An investigation into the role of the hyperpolarisation-activated cyclic nucleotide-gated on channels in dorsal root ganglion neurons in rat models of chronic inflammatory and neuropathic pain

Chronic pain {CP} is a major health problem that affects about 20% of adults worldwide. Unlike acute, physiological pain, which resolves promptly once the painful stimulus is removed, CP can last for months, years or even a lifetime. CP, which includes inflammatory pain {IP} that is associated with both tissue injury and the accompanying inflammation and peripheral neuropathic pain {NP} that is a direct consequence of a lesion or disease affecting the peripheral nervous system {PNS}, often is a constant burden, degrades peoples’ quality of life, and costs billions of pounds. Patients with CP usually complain of either: a) continuous or intermittent spontaneous, un-provoked pain; or b) hypersensitivity, due to either increased pain from a stimulus that normally provokes pain or pain due to a stimulus that does not normally provoke pain. Successful therapy for CP, particularly NP, remains a challenge because the currently available drugs are largely ineffective and many result in adverse side effects. Therefore, there is a pressing need to understand the pathophysiology of CP, in order to devise appropriate palliative and curative strategies. CP is believed to be due, at least partly, to increased excitability of normally quiescent dorsal root ganglion {DRG} neurons, which convey sensory information from the periphery to the central nervous system {CNS}. However, the underlying ionic and molecular mechanisms of this neuronal hyperexcitability and spontaneous activity {SA} are poorly understood. The aim of this research project was to examine the hypothesis that during peripheral CP states, hyperexcitability in DRG neurons could be due to increased expression of hyperpolarisation-activated cyclic nucleotide-gated {HCN} channels, possibly in combination with a change in their activation properties. This is because these channels, which are composed of 4 subunits {HCN1-4}, produce an excitatory inward current, termed the hyperpolarisation-activated {Ih} current in neurons, that depolarizes the membrane potential toward the threshold of action potential {AP} generation. To test this hypothesis, several integrated approaches, including behavioural pharmacology, in vivo electrophysiology, and immunofluorescent staining, were used in two rat models of CP that were compared to appropriate controls. The rat models of CP were: a) chronic inflammatory pain {CIP} model, which involved induction of hindlimb inflammation with complete Freund’s adjuvant {CFA}; and b) chronic neuropathic pain {CNP} model that involved L5 spinal nerve {SN} axotomy, in addition to loose ligation of the L4 SN with neuro-inflammation inducing chromic gut, referred to as modified SN Axotomy {mSNA}. The objectives of the current project were to: (i) evaluate, using behavioural pharmacology, the influence of modulating the HCN channels with the Ih-specific blocker, ZD7288, on pain hypersensitivity in both CIP and CNP. (ii) determine, using in vivo intracellular voltage and current recordings, the difference in AP parameters between normal and mSNA-treated L4 DRG neurons and the effect of ZD7288 on SA in the mSNA-treated L4 DRG neurons. (iii) determine, using immunofluoresence, the types of DRG neuron that express HCN1-HCN3 subunits in normal rats and whether expression of these subunits is altered in both CIP and CNP. The results showed: 1. In both CIP and CNP, peripheral administration of ZD7288 resulted in significant attenuation of mechanical hypersensitivity and a non-significant absence of spontaneous pain {SP}. 2. In the L4 DRG neurons of mSNA-treated animals with CNP, ZD7288 had no effect on the frequency of SA from low-threshold mechanoreceptors {LTM} and induced changes in hyperpolarisation-associated AP parameters in Aα/β-fibre DRG neurons. 3. In both CIP and CNP, an increased proportion of small and medium sized DRG neurons express HCN2, but not HCN1 or HCN3, channel protein. Taken together, the findings suggest that HCN channels, particularly HCN2, in specific sub-populations of DRG neurons contribute to the development!of CIP and CNP.