Identification of the Visceral Pain Pathway Activated by Noxious Colorectal Distension in Mice

Department of Human Physiology, Flinders Medical Science and Technology Cluster, Flinders University Adelaide, SA, Australia.
Frontiers in Neuroscience (Impact Factor: 3.66). 02/2011; 5:16. DOI: 10.3389/fnins.2011.00016
Source: PubMed


In patients with irritable bowel syndrome (IBS), visceral pain is evoked more readily following distension of the colorectum. However, the identity of extrinsic afferent nerve pathway that detects and transmits visceral pain from the colorectum to the spinal cord is unclear. In this study, we identified which extrinsic nerve pathway(s) underlies nociception from the colorectum to the spinal cord of rodents. Electromyogram (EMG) recordings were made from the transverse oblique abdominal muscles in anesthetized wild type (C57BL/6) mice and acute noxious intraluminal distension (100-120 mmHg) applied to the terminal 15mm of rectum to activate visceromotor responses (VMRs). Cutting the lumbar colonic nerves in vivo had no detectable effect on the VMRs evoked by colorectal distension. Lesioning right or left hypogastric nerves also failed to reduce VMRs. However, lesioning left and right branches of the rectal nerves completely abolished the VMRs, regardless of whether the lumbar colonic or hypogastric nerves were severed. Electrical stimulation applied to either the lumbar colonic or hypogastric nerves in vivo, failed to elicit a VMR. In contrast, electrical stimulation (2-5Hz, 0.4ms, 60V) applied to the rectum reliably elicited VMRs, which were abolished by selective lesioning of the rectal nerves. DiI retrograde labelling from the colorectum labelled sensory neurons only in dorsal root ganglia (DRG) of the lumbosacral region of the spinal cord. In contrast, injection of DiI into the mid to proximal colon labelled sensory neurons in DRG primarily of the lower thoracic level (T8-L4) of the spinal cord. The visceral pain pathway activated by acute noxious distension of the terminal 15 mm of mouse rectum is transmitted predominantly, if not solely, through rectal/pelvic afferent nerve fibres to the spinal cord. The sensory neurons of this spinal afferent pathway lie in the lumbosacral region of the spinal cord, primarily at the level of S2 and S3.

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    • "In the GI tract, extensive evidence has now been presented that noxious and innocuous stimuli from the GI-tract are detected and transmitted by spinal afferent neurons, whose cell bodies lie in dorsal root ganglia (DRG), but whose nerve endings lie within the wall of the GI-tract (Traub, 2000; Kyloh et al., 2011; Zagorodnyuk et al., 2011). Whilst much has been learnt from extracellular recordings of spinal afferents that lie outside the gut wall, this technique does not reveal direct information about the mechanisms underlying sensory transduction, since this process only occurs within the afferent nerve endings located within the peripheral organ. "
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    ABSTRACT: Spinal afferent neurons play a major role in detecting noxious and innocuous stimuli from visceral organs, such as the gastrointestinal tract. However, all our understanding about spinal afferents has been obtained from recordings of spinal afferent axons, or cell bodies that lie outside the gut wall, or peripheral organ they innervate. No recordings have been made directly from spinal afferent nerve endings, which is where sensory transduction occurs. We developed a preparation whereby recordings could be made from rectal afferent nerve endings in the colon, to characterize mechanisms underlying sensory transduction. Dorsal root ganglia (L6-S2) were removed from mice, whilst retaining neural continuity with the colon. Fluo-4-AM was used to record from rectal afferent nerve endings in myenteric ganglia and circular muscle at 36°C. In slack (unstretched) preparations of colon, no calcium transients were recorded from spinal afferent endings. However, in response to a maintained increase in circumferential diameter, a maintained discharge of calcium transients occurred simultaneously in multiple discrete varicosities along single axons of rectal afferents in myenteric ganglia and circular muscle. Stretch-activated calcium transients were resistant to hexamethonium and nifedipine, but were abolished by tetrodotoxin, CPA, BAPTA-AM, cobalt, gadolinium, or replacement of extracellular Na(+) with NMDG. In summary, we present a novel preparation in which stretch-activated firing of spinal afferent nerve endings can be recorded, using calcium imaging. We show that circumferential stretch of the colon activates a maintained discharge of calcium transients simultaneously in varicosities along single rectal afferent endings in myenteric ganglia and circular muscle. Non-selective cation channels, TTX-sensitive Na(+) channels and both extracellular calcium influx and intracellular Ca(2+) stores are required for stretch-activated calcium transients in rectal afferent endings.
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    ABSTRACT: Visceral pain, although different from somatic pain in several important features, is not as widely researched and consequently our knowledge of neurophysiologic mechanisms as well as clinical management of visceral pain states remains unsatisfactory. Several recent studies have employed different visceral pain animal models to provide insight into the peripheral and central nervous system mechanisms underlying pain originating from the urinary bladder, ureter, and gastrointestinal tract. The effects of opioid and nonopioid drugs in these models have also been evaluated and are reviewed in this article. The importance of anatomic pathways relaying pain sensation in the central nervous system, particularly the newly described dorsal column pathway, is also discussed. In human subjects, new techniques like positron emission tomography are now being used to better understand visceral pain perception. Such findings deriving from basic animal research and human studies summarized in the present overview lead to a better understanding of visceral pain states and may be helpful in developing better treatment strategies to combat visceral pain states in the clinical setting.
    Current Review of Pain 02/2000; 4(6):499-506. DOI:10.1007/7854_2014_315
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    ABSTRACT: The concept that the gut and the brain are closely connected, and that this interaction plays an important part not only in gastrointestinal function but also in certain feeling states and in intuitive decision making, is deeply rooted in our language. Recent neurobiological insights into this gut-brain crosstalk have revealed a complex, bidirectional communication system that not only ensures the proper maintenance of gastrointestinal homeostasis and digestion but is likely to have multiple effects on affect, motivation and higher cognitive functions, including intuitive decision making. Moreover, disturbances of this system have been implicated in a wide range of disorders, including functional and inflammatory gastrointestinal disorders, obesity and eating disorders.
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