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Anxiety-induced hyperalgesia in female rats is mediated by cholecystokinin 2 receptor in rostral ventromedial medulla and spinal 5-hydroxytryptamine 2B receptor

Journal of Pain Research. 2019;Volume 12:2009-2026


Journal Homepage

Journal Title: Journal of Pain Research

ISSN: 1178-7090 (Online)

Publisher: Dove Medical Press

LCC Subject Category: Medicine: Medicine (General)

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML



Jiang M

Bo J

Lei Y

Hu F

Xia Z

Liu Y

Lu C

Sun Y

Hou B

Ni K

Ma Z

Gu X


Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 16 weeks


Abstract | Full Text

Ming Jiang1,*, Jinhua Bo1,*, Yishan Lei,1 Fan Hu,2 Zhengrong Xia,2 Yue Liu,1 Cui’e Lu,1 Yu’e Sun,1 Bailing Hou,1 Kun Ni,1 Zhengliang Ma,1 Xiaoping Gu1 1Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People’s Republic of China; 2Department of Basic Medicine, Analytical & Testing Center, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China*These authors contributed equally to this workBackground: Preoperative anxiety is associated with postoperative hyperalgesia; however, few studies have investigated the mechanism underlying this association in female surgical patients. Research has suggested that ON cells in the rostral ventromedial medulla (RVM) receive nerve impulses via cholecystokinin 2 (CCK2) receptors, facilitating hyperalgesia. Additionally, the downstream serotonergic projection system from the RVM to the spinal cord has a dual regulating effect on pain responses, and the 5-hydoxytryptophan 2B (5-HT2B) receptor in spinal dorsal horn neurons is critically involved in mechanical allodynia.Methods: Ovariectomized rats were treated with estrogen replacement, single prolonged stress (SPS), and plantar incision. Various receptor agonists and antagonists were then administered into the RVM and spinal cord to study the mechanism underlying postoperative hyperalgesia caused by preoperative anxiety in female rats.Results: Behavioral testing revealed that preoperative SPS induced postoperative hyperalgesia, as well as the expression of the CCK2 receptor in the RVM and the expression of the 5-HT2B receptor, protein kinase Cγ (PKCγ), and phosphorylation of the N-methyl-d-aspartate receptor1 (p-NR1) in the spinal cord increased confirmed by Western blot. RVM microinjection of the CCK2 receptor agonist CCK-8 and intrathecal injection of the 5-HT2B receptor agonist BW723C86 both produced hyperalgesia in female rats after plantar incision, whereas the CCK2 receptor antagonist YM022, the 5-HT2B receptor antagonist RS127445, and the PKCγ inhibitor C37H65N9O13 decreased the rats’ sensitivity to the same stimulus. Additionally, electrophysiological analysis suggested that activation of the 5-HT2B receptor increased the whole-cell current (IBa) in superficial dorsal horn neurons through the PKCγ pathway.Conclusion: Our study demonstrated that preoperative anxiety-induced postoperative hyperalgesia in female rats is associated with descending pain pathways. The CCK2 receptor in the RVM and spinal 5-HT2B receptor may play a role in this hyperalgesic effect.Keywords: cholecystokinin 2 receptor, 5-hydoxytryptophan 2B receptor, preoperative anxiety, postoperative hyperalgesia, rostral ventromedial medulla, spinal cord