Abstract

Neurotensin (NT) is an endogenous neuropeptide that exerts potent opioid-independent analgesic effects, most likely via the type 2 NT receptor (NTR2). Previous morphological and electrophysiological studies suggested that the NT-NTR2 system is primarily localized in structures that constitute the descending pain control pathway, such as the periaqueductal gray (PAG), the rostral ventromedial medulla (RVM), and the spinal dorsal horn (SDH). However, relevant morphological evidence for this neurotensinergic (NTergic) circuit is lacking. Thus, the aim of the present study was to morphologically elucidate the potential sites and connections in the NT-NTR2 system that are involved in the descending pain control pathway. Based on light and electron microscopy combined with anterograde and retrograde tracing, we found evidence that NTR2-immunoreactive (IR) neurons in the RVM receive NT-IR projections originating from the PAG; express NT, serotonin (5-HT), or both; and send projections that terminate in laminae I and II of the SDH. These results suggest that NTR2 may contribute to pain control by binding to NT in the PAG-RVM-SDH pathway. In conclusion, our data provide morphological evidence for an NTergic PAG-RVM-SDH pathway, implicating novel mechanisms of NT-induced analgesia.

Highlights

  • Pain is most likely one of the most prevalent human health problems, contributing to individual morbidity and mortality and imposing high societal costs (Mogil, 2013)

  • Based on light and electron microscopy combined with anterograde and retrograde tracing, we found evidence that NTR2-immunoreactive (IR) neurons in the rostral ventromedial medulla (RVM) receive NT-IR projections originating from the periaqueductal gray (PAG); express NT, serotonin (5-HT), or both; and send projections that terminate in laminae I and II of the spinal dorsal horn (SDH)

  • These results suggest that NTR2 may contribute to pain control by binding to NT in the PAG-RVM-SDH pathway

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Summary

Introduction

Pain is most likely one of the most prevalent human health problems, contributing to individual morbidity and mortality and imposing high societal costs (Mogil, 2013) Due to their limited efficacy and large numbers of side effects, the current analgesics for pain remain far from optimal. The periaqueductal gray (PAG) modulates nociception via a descending pathway that relays in the rostral ventromedial medulla (RVM) and terminates in superficial laminae (laminae I and II) of the spinal dorsal horn (SDH; Morgan et al, 2008), referred to as the PAG-RVM-SDH pathway This pathway comprises an essential neural circuit that exerts powerful modulatory influences on pain (Basbaum and Fields, 1984). The roles of other neurotransmitters, including neurotensin (NT), are not fully supported by these experimental data

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