalgesia was also observed in the group that had the NP removed 3 weeks after the implantation, although the intensity of the hyperalgesia did not decreased totally. The removal of the NP after 5 weeks did not changed the hyperalgesia observed in the hind paw, which suggests that the longer the contact of the NP with the DRG, the greater is the possibility of development of chronic pain. Together our results indicate that specific cytokines released during the inflammatory process induced by the herniated intervertebral disc play fundamental role in the development of the two modalities of hyperalgesia (mechanical and thermal) and that the maintenance of this inflammation may be the most important point for the chronification of the pain.

Stimulation of peripheral Kappa opioid receptors inhibits inflammatory hyperalgesia via activation of the PI3Kγ/AKT/nNOS/NO signaling pathway

Abstract Background In addition to their central effects, opioids cause peripheral analgesia. There is evidence showing that peripheral activation of kappa opioid receptors (KORs) inhibits inflammatory pain. Moreover, peripheral μ-opioid receptor (MOR) activation are able to direct block PGE2-induced ongoing hyperalgesia However, this effect was not tested for KOR selective activation. In the present study, the effect of the peripheral activation of KORs on PGE2-induced ongoing hyperalgesia was investigated. The mechanisms involved were also evaluated. Results Local (paw) administration of U50488 (a selective KOR agonist) directly blocked, PGE2-induced mechanical hyperalgesia in both rats and mice. This effect was reversed by treating animals with L-NMMA or N-propyl-L-arginine (a selective inhibitor of neuronal nitric oxide synthase, nNOS), suggesting involvement of the nNOS/NO pathway. U50488 peripheral effect was also dependent on stimulation of PI3Kγ/AKT because inhibitors of these kinases also reduced peripheral antinociception induced by U50488. Furthermore, U50488 lost its peripheral analgesic effect in PI3Kγ null mice. Observations made in vivo were confirmed after incubation of dorsal root ganglion cultured neurons with U50488 produced an increase in the activation of AKT as evaluated by western blot analyses of its phosphorylated form. Finally, immunofluorescence of DRG neurons revealed that KOR-expressing neurons also express PI3Kγ (≅ 43%). Conclusions The present study indicates that activation of peripheral KORs directly blocks inflammatory hyperalgesia through stimulation of the nNOS/NO signaling pathway which is probably stimulated by PI3Kγ/AKT signaling. This study extends a previously study of our group suggesting that PI3Kγ/AKT/nNOS/NO is an important analgesic pathway in primary nociceptive neurons.

Sensibilisierung hitzeevozierter Ionenströme an nozizeptiven Spinalganglienneuronen der Ratte

Die freien Endigungen von Spinalganglienneuronen sind für die Detektion schmerzhafter Reize verantwortlich. Dabei rufen thermische, chemische oder mechanische Reize Ionenströme über die Membran und dadurch Membranpotentialänderungen hervor. Diese noxisch induzierten Ströme sind in großem Ausmaß durch chemische Substanzen und andere Reize modulierbar. Der Ionenkanal TRPV1 ist für die Detektion zahlreicher chemischer Reize und zumindest eines Teils der noxischen Hitzereize verantwortlich. Im Rahmen dieser Arbeit wurden einige der Mechanismen geklärt, die zur schnellen Sensibilisierung hitzeevozierter Ionenströme führen. Hierfür wurden akut dissoziierte Spinalganglienneurone der Ratte als Modell ihrer peripheren Endigung verwendet und mittels Ganzzellableitung in der patch-clamp-Technik untersucht. Die Verwendung von Trypsin während der Präparation von Spinalganglienneuronen hat keinen funktionellen Einfluss auf hitze- oder capsaicininduzierte Ströme, verbessert aber die Untersuchungsbedingungen für das patch-clamp-Verfahren. Bei 144 akut dissoziierten Spinalganglienneuronen wurden die Stromantworten auf drei im Abstand von 40 s durch Überspülen mit 45,3 bis 46,3°C heißer Extrazellularlösung applizierte einsekündige Hitzereize gemessen. Dabei ließen sich repetitiv reproduzierbare hitzeinduzierte Einwärtsströme von etwa 160 pA erzielen; es konnte keine Tachyphylaxie und nahezu keine Inaktivierung beobachtet werden. Direkt vor dem zweiten Hitzereiz wurden die Neurone für zwei Sekunden mit Extrazellularlösung überspült, die Kontrolllösung, 0,5 μM Capsaicin, 10 μM Natriumnitroprussid oder 10 μM YC-1 enthielt. Es fand sich kein Hinweis, dass Stickstoffmonoxid oder die Guanylatzyklase einen signifikanten Beitrag zur Sensibilisierung von hitzeinduzierten Strömen in Spinalganglienneuronen leisten, wobei ein durch den Versuchsaufbau bedingtes Auswaschen zytosolischer Faktoren, die für den Signalweg notwendig sind, nicht ausgeschlossen werden kann. Bei einer Konzentration von 0,5 μM löst Capsaicin für zwei Sekunden einen sehr kleinen Einwärtsstrom von etwa 33 pA aus und führt innerhalb von zwei Sekunden zu einer schnell reversiblen Sensibilisierung von hitzeinduzierten Einwärtsströmen in Spinalganglienneuronen (p<0,01). Das Ausmaß der Sensibilisierung ist proportional zur Größe des capsaicininduzierten Stromes (r=−0,7, p<0,001). Konstant halten der intrazellulären Calciumkonzentration mittels des Calciumchelators BAPTA verhindert die capsaicininduzierte Sensibilisierung hitzeinduzierter Ströme an Spinalganglienneuronen. Demzufolge beruht die capsaicininduzierte Sensibilisierung trotz der schnellen Kinetik nicht auf einer synergistischen Wirkung der beiden Agonisten Capsaicin und Hitze auf ihren gemeinsamen Rezeptor; vielmehr ist sie von einer Erhöhung der intrazellulären freien Calciumkonzentration abhängig. Funktionelle Änderungen der zellulären Funktion werden häufig durch Proteinkinasen vermittelt. Die zur Gruppe der MAP-Kinasen gehörende ERK (extracellular signal related kinase) wird bei Membrandepolarisation und Calciumeinstrom in die Zelle durch MEK (MAPK/extracellular signal related kinase kinase) aktiviert. Blockade der MEK/ERK-Kaskade durch den spezifischen MEK-Hemmstoff U0126 führt ebenfalls zu einer Aufhebung der Sensibilisierung der Hitzeantworten durch Capsaicin. Applikation von Capsaicin führt innerhalb von zwei Sekunden zu einer schnell reversiblen Sensibilisierung hitzeevozierter Ionenströme an nozizeptiven Spinalganglienneuronen. Diese Sensibilisierung wird durch einen Calciumeinstrom in die Zelle und die dadurch eintretende Aktivierung von Proteinkinasen hervorgerufen. Die MEK/ERK-Kaskade ist ein sehr schnell (deutlich unter 2 s) aktivierbares intrazelluläres Signalsystem, welches bei der Regulation der Empfindlichkeit nozizeptiver Spinalganglienneurone eine entscheidende Rolle spielt; die schnelle Kinetik ist dabei nur durch eine membranständige oder zumindest membrannahe Lokalisation dieser Proteinkinasen erklärbar. Durch Applikation zehnsekündiger Hitzereize lässt sich ebenfalls eine Sensibilisierung hitzeevozierter Ionenströme auslösen, die ebenso ausgeprägt ist, wie die Sensibilisierung durch 0,5 μM Capsaicin (p<0,005). Durch das immer größere Verständnis der Funktionsweise des nozizeptiven Systems ergeben sich ständig neue Ansätze für die Entwicklung neuer Analgetika. So könnte durch Modulation spezifischer intrazellulärer Proteinkinasen der Phosphorylierungszustand und damit die Aktivierbarkeit von Ionenkanälen, die der Transduktion noxischer Reize dienen, positiv beeinflusst werden. Neuere, noch spezifischere Inhibitoren der MEK können der Forschung und später auch der Therapie neue Möglichkeiten eröffnen.

Expression der pronozizeptiven Vanilloidrezeptoren TRPV1 und TRPV2 und des antinozizeptiven Cannabinoidrezeptors CB1 in Spinalganglienneuronen der Ratte

Nozizeptive Spinalganglienneurone detektieren mit einer Vielzahl liganden- und spannungsgesteuerter Ionenkanäle noxische Reize, d.h. Reize, die eine Gewebeschädigung bewirken können, wandeln sie in Aktionspotenzialentladungen um und leiten sie über das Rückenmark zum Gehirn weiter, wo eine Schmerzempfindung ausgelöst wird. Die pronozizeptiven transienten Rezeptor-Potenzial-Kanäle der Vanilloidrezeptorfamilie, TRPV1 und TRPV2, sind die klassischen Transduktionsmoleküle für noxische Hitzereize in den Spinalganglien und werden von Reiztemperaturen über 43°C bzw. 52°C aktiviert. Daneben finden sich auch antinozizeptive Membranproteine, wie z.B. der metabotrope Cannabinoidrezeptor CB1. Er koppelt an spannungsgesteuerte Kaliumkanäle, die neben Natrium- und Kalziumkanälen ebenfalls an der neuronalen Erregbarkeit beteiligt sind. Von den spannungsgesteuerten Kaliumkanälen könnte der Kv1.4, der einen schnell inaktivierenden A-Strom vermittelt, an antinozizeptiven Signalwegen beteiligt sein. Um die molekulare Physiologie der Regulation von Nozizeption und Antinozizeption zu charakterisieren, wurde die Expression bzw. Ko-Expression dieser Membranproteine auf der einen als auch die funktionelle Charakterisierung von TRPV1 auf der anderen Seite im Soma der Spinalganglienneurone und im heterologen Expressionssystem untersucht. TRPV1 wurde in je einem Drittel und TRPV2 in je einem Zehntel aller Spinalganglienneurone nachgewiesen. Das Expressionsmuster veränderte sich nicht zwischen verschiedenen Präparationsmethoden, die zur Aufarbeitung der Zellen für unterschiedliche experimentelle Ansätze notwendig sind. Somit können die aus Expressionsanalysen und funktionellen Untersuchungen gewonnenen Ergebnisse miteinander verglichen werden. Obwohl TRPV1 und TRPV2 in unterschiedlich großen Zellen exprimiert werden, überlappen dennoch ihre Größenverteilungen. Durch Ko-Expressionsanalysen konnten hier erstmalig TRPV1-TRPV2-ko-exprimierende Neurone detektiert werden. Mit dem neu entwickelten N-terminalen Antikörper gegen TRPV1 (3C11) konnte gezeigt werden, dass für TRPV1 verschiedene Splice-Varianten existieren. Neben den bereits bekannten Splice-Varianten wurde hier die neue Variante Vr.3’sv isoliert. Diese besitzt zwischen Exon 15 und 16 eine Insertion aus 104 Basen und exprimiert daher einen veränderten C-Terminus. Trotz dieser Veränderung bildeten sich im heterologen Expressionssystem funktionelle Kanäle aus, die im Gegensatz zu den anderen Varianten immer noch durch Capsaicin aktivierbar waren. Vr.3’sv könnte als Homo- oder Heterotetramer die Eigenschaften TRPV1-positiver Neurone beeinflussen. Bei der Bestimmung der Häufigkeit von TRPV1 in einem Gewebe ist somit die Wahl des Antikörpers von entscheidender Bedeutung. Für TRPV2 dagegen gibt es hier keine Hinweise auf Splice-Varianten. TRPV1 wird durch das Vanilloid Capsaicin aktiviert, wobei diese Substanz neurotoxisch ist und eine Degeneration von Neuronen und epidermalen Nervenfasern bewirkt. Hier wurde nun gezeigt, dass unabhängig von den Splice-Varianten nicht alle TRPV1-positiven Neurone bei langer Inkubationszeit absterben. Funktionelle Untersuchungen belegten, dass auch Capsaicin-sensitive Zellen unter dem Einfluss des Agonisten überleben können. Dieser Schutzmechanismus wird möglicherweise von den verschiedenen Splice-Varianten vermittelt. Ko-Expressionsanalysen zeigten, dass der spannungsgesteuerte Kaliumkanal Kv1.4 in nahezu allen TRPV1- aber nicht TRPV2-positiven Neuronen exprimiert wird. Desweiteren ko-exprimierten nahezu alle TRPV1-positiven Neurone auch den Cannabinoidrezeptor CB1. Diese fast vollständige Ko-Lokalisation von CB1 und Kv1.4 in nozizeptiven Spinalganglienneuronen spricht für eine funktionell synergistische Aktivität. Der Kaliumkanal kann unter der regulativen Kontrolle von CB1 als Vermittler von A-Typ-Kaliumströmen an der Kontrolle der repetitiven Entladungen in der Peripherie und der Transmitterausschüttung zentral beteiligt sein. Es ergeben sich daraus Ansatzpunkte für die Entwicklung neuer Medikamente. Mit Kv1.4-Aktivatoren und/oder peripher wirkenden Cannabinoiden könnten die Nebenwirkungen der Cannabinoide im zentralen Nervensystem umgangen werden.

Studio e caratterizzazione di biosensori sviluppati su dispositivi inorganici ed organici

L’attività di dottorato qui descritta ha riguardato inizialmente lo sviluppo di biosensori elettrochimici semplificati per la rilevazione di DNA e successivamente lo studio di dispositivi organici ad effetto di campo per la stimolazione e il rilevamento dell’attività bioelettrica di cellule neuronali. Il lavoro di ricerca riguardante il prima parte è stato focalizzato sulla fabbricazione e sulla caratterizzazione di un biosensore a due elettrodi per la rilevazione di DNA solubile , facilmente producibile a livello industriale. Tale sensore infatti, è in grado di leggere livelli diversi di correnti faradiche sulle superfici in oro degli elettrodi, a discrezione di un eventuale ibridizzazione del DNA da analizzare su di esse. I risultati ottenuti riguardo a questo biosensore sono :la paragonabilità dello stesso con i sensori standard a tre elettrodi basati sulla medesima metodica, la possibilità di effettuare due misure in parallelo di uno stesso campione o di 2 diversi campioni su di uno stesso di dispositivo e la buona applicabilità della chimica superficiale a base di tale biosensore a superfici create con tecnologie industriali. Successivamente a tali studi, mi sono focalizzato sull’utilizzo di dispositivi organici ad effetto campo (in particolare OTFT) per lo sviluppo di un biosensore capace di stimolare e registrare l’attività bioelettrica di cellule neuronali. Inizialmente sono state identificate le caratteristiche del materiale organico utilizzato e successivamente del dispositivo fabbricato pre e post esposizione all’ambiente fisiologico. Poi, sono stati effettuati esperimenti per osservare la capacità di stimolare e di leggere i segnali elettrogenici da parte dell’OTFT. I risultati ottenuti da tali studi sono che: il materiale organico ed il dispositivo mantengo le loro caratteristiche morfologiche e funzionali dopo l’esposizione per giorni all’ambiente fisiologico. Inoltre l’OFET in grado di stimolare il cambiamento delle tensioni di membrana cellulari e contemporaneamente di registrare tali variazioni e le eventuali risposte cellulari provocate da esse.

Rufinamide attenuates mechanical allodynia in a model of neuropathic pain in the mouse and stabilizes voltage-gated sodium channel inactivated state

Background: Voltage-gated sodium channels dysregulation is important for hyperexcitability leading to pain persistence. Sodium channel blockers currently used to treat neuropathic pain are poorly tolerated. Getting new molecules to clinical use is laborious. We here propose a drug already marketed as anticonvulsant, rufinamide. Methods: We compared the behavioral effect of rufinamide to amitriptyline using the Spared Nerve Injury neuropathic pain model in mice. We compared the effect of rufinamide on sodium currents using in vitro patch clamp in cells expressing the voltage-gated sodium channel Nav1.7 isoform and on dissociated dorsal root ganglion neurons to amitriptyline and mexiletine. Results: In naive mice, amitriptyline (20 mg/kg) increased withdrawal threshold to mechanical stimulation from 1.3 (0.6–1.9) (median [95% CI]) to 2.3 g (2.2–2.5) and latency of withdrawal to heat stimulation from 13.1 (10.4–15.5) to 30.0 s (21.8–31.9), whereas rufinamide had no effect. Rufinamide and amitriptyline alleviated injury-induced mechanical allodynia for 4 h (maximal effect: 0.10 ± 0.03 g (mean ± SD) to 1.99 ± 0.26 g for rufinamide and 0.25 ± 0.22 g to 1.92 ± 0.85 g for amitriptyline). All drugs reduced peak current and stabilized the inactivated state of voltage-gated sodium channel Nav1.7, with similar effects in dorsal root ganglion neurons. Conclusions: At doses alleviating neuropathic pain, amitriptyline showed alteration of behavioral response possibly related to either alteration of basal pain sensitivity or sedative effect or both. Side-effects and drug tolerance/compliance are major problems with drugs such as amitriptyline. Rufinamide seems to have a better tolerability profile and could be a new alternative to explore for the treatment of neuropathic pain.

Dysregulation of voltage-gated sodium channels by ubiquitin ligase NEDD4-2 in neuropathic pain

Peripheral neuropathic pain is a disabling condition resulting from nerve injury. It is characterized by the dysregulation of voltage-gated sodium channels (Navs) expressed in dorsal root ganglion (DRG) sensory neurons. The mechanisms underlying the altered expression of Na(v)s remain unknown. This study investigated the role of the E3 ubiquitin ligase NEDD4-2, which is known to ubiquitylate Navs, in the pathogenesis of neuropathic pain in mice. The spared nerve injury (SNI) model of traumatic nerve injury-induced neuropathic pain was used, and an Na(v)1.7-specific inhibitor, ProTxII, allowed the isolation of Na(v)1.7-mediated currents. SNI decreased NEDD4-2 expression in DRG cells and increased the amplitude of Na(v)1.7 and Na(v)1.8 currents. The redistribution of Na(v)1.7 channels toward peripheral axons was also observed. Similar changes were observed in the nociceptive DRG neurons of Nedd4L knockout mice (SNS-Nedd4L(-/-)). SNS-Nedd4L(-/-) mice exhibited thermal hypersensitivity and an enhanced second pain phase after formalin injection. Restoration of NEDD4-2 expression in DRG neurons using recombinant adenoassociated virus (rAAV2/6) not only reduced Na(v)1.7 and Na(v)1.8 current amplitudes, but also alleviated SNI-induced mechanical allodynia. These findings demonstrate that NEDD4-2 is a potent posttranslational regulator of Na(v)s and that downregulation of NEDD4-2 leads to the hyperexcitability of DRG neurons and contributes to the genesis of pathological pain.

Ubiquitylation of voltage-gated sodium channels.

Ion channel proteins are regulated by different types of posttranslational modifications. The focus of this review is the regulation of voltage-gated sodium channels (Navs) upon their ubiquitylation. The amiloride-sensitive epithelial sodium channel (ENaC) was the first ion channel shown to be regulated upon ubiquitylation. This modification results from the binding of ubiquitin ligase from the Nedd4 family to a protein-protein interaction domain, known as the PY motif, in the ENaC subunits. Many of the Navs have similar PY motifs, which have been demonstrated to be targets of Nedd4-dependent ubiquitylation, tagging them for internalization from the cell surface. The role of Nedd4-dependent regulation of the Nav membrane density in physiology and disease remains poorly understood. Two recent studies have provided evidence that Nedd4-2 is downregulated in dorsal root ganglion (DRG) neurons in both rat and mouse models of nerve injury-induced neuropathic pain. Using two different mouse models, one with a specific knockout of Nedd4-2 in sensory neurons and another where Nedd4-2 was overexpressed with the use of viral vectors, it was demonstrated that the neuropathy-linked neuronal hyperexcitability was the result of Nav1.7 and Nav1.8 overexpression due to Nedd4-2 downregulation. These studies provided the first in vivo evidence of the role of Nedd4-2-dependent regulation of Nav channels in a disease state. This ubiquitylation pathway may be involved in the development of symptoms and diseases linked to Nav-dependent hyperexcitability, such as pain, cardiac arrhythmias, epilepsy, migraine, and myotonias.

Semaphorin 3A growth cone collapse requires a sequence homologous to tarantula hanatoxin

Axonal guidance is key to the formation of neuronal circuitry. Semaphorin 3A (Sema 3A; previously known as semaphorin III, semaphorin D, and collapsin-1), a secreted subtype of the semaphorin family, is an important axonal guidance molecule in vitro and in vivo. The molecular mechanisms of the repellent activity of semaphorins are, however, poorly understood. We have now found that the secreted semaphorins contain a short sequence of high homology to hanatoxin, a tarantula K+ and Ca2+ ion channel blocker. Point mutations in the hanatoxin-like sequence of Sema 3A reduce its capacity to repel embryonic dorsal root ganglion axons. Sema 3A growth cone collapse activity is inhibited by hanatoxin, general Ca2+ channel blockers, a reduction in extracellular or intracellular Ca2+, and a calmodulin inhibitor, but not by K+ channel blockers. Our data support an important role for Ca2+ in mediating the Sema 3A response and suggest that Sema 3A may produce its effects by causing the opening of Ca2+ channels.

Identification of genes differentially expressed by nerve growth factor- and neurotrophin-3-dependent sensory neurons

The neurotrophins nerve growth factor (NGF) and neurotrophin-3 (NT3) support the survival of subpopulations of primary sensory neurons with defined and distinct physiological characteristics. Only a few genes have been identified as being differentially expressed in these subpopulations, and not much is known about the nature of the molecules involved in the processing of sensory information in NGF-dependent nociceptive neurons or NT3-dependent proprioceptive neurons. We devised a simple dorsal root ganglion (DRG) explant culture system, allowing the selection of neuronal populations preferentially responsive to NGF or NT3. The reliability of this assay was first monitored by the differential expression of the NGF and NT3 receptors trkA and trkC, as well as that of neuropeptides and calcium-binding proteins. We then identified four differentially expressed sodium channels, two enriched in the NGF population and two others in the NT3 population. Finally, using an optimized RNA fingerprinting protocol, we identified 20 additional genes, all differentially expressed in DRG explants cultured with NGF or NT3. This approach thus allows the identification of large number of genes expressed in subpopulations of primary sensory neurons and opens the possibility of studying the molecular mechanisms of nociception and proprioception.