Douleur chronique et système cholinergique spinal

An endogenous spinal cholinergic tone modulating nociceptive (pain­like) behaviors has been demonstrated in rodents and humans. One potential source of this acetylcholine is the spinal Dorsal Horn (DH) cholinergic interneurons. Our objectives were to: (1) characterize the spinal cholinergic tone establishing mechanical nociceptive thresholds and (2) to elucidate the role of DH cholinergic neurons in the modulation of sensory information of naïve and neuropathic animals. We have confirmed the presence of a cholinergic tone modulating mechanical thresholds and demonstrated that it is still present, although altered, after neuropathy. The DH cholinergic interneurons receive excitatory inputs from distant spinal segments and generally receive lower inhibitory inputs. In addition, they are indirectly connected by a subset of nociceptive primary afferents expressing TRPV1, demonstrating their involvement in nociceptive processing. In neuropathic spinal circuits, the inputs to LIII/IV neurons appears to be unaffected after injury. Better understanding the spinal cholinergic system can pave way to alternative pain therapy.Chez les rongeurs et humains, un « tonus » cholinergique spinal endogène modulant les comportements nociceptifs (douloureux) a été décrit. Une source potentielle de cette acétylcholine sont les interneurones cholinergiques de la corne dorsale (CD) de la moelle épinière. Nos objectifs étaient les suivants : (1) caractériser le « tonus » cholinergique spinal responsable de l’établissement des seuils mécaniques nociceptifs et (2) élucider le rôle des neurones cholinergiques CD dans la modulation de l'information sensorielle chez des animaux naïfs et neuropathiques. Nous avons confirmé la présence d'un « tonus » cholinergique qui module les seuils mécaniques et démontré qu'il est encore présent, bien qu'il soit modifié, après une neuropathie. Les interneurones cholinergiques reçoivent des entrées excitatrices localisées sur des segments plus distants et reçoivent généralement une faible fréquence d’entrées inhibitrices. De plus, ils sont indirectement reliés par des afférences primaires nociceptives qui expriment TRPV1, ce qui démontre leur implication dans le circuit nociceptif. Dans les conditions neuropathiques, les entrées des neurones LIII / IV ne sont pas affectées après une lésion du nerf périphérique. Une meilleure compréhension du système cholinergique spinal peut ouvrir la voie à une thérapie alternative contre la douleur

Enhanced analgesic cholinergic tone in the spinal cord in a mouse model of neuropathic pain

Endogenous acetylcholine (ACh) is an important modulator of nociceptive sensory processing in the spinal cord. An increased level of spinal ACh induces analgesia both in humans and rodents while interfering with cholinergic signaling is allodynic, demonstrating that a basal tone of spinal ACh modulates nociceptive responses in naïve animals. The plasticity undergone by this cholinergic system in chronic pain situation is unknown, and the mere presence of this tone in neuropathic animals is controversial. We have addressed these issues in mice through behavioral experiments, histology, electrophysiology and molecular biology, in the cuff model of peripheral neuropathy. Our behavior experiments demonstrate the persistence, and even increased impact of the analgesic cholinergic tone acting through nicotinic receptors in cuff animals. The neuropathy does not affect the number or membrane properties of dorsal horn cholinergic neurons, nor specifically the frequency of their synaptic inputs. The alterations thus appear to be in the neurons receiving the cholinergic signaling, which is confirmed by the fact that subthreshold doses of acetylcholinesterase (AChE) inhibitors in sham animals become anti-allodynic in cuff mice and by the altered expression of the β2 nicotinic receptor subunit. Our results demonstrate that endogenous cholinergic signaling can be manipulated to relieve mechanical allodynia in animal models of peripheral neuropathy. Until now, AChE inhibitors have mainly been used in the clinics in situations of acute pain (parturition, post-operative). The fact that lower doses (thus with fewer side effects) could be efficient in chronic pain conditions opens new avenues for the treatment of neuropathic pain. Significance statement: Chronic pain continues to be the most common cause of disability that impairs the quality of life, accruing enormous and escalating socio-economic costs. A better understanding of the plasticity of spinal neuronal networks, crucially involved in nociceptive processing, could help designing new therapeutic avenues. We here demonstrate that chronic pain modifies the spinal nociceptive network in such a way that it becomes more sensitive to cholinergic modulations. The spinal cholinergic system is responsible for an analgesic tone that can be exacerbated by acetylcholinesterase inhibitors, a property used in the clinic to relief acute pain (child birth, post-op). Our results suggest that lower doses of acetylcholinesterases, with even fewer side effects, could be efficient to relieve chronic pain

The presynaptic glycine transporter GlyT2 is regulated by the Hedgehog pathway in vitro and in vivo

International audienceThe identity of a glycinergic synapse is maintained presynaptically by the activity of a surface glycine transporter, GlyT2, which recaptures glycine back to presynaptic terminals to preserve vesicular glycine content. GlyT2 loss-of-function mutations cause Hyperekplexia, a rare neurological disease in which loss of glycinergic neurotransmission causes generalized stiffness and strong motor alterations. However, the molecular underpinnings controlling GlyT2 activity remain poorly understood. In this work, we identify the Hedgehog pathway as a robust controller of GlyT2 expression and transport activity. Modulating the activation state of the Hedgehog pathway in vitro in rodent primary spinal cord neurons or in vivo in zebrafish embryos induced a selective control in GlyT2 expression, regulating GlyT2 transport activity. Our results indicate that activation of Hedgehog reduces GlyT2 expression by increasing its ubiquitination and degradation. This work describes a new molecular link between the Hedgehog signaling pathway and presynaptic glycine availability

GluN3A excitatory glycine receptors control adult cortical and amygdalar circuits

International audienceGluN3A is an atypical glycine-binding subunit of NMDA receptors (NMDARs) whose actions in the brain are mostly unknown. Here, we show that the expression of GluN3A subunits controls the excitability of mouse adult cortical and amygdalar circuits via an unusual signaling mechanism involving the formation of excitatory glycine GluN1/GluN3A receptors (eGlyRs) and their tonic activation by extracellular glycine. eGlyRs are mostly extrasy- naptic and reside in specific neuronal populations, including the principal cells of the basolateral amygdala (BLA) and SST-positive interneurons (SST-INs) of the neocortex. In the BLA, tonic eGlyR currents are sensitive to fear-conditioning protocols, are subject to neuromodulation by the dopaminergic system, and control the sta- bility of fear memories. In the neocortex, eGlyRs control the in vivo spiking of SST-INs and the behavior-depen- dent modulation of cortical activity. GluN3A-containing eGlyRs thus represent a novel and widespread signaling modality in the adult brain, with attributes that strikingly depart from those of conventional NMDARs