Abstract

Diabetic peripheral neuropathic pain (DPNP) is the most devastating complication of diabetes mellitus. Unfortunately, successful therapy for DPNP remains a challenge because its pathogenesis is still elusive. However, DPNP is believed to be due partly to abnormal hyperexcitability of dorsal root ganglion (DRG) neurons, but the relative contributions of specific functional subtypes remain largely unknown. Here, using the strepotozotocin (STZ) rat model of DPNP induced by a STZ injection (60 mg/kg, i.p), and intracellular recordings of action potentials (APs) from DRG neurons in anesthetized rats, we examined electrophysiological changes in C-and Aβ-nociceptive and Aβ-low threshold mechanoreceptive (LTM) neurons that may contribute to DPNP. Compared with control, we found in STZ-rats with established pain hypersensitivity (5 weeks post-STZ) several significant changes including: (a) A 23% increase in the incidence of spontaneous activity (SA) in Aβ-LTMs (but not C-mechanosensitive nociceptors) that may cause dysesthesias/paresthesia suffered by DPNP patients, (b) membrane hyperpolarization and a ∼85% reduction in SA rate in Aβ-LTMs by Kv7 channel activation with retigabine (6 mg/kg, i.v.) suggesting that Kv7/M channels may be involved in mechanisms of SA generation in Aβ-LTMs, (c) decreases in AP duration and in duration and amplitude of afterhyperpolarization (AHP) in C-and/or Aβ-nociceptors. These faster AP and AHP kinetics may lead to repetitive firing and an increase in afferent input to the CNS and thereby contribute to DPNP development, and (d) a decrease in the electrical thresholds of Aβ-nociceptors that may contribute to their sensitization, and thus to the resulting hypersensitivity associated with DPNP.

Highlights

  • METHODSDiabetic peripheral neuropathic pain (DPNP) is the most debilitating complication of diabetes mellitus with up to 50% of people with diabetic neuropathy (DN) having some degree of PNP (e.g., Lee-Kubli and Calcutt, 2014)

  • We report several novel electrophysiological changes in Aβ-low threshold mechanoreceptive (LTM), and C-and Aβ-nociceptors in STZ-rats that are likely to contribute to DPNP pathogenesis

  • These include: (1) increased incidence of spontaneous activity (SA) in Aβ-LTMs that may result in dysesthesias/paresthesias associated with DPNP, and (2) faster action potentials (APs) and AHP kinetics, and reduced electrical thresholds (C-and/or Aβ-nociceptors) that may lead to their repetitive firing and sensitization respectively, and thereby contribute to development of DPNP

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Summary

METHODS

Diabetic peripheral neuropathic pain (DPNP) is the most debilitating complication of diabetes mellitus with up to 50% of people with diabetic neuropathy (DN) having some degree of PNP (e.g., Lee-Kubli and Calcutt, 2014). We found (5 weeks post-STZ) several significant changes in both nociceptive and non-nociceptive DRG neurons in STZ rats These include SA in A/β-LTMs (but not in C-mechanosensitive nociceptors) that may cause dysesthesias/paresthesias experienced by many patients with DPNP. Pain behavioral testing was conducted on 10 STZ rats by an experimenter blind to the various treatment animal groups as reported recently (Djouhri et al, 2019). Nociceptive neurons were those that failed to respond to the non-noxious mechanical stimuli but responded either to noxious mechanical stimuli (applied with a needle, fine forceps or coarse toothed forceps) only, or to both noxious mechanical and noxious heat stimuli (hot water at 50–65◦C applied with a syringe). Statistical significance: ∗P < 0.05, ∗∗P < 0.01, and ∗∗∗P < 0.001

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