Résumé
Les douleurs neuropathiques, consécutives à une lésion du système nerveux, répondent mal aux traitements antalgiques usuels et souffrent d’une prise en charge thérapeutique insuffisante. Une des conséquences d’une lésion nerveuse périphérique est l’apparition d’activités électriques anormales au sein des fibres afférentes primaires lésées. Les données expérimentales réunies au cours de ces dernières années ont permis de révéler la multiplicité et la complexité des remaniements périphériques et centraux potentiellement impliqués dans le déterminisme de ces douleurs. Il existe notamment des modifications de la répartition spatiale, de l’expression et de l’activité de certaines isoformes des canaux sodiques au niveau des fibres lésées. Le développement de médicaments spécifiquement destinés à agir sur ces canaux permettra sans doute d’obtenir des composés dotés d’une efficacité thérapeutique accrue et dépourvus de certains effets indésirables.
Abstract
Management of neuropathic pain remains a major clinical challenge. Clinical and experimental data indicate that changes in the expression of voltage-gated sodium channels play a key role in the pathogenesis of neuropathic pain. Several of the sodium channel isoforms that are implicated in neuropathic pain states are selectively expressed in somatosensory primary afferent neurons. This restricted expression pattern raises the possibility that isoform-specific drugs might be analgesic and lack the cardiotoxicity and neurotoxicity that limit the use of current sodium channel blockers.
Références
Abram SE, Yaksh TL (1994) Systemic lidocaine blocks nerve injuryinduced hyperalgesia and nociceptor-driven spinal sensitization in the rat. Anesthesiology 80(2): 383–391
Amaya F, Wang H, Costigan M, et al. (2006) The voltage-gated sodium channel Nav1.9 is an effector of peripheral inflammatory pain hypersensitivity. J Neurosci 26(50): 12852–12860
Arnér S, Lindblom U, Meyerson BA, Molander C (1990) Prolonged relief of neuralgia after regional anesthetic blocks. A call for further experimental and systematic clinical studies. Pain 43(3): 287–297
Beckh S (1990) Differential expression of sodium channel mRNAs in rat peripheral nervous system and innervated tissues. FEBS Lett 262(2): 317–322
Black JA, Cummins TR, Plumpton C, et al. (1999) Up regulation of a silent sodium channel after peripheral, but not central, nerve injury in DRG neurons. J Neurophysiol 82(5): 2776–2785
Black JA, Dib-Hajj S, McNabola K, et al. (1996) Spinal sensory neurons express multiple sodium channel alpha-subunit mRNAs. Brain Res Mol Brain Res 43(1–2): 117–131
Black JA, Liu S, Tanaka M, et al. (2004) Changes in the expression of tetrodotoxin-sensitive sodium channels within dorsal root ganglia neurons in inflammatory pain. Pain 108(3): 237–247
Black JA, Renganathan M, Waxman SG (2002) Sodium channel Nav1.6 is expressed along non-myelinated axons and it contributes to conduction. Brain Res Mol Brain Res 105(1–2): 19–28
Blackburn-Munro G, Fleetwood-Walker SM (1999) The sodium channel auxiliary subunits beta1 and beta2 are differentially expressed in the spinal cord of neuropathic rats. Neuroscience 90(1): 153–164
Blair NT, Bean BP (2003) Role of tetrodotoxin-resistant Na+ current slow inactivation in adaptation of action potential firing in small-diameter dorsal root ganglion neurons. J Neurosci 23(32): 10338–10350
Boucher TJ, Okuse K, Bennett DL, et al. (2000) Potent analgesic effects of GDNF in neuropathic pain states. Science 290(5489): 124–127
Burgess SE, Gardell LR, Ossipov MH, et al. (2002) Time-dependent descending facilitation from the rostral ventromedial medulla maintains, but does not initiate, neuropathic pain. J Neurosci 22(12): 5129–5136
Campbell JN, Meyer RA (2006) Mechanisms of neuropathic pain. Neuron 52(1): 77–92
Casula MA, Facer P, Powell AJ, et al. (2004) Expression of the sodium channel beta3 subunit in injured human sensory neurons. Neuroreport 15(10): 1629–1632
Catterall WA (2000) From ionic currents to molecular mechanisms: the structure and function of voltage-gated sodium channels. Neuron 26(1): 13–25
Chabal C, Jacobson L, Mariano A, et al. (1992) The use of oral mexiletine for the treatment of pain after peripheral nerve injury. Anesthesiology 76(4): 513–517
Chabal C, Russell LC, Burchiel KJ (1989) The effect of intravenous lidocaine, tocainide, and mexiletine on spontaneously active fibers originating in rat sciatic neuromas. Pain 38(3): 333–338
Chiou-Tan FY, Tuel SM, Johnson JC, et al. (1996) Effect of mexiletine on spinal cord injury dysesthetic pain. Am J Phys Med Rehabil 75(2): 84–87
Chung JM, Chung K (2004) Sodium channels and neuropathic pain. Novartis Found Symp 261: 19–27
Coste B, Crest M, Delmas P (2007) Pharmacological dissection and distribution of NaN/Nav1.9, t-type Ca2+ currents, and mechanically activated cation currents in different populations of DRG neurons. J Gen Physiol. 129(1): 57–77
Coste B, Osorio N, Padilla F, et al. (2004) Gating and modulation of presumptive Nav1.9 channels in enteric and spinal sensory neurons. Mol Cell Neurosci 26(1): 123–134
Coward K, Jowett A, Plumpton C, et al. (2001) Sodium channel beta1 and beta2 subunits parallel SNS/PN3 alpha-subunit changes in injured human sensory neurons. Neuroreport 12(3): 483–488
Coward K, Plumpton C, Facer P, et al. (2000) Immunolocalization of SNS/PN3 and NaN/SNS2 sodium channels in human pain states. Pain 85(1–2): 41–50
Craner MJ, Klein JP, Renganathan M, et al. (2002) Changes of sodium channel expression in experimental painful diabetic neuropathy. Ann Neurol 52(6): 786–792
Cummins TR, Dib-Hajj SD, Waxman SG (2004) Electrophysiological properties of mutant Nav1.7 sodium channels in a painful inherited neuropathy. J Neurosci 24(38): 8232–8236
Dejgard A, Petersen P, Kastrup J (1988) Mexiletine for treatment of chronic painful diabetic neuropathy. Lancet 1(8575-6): 9–11
Devor M (1991) Neuropathic pain and injured nerve: peripheral mechanisms. Br Med Bull 47(3): 619–630
Devor M, Govrin-Lippmann R, Angelides K (1993) Na+ channel immunolocalization in peripheral mammalian axons and changes following nerve injury and neuroma formation. J Neurosci 13(5): 1976–1992
Devor M, Wall PD, Catalan N (1992) Systemic lidocaine silences ectopic neuroma and DRG discharge without blocking nerve conduction. Pain 48(2): 261–268
Dib-Hajj SD, Fjell J, Cummins TR, et al. (1999) Plasticity of sodium channel expression in DRG neurons in the chronic constriction injury model of neuropathic pain. Pain 83(3): 591–600
Dib-Hajj SD, Rush AM, Cummins TR, et al. (2005) Gain-of-function mutation in Nav1.7 in familial erythromelalgia induces bursting of sensory neurons. Brain 128(Pt 8): 1847–1854
Dick IE, Brochu RM, Purohit Y, et al. (2007) Sodium channel blockade may contribute to the analgesic efficacy of antidepressants. J Pain 8(4): 315–324
Djouhri L, Fang X, Okuse K, et al. (2003) The TTX-resistant sodium channel Nav1.8 (SNS/PN3): expression and correlation with membrane properties in rat nociceptive primary afferent neurons. J Physiol 550(Pt 3): 739–752
Dogra S, Beydoun S, Mazzola J, et al. (2005) Oxcarbazepine in painful diabetic neuropathy: a randomized, placebo-controlled study. Eur J Pain 9(5): 543–554
Ferrante FM, Paggioli J, Cherukuri S, Arthur GR (1996) The analgesic response to intravenous lidocaine in the treatment of neuropathic pain. Anesth Analg 82(1): 91–97
Fjell J, Cummins TR, Dib-Hajj SD, et al. (1999) Differential role of GDNF and NGF in the maintenance of two TTX-resistant sodium channels in adult DRG neurons. Brain Res Mol Brain Res 67(2): 267–282
Galer BS, Miller KV, Rowbotham MC (1993) Response to intravenous lidocaine infusion differs based on clinical diagnosis and site of nervous system injury. Neurology 43(6): 1233–1235
Gammaitoni AR, Alvarez NA, Galer BS (2003) Safety and tolerability of the lidocaïne patch 5%, a targeted peripheral analgesic: a review of the literature. J Clin Pharmacol 43(2): 111–117
Gold MS, Weinreich D, Kim CS, et al. (2003) Redistribution of Nav1.8 in uninjured axons enables neuropathic pain. J Neurosci 23(1): 158–166
Gracely RH, Lynch SA, Bennett GJ (1992) Painful neuropathy: altered central processing maintained dynamically by peripheral input. Pain 51(2): 175–194
Hong S, Morrow TJ, Paulson PE, et al. (2004) Early painful diabetic neuropathy is associated with differential changes in tetrodotoxinsensitive and-resistant sodium channels in dorsal root ganglion neurons in the rat. J Biol Chem 279(28): 29341–29350
Hong S, Wiley JW (2006) Altered expression and function of sodium channels in large DRG neurons and myelinated A-fibers in early diabetic neuropathy in the rat. Biochem Biophys Res Commun 339(2): 652–660
Isom LL (2000) I. Cellular and molecular biology of sodium channel beta-subunits: therapeutic implications for pain? Am J Physiol Gastrointest Liver Physiol 278(3): G349–G353
Isom LL, De Jongh KS, Patton DE, et al. (1992) Primary structure and functional expression of the beta1 subunit of the rat brain sodium channel. Science 256(5058): 839–842
Ji RR, Woolf CJ (2001) Neuronal plasticity and signal transduction in nociceptive neurons: implications for the initiation and maintenance of pathological pain. Neurobiol Dis 8(1): 1–10
Kajander KC, Bennett GJ (1992) Onset of a painful peripheral neuropathy in rat: a partial and differential deafferentation and spontaneous discharge in A beta and A delta primary afferent neurons. J Neurophysiol 68(3): 734–744
Kalso E, Tramèr MR, McQuay HJ, Moore RA (1998) Systemic local-anaesthetic-type drugs in chronic pain: a systematic review. Eur J Pain 2(1): 3–14
Kastrup J, Petersen P, Dejgaård A, et al. (1987) Intravenous lidocaine infusion: a new treatment of chronic painful diabetic neuropathy? Pain 28(1): 69–75
Kemper CA, Kent G, Burton S, Deresinski SC (1998) Mexiletine for HIV-infected patients with painful peripheral neuropathy: a double blind, placebo-controlled, crossover treatment trial. J Acquir Immune Defic Syndr Hum Retrovirol 19(4): 367–372
Kerr BJ, Souslova V, McMahon SB, Wood JN (2001) A role for the TTX-resistant sodium channel Nav1.8 in NGF-induced hyperalgesia, but not neuropathic pain. Neuroreport 12(14): 3077–3080
Kieburtz K, Simpson D, Yiannoutsos C, et al. (1998) A randomized trial of amitriptyline and mexiletine for painful neuropathy in HIV infection. AIDS Clinical Trial Group 242 Protocol Team. Neurology 51(6): 1682–1688
Kim CH, Oh Y, Chung JM, Chung K (2001) The changes in expression of three subtypes of TTX sensitive sodium channels in sensory neurons after spinal nerve ligation. Brain Res Mol Brain Res 95(1–2): 153–161
Kral MG, Xiong Z, Study RE (1999) Alteration of Na+ currents in dorsal root ganglion neurons from rats with a painful neuropathy. Pain 81(1–2): 15–24
Krzemien DM, Schaller KL, Levinson SR, Caldwell JH (2000) Immunolocalization of sodium channel isoform NaCh6 in the nervous system. J Comp Neurol 420(1): 70–83
Lai J, Gold MS, Kim CS, et al. (2002) Inhibition of neuropathic pain by decreased expression of the tetrodotoxin-resistant sodium channel, Nav1.8. Pain 95(1–2): 143–152
Leffler A, Cummins TR, Dib-Hajj SD, et al. (2002) GDNF and NGF reverse changes in repriming of TTX-sensitive Na(+) currents following axotomy of dorsal root ganglion neurons. J Neurophysiol 88(2): 650–658
Lyu YS, Park SK, Chung K, Chung JM (2000) Low-dose of tetrodotoxin reduces neuropathic pain behaviors in an animal model. Brain Res 871(1): 98–103
Maingret F, Coste B, Padilla F, et al. (2008) Inflammatory mediators increase Nav1.9 current and excitability in nociceptors through a coincident detection mechanism. J Gen Physiol 131(3): 211–225
Mao J, Chen LL (2000) Systemic lidocaïne for neuropathic pain relief. Pain 87(1): 7–17
Nassar MA, Stirling LC, Forlani G, et al. (2004) Nociceptor-specific gene deletion reveals a major role for Nav1.7 (PN1) in acute and inflammatory pain. Proc Natl Acad Sci USA 101(34): 12706–12711
Omana-Zapata I, Khabbaz MA, Hunter JC, et al. (1997) Tetrodotoxin inhibits neuropathic ectopic activity in neuromas, dorsal root ganglia and dorsal horn neurons. Pain 72(1–2): 41–49
Padilla F, Couble ML, Coste B, et al. (2007) Expression and localization of the Nav1.9 sodium channel in enteric neurons and in trigeminal sensory endings: implication for intestinal reflex function and orofacial pain. Mol Cell Neurosci 35(1): 138–152
Pertin M, Ji RR, Berta T, et al. (2005) Up regulation of the voltagegated sodium channel beta2 subunit in neuropathic pain models: characterization of expression in injured and non-injured primary sensory neurons. J Neurosci 25(47): 10970–10980
Priest BT, Murphy BA, Lindia JA, et al. (2005) Contribution of the tetrodotoxin-resistant voltage-gated sodium channel Nav1.9 to sensory transmission and nociceptive behavior. Proc Natl Acad Sci USA 102(26): 9382–9387
Renganathan M, Dib-Hajj S, Waxman SG (2002) Na(v)1.5 underlies the “third TTX-R sodium current” in rat small DRG neurons. Brain Res Mol Brain Res 106(1–2): 70–78
Rowbotham MC, Reisner-Keller LA, Fields HL (1991) Both intravenous lidocaine and morphine reduce the pain of postherpetic neuralgia. Neurology 41(7): 1024–1028
Roy ML, Narahashi T (1992) Differential properties of tetrodotoxinsensitive and tetrodotoxin-resistant sodium channels in rat dorsal root ganglion neurons. J Neurosci 12(6): 2104–2111
Roza C, Laird JM, Souslova V, et al. (2003) The tetrodotoxin-resistant Na+ channel Nav1.8 is essential for the expression of spontaneous activity in damaged sensory axons of mice. J Physiol 550(Pt 3): 921–926
Sangameswaran L, Fish LM, Koch BD, et al. (1997) A novel tetrodotoxin-sensitive, voltage-gated sodium channel expressed in rat and human dorsal root ganglia. J Biol Chem 272(23): 14805–14809
Shah BS, Gonzalez MI, Bramwell S, et al. (2001) Beta3, a novel auxiliary subunit for the voltage gated sodium channel is up regulated in sensory neurones following streptozocin induced diabetic neuropathy in rat. Neurosci Lett. 309(1): 1–4
Shah BS, Stevens EB, Gonzalez MI, et al. (2000) Beta3, a novel auxiliary subunit for the voltage-gated sodium channel, is expressed preferentially in sensory neurons and is up regulated in the chronic constriction injury model of neuropathic pain. Eur J Neurosci 12(11): 3985–3990
Sindrup SH, Jensen TS (1999) Efficacy of pharmacological treatments of neuropathic pain: an update and effect related to mechanism of drug action. Pain 83(3): 389–400
Sleeper AA, Cummins TR, Dib-Hajj SD, et al. (2000) Changes in expression of two tetrodotoxin-resistant sodium channels and their currents in dorsal root ganglion neurons after sciatic nerve injury but not rhizotomy. J Neurosci 20(19): 7279–7289
Takahashi N, Kikuchi S, Dai Y, et al. (2003) Expression of auxiliary beta subunits of sodium channels in primary afferent neurons and the effect of nerve injury. Neuroscience 121(2): 441–450
Veneroni O, Maj R, Calabresi M, et al. (2003) Anti-allodynic effect of NW-1029, a novel Na(+) channel blocker, in experimental animal models of inflammatory and neuropathic pain. Pain 102(1–2): 17–25
Wall PD, Devor M (1983) Sensory afferent impulses originate from dorsal root ganglia as well as from the periphery in normal and nerve injured rats. Pain 17(4): 321–339
Wang R, Guo W, Ossipov MH, et al. (2003) Glial cell line-derived neurotrophic factor normalizes neurochemical changes in injured dorsal root ganglion neurons and prevents the expression of experimental neuropathic pain. Neuroscience 121(3): 815–824
Waxman SG, Kocsis JD, Black JA (1994) Type III sodium channel mRNA is expressed in embryonic but not adult spinal sensory neurons, and is re-expressed following axotomy. J Neurophysiol 72(1): 466–470
West JW, Patton DE, Scheuer T, et al. (1992) A cluster of hydrophobic amino acid residues required for fast Na(+)-channel inactivation. Proc Natl Acad Sci USA 89(22): 10910–10914
Wu G, Ringkamp M, Murinson BB, et al. (2002) Degeneration of myelinated efferent fibers induces spontaneous activity in uninjured C-fiber afferents. J Neurosci 22(17): 7746–7753
Xiao HS, Huang QH, Zhang FX, et al. (2002) Identification of gene expression profile of dorsal root ganglion in the rat peripheral axotomy model of neuropathic pain. Proc Natl Acad Sci USA 99(12): 8360–8365
Yang Y, Wang Y, Li S, et al. (2004) Mutations in SCN9A, encoding a sodium channel alpha subunit, in patients with primary erythermalgia. J Med Genet 41(3): 171–174
Yashpal K, Pitcher GM, Parent A, et al. (1995) Noxious thermal and chemical stimulation induce increases in 3H-phorbol 12,13-dibutyrate binding in spinal cord dorsal horn as well as persistent pain and hyperalgesia, which is reduced by inhibition of protein kinase C. J Neurosci 15(5 Pt 1): 3263–3272
Yu FH, Westenbroek RE, Silos-Santiago I, et al. (2003) Sodium channel beta4, a new disulfide-linked auxiliary subunit with similarity to beta2. J Neurosci 23(20): 7577–7585
Zhang XF, Zhu CZ, Thimmapaya R, et al. (2004) Differential action potentials and firing patterns in injured and uninjured small dorsal root ganglion neurons after nerve injury. Brain Res 1009(1–2): 147–158
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Maingret, F., Delmas, P. Rôle des canaux sodium des neurones afférents primaires dans les douleurs neuropathiques périphériques. Douleur analg 21, 194–202 (2008). https://doi.org/10.1007/s11724-008-0107-2
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DOI: https://doi.org/10.1007/s11724-008-0107-2