摘要
目的:探讨脊髓电刺激(spinal cord stimulation, SCS)治疗慢性疼痛的神经免疫机制。方法:在健康小鼠中植入电极,进行连续SCS,观察机械痛阈值的改变和脊髓中小胶质细胞的极化状态。测定脊髓和脑脊液中转化生长因子-β(transforming growth factor-β, TGF-β)的表达水平,以及抑制TGF-β功能后SCS对机械痛阈值改变的影响。结果:电极植入术未改变小鼠的机械痛阈值和运动能力。连续SCS可显著提高小鼠的机械痛阈,增加脊髓背角中小胶质细胞M2极化水平和TGF-β的表达,鞘内注射TGF-β抗体减弱SCS对机械痛阈值的影响。结论:连续的SCS通过激活脊髓小胶质细胞并使其进入M2极化状态,释放TGF-β,进而上调疼痛阈值发挥镇痛作用。
Objective:To investigate the neuroimmune mechanism of spinal cord stimulation(SCS)in the treatment of chronic pain.Methods:Electrodes were implanted in healthy mice and continuous SCS was performed to observe the changes in mechanical pain threshold and the polarisation status of microglia in the spinal cord.The expression levels of transforming growth factor-β(TGF-β)in the spinal cord and cerebrospinal fluid were measured,and the effects of SCS on the alteration of mechanical pain threshold after inhibiting the function of TGF-βwere determined.Results:Electrode implantation did not influence the mechanical pain threshold and locomotor ability of mice.Continuous SCS significantly increased the mechanical pain threshold,the M2 polarisation level and TGF-βexpression in microglia in the dorsal horn of the spinal cord,and intrathecal injection of TGF-βantibody attenuated the effect of SCS on the mechanical pain threshold.Conclusion:Continuous SCS exerts analgesic effects by activating spinal microglia into M2 polarised state and releasing TGF-β,and then up-regulates the pain threshold.
作者
董莎娜
罗清甜
周晓琴
李楠
张咏芳
季涵璞
熊东林
肖礼祖
罗裕辉
樊碧发
蒋昌宇
DONG Sha-na;LUO Qing-tian;ZHOU Xiao-qin;LI Nan;ZHANG Yong-fang;JI Han-pu;XIONG Dong-lin;XIAO Li-zu;LUO Yu-hui;FAN Bi-fa;JIANG Chang-yu(Guangdong Medical University,Zhanjiang 524023,China;Department of Gastroenterology,Shenzhen Nanshan People's Hospital,Shenzhen 518052,China;Department of Anesthesiology,Dongguan Hospital of Guangzhou University of Chinese Medicine,Dongguan 523000,China;Department of Pain Medicine,Shenzhen Nanshan People's Hospital,Shenzhen 518052,China;Shenzhen University Health Science,Shenzhen 518060,China;Department of Pain Medicine,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国疼痛医学杂志》
北大核心
2025年第7期510-519,共10页
Chinese Journal of Pain Medicine
基金
国家自然科学基金(82171221)
广东省基础与应用基础研究基金(2021A1515110799、2023A1515010144)
深圳市科技计划资助(JCYJ20220530142000001)
深圳市科技创新委员会基础研究面上项目(JCYJ20220818103206013)
深圳市科技创新委员会基础研究重点项目(JCYJ20220818103206013)
深圳市南山区卫生健康系统科技重大项目(NSZD2024015)
深圳市医疗卫生三名工程引进“中日友好医院樊碧发教授疼痛医学团队”项目(SZSM202103018)
国家重点研发计划“主动健康和人口老龄化科技应对”重点专项(2022YFC3602201)。
