Abstract
Descending controls of spinal nociceptive processing play a critical role in the development of inflammatory hyperalgesia. Acute peripheral nociceptor sensitization drives spinal sensitization and activates spino–supraspinal–spinal loops leading to descending inhibitory and facilitatory controls of spinal neuronal activity that further modify the extent and degree of the pain state. The afferent inputs from hairy and glabrous skin are distinct with respect to both the profile of primary afferent classes and the degree of their peripheral sensitization. It is not known whether these differences in afferent input differentially engage descending control systems to different extents or in different ways. Injection of complete Freund's adjuvant resulted in inflammation and swelling of hairy hind foot skin in rats, a transient thermal hyperalgesia lasting <2 h, and longlasting primary mechanical hyperalgesia (≥7 days). Much longer lasting thermal hyperalgesia was apparent in glabrous skin (1 h to >72 h). In hairy skin, transient hyperalgesia was associated with sensitization of withdrawal reflexes to thermal activation of either A- or C-nociceptors. The transience of the hyperalgesia was attributable to a rapidly engaged descending inhibitory noradrenergic mechanism, which affected withdrawal responses to both A- and C-nociceptor activation and this could be reversed by intrathecal administration of yohimbine (α-2-adrenoceptor antagonist). In glabrous skin, yohimbine had no effect on an equivalent thermal inflammatory hyperalgesia. We conclude that acute inflammation and peripheral nociceptor sensitization in hind foot hairy skin, but not glabrous skin, rapidly activates a descending inhibitory noradrenergic system. This may result from differences in the engagement of descending control systems following sensitization of different primary afferent classes that innervate glabrous and hairy skin.
Highlights
Tissue damage and subsequent inflammation activate and sensitize peripheral nociceptors
Injection of 50 μg complete Freund’s adjuvant (CFA) into the hind foot dorsum resulted in foot oedema that was evident after 1 h and persisted for 7 days (Fig. 2A)
CFA produced a mechanical hyperalgesia to a noxious pinch (Fig. 2B), but did not induce a thermal hyperalgesia in hairy skin (Fig. 2C)
Summary
Tissue damage and subsequent inflammation activate and sensitize peripheral nociceptors This increases afferent input to central nociceptive circuits and leads to enhanced sensitivity to nociceptive stimuli (hyperalgesia), and sensations of pain to innocuous stimulation (allodynia) (Meyer et al 2005; Latremoliere & Woolf, 2009). Medullary and brainstem nuclei are major sources of spinally projecting monoaminergic fibres (Westlund et al 1983; Yoshimura & Furue, 2006) that are known to exert inhibitory influences, which modulate the development of acute and persistent pain states (Vanegas & Schaible, 2004; Pertovaara, 2006, 2013; Yoshimura & Furue, 2006). Peripheral nerve stimulation evokes spinal release of monoamines in the presence of ganglionic blocking agents (Tyce & Yaksht, 1981), and it is widely accepted that the major sources of spinal noradrenaline and serotonin are projections from medullary and brainstem nuclei (Pertovaara, 2006; Yoshimura & Furue, 2006)
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