Abstract

Significant age- and experience-dependent remodelling of spinal and supraspinal neural networks occur, resulting in altered pain responses in early life. In adults, endogenous opioid peptide and endocannabinoid (ECs) pain control systems exist which modify pain responses, but the role they play in acute responses to pain and postnatal neurodevelopment is unknown. Here, we have studied the changing role of the ECs in the brainstem nuclei essential for the control of nociception from birth to adulthood in both rats and humans. Using in vivo electrophysiology, we show that substantial functional changes occur in the effect of microinjection of ECs receptor agonists and antagonists in the periaqueductal grey (PAG) and rostroventral medulla (RVM), both of which play central roles in the supraspinal control of pain and the maintenance of chronic pain states in adulthood. We show that in immature PAG and RVM, the orphan receptor, GPR55, is able to mediate profound analgesia which is absent in adults. We show that tissue levels of endocannabinoid neurotransmitters, anandamide and 2-arachidonoylglycerol, within the PAG and RVM are developmentally regulated (using mass spectrometry). The expression patterns and levels of ECs enzymes and receptors were assessed using quantitative PCR and immunohistochemistry. In human brainstem, we show age-related alterations in the expression of key enzymes and receptors involved in ECs function using PCR and in situ hybridisation. These data reveal that significant changes on ECs that to this point have been unknown and which shed new light into the complex neurochemical changes that permit normal, mature responses to pain.

Highlights

  • Pain in infancy is a clinical concern and has been recognised as being suboptimally managed.[58]

  • We first measured the concentrations of endogenous CB1 receptor ligands, anandamide (AEA) and 2-AG, in the periaqueductal grey (PAG) and rostroventral medulla (RVM) of postnatal day (P)[10], P21, and P40 rats by tandem liquid chromatography–mass spectrometry

  • We focused on the ventral PAG (vPAG) as neurons from this region indirectly project to the dorsal horn (DH) via the RVM.[3,59]

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Summary

Introduction

Pain in infancy is a clinical concern and has been recognised as being suboptimally managed.[58] Previous studies have shown that pain processing in young mammals is immature: nocifensive withdrawal thresholds are lower, and response magnitudes are greater and longer lasting during early life.[21] Normal adult processing of noxious sensory inputs requires a constant balance between synaptic excitation and inhibition within the Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. A School of Life Sciences, The University of Nottingham, Nottingham, United Kingdom. Kwok with the Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada, b Centre for Analytical Bioscience, School of Pharmacy, The University of Nottingham, Nottingham, United Kingdom, c Arthritis Research UK Pain Centre, Nottingham, United Kingdom

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