A Study of Pro- and Anti-Nociceptive Factors In A Model of Colitis-Associated Visceral Pain
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Chronic abdominal pain is a major cause of patient morbidity in inflammatory bowel diseases (IBD). A balance of pro- and anti-nociceptive factors regulating colonic dorsal root ganglion (DRG) neurons, which synapse onto second order dorsal horn neurons, are known to regulate chronic pain but the mechanisms are poorly understood. This thesis examined whether neuroanatomical remodeling of DRG central nerve terminals underlies pro-nociceptive signaling and whether subsets of immune cells source the anti-nociceptive factor, β-endorphin. To examine pro-nociceptive mechanisms, acute and chronic dextran sulfate sodium (DSS) mouse models of colitis were established and substance P (SP; marker of nociceptor terminals) immunohistochemistry used to investigate changes in immunoreactivity of DRG terminals in the thoracic dorsal horn (segments T9-T13). SP immunoreactivity was increased in the dorsal horn (4 fold; P < 0.001) and central canal (P < 0.001) following chronic colitis. In contrast, SP immunoreactivity was unchanged in acute colitis. However, five weeks later SP immunoreactivity was increased both in the dorsal horn (4 fold; P < 0.01) and central canal (P < 0.001). In the cervical spinal cord, SP immunoreactivity was not increased following colitis, suggesting that changes seen in the thoracic level were specific to signaling from colonic DRG neurons. Immunoreactivity for the SP NK1 receptor on second order neurons was also examined and a significant increase in immunoreactivity was observed on post-synaptic second order cell bodies following chronic DSS. This could provide an additional mechanism for enhanced SP neurotransmission centrally. ii The source of the anti-nociceptive mediator, β-endorphin, during chronic DSS colitis was investigated using magnetic cell sorting and flow cytometry. The number of β- endorphin expressing CD4+ (2.4 fold; P < 0.05) and CD11b+ (2.6 fold; P < 0.05) cells in mice increased following chronic colitis. These findings suggest that during colitis there is a time-dependent increase of SP immunoreactivity in thoracic DRG central terminals, which could play a role in pro- nociceptive signaling in chronic inflammation. These actions may be balanced by anti- nociceptive factors such as β-endorphin which are found in subsets of immune cells.