肌肉痛及其慢性化中枢调控作用失衡及P2X受体机制研究

由于不正常的姿势以及肌肉使用不当，近年来肌肉痛已经成为危害人类健康的常见、多发病。已知“ATP能量危机”在外周“肌筋膜触发点”的形成和肌肉痛的发生中起重要作用，但中枢ATP及其P2X受体在肌肉痛及慢性化中的作用尚未被阐明。课题组前期实验表明：P2X受体参与丘脑MD/VM核团介导的痛觉内源性易化和抑制调控作用，并在肌肉痛不同阶段出现表达增强和减弱现象。据此，申请者推测丘脑MD/VM核团内P2X受体不同亚型的表达增强或减弱导致痛觉内源性下行易化作用持续增强和下行抑制作用减弱，可能是促使“肌筋膜触发点”活化和肌肉痛慢性化的重要因素之一。基于电生理同步记录（脊髓背角伤害感受性神经元-丘脑MD/VM核团-腓肠肌肌电），联合行为学，免疫组化及分子生物学等方法，本课题将阐明P2X受体在肌肉痛及其慢性化中枢调控作用失衡及温针治疗中的作用，为肌肉痛的机制探索和临床康复提供科研新证据。

Due to abnormal posture and improper use of muscle, muscle pain is common and prevalent disease, which may seriously influence human health. Despite the theory of the peripheral “ATP energy crisis” widely accepted in the initiation and development of the myofascial trigger point and muscle pain, the functions of ATP and its receptor (P2X receptor) in development and chronicity of muscle pain within the central nervous system (CNS) remain unclear. Our previous series of studies showed that subtypes of P2X receptors were involved in thalamic MD/VM mediated endogenous descending modulation of pain, and expressions of different subtypes of P2X receptors were increased or decreased during different processes of muscle pain. Accordingly, the applicant proposes here that the enhanced or decreased expression of P2X receptor subunits in thalamic MD/VM nuclei may be one of the critical factors to provoke strengthening of descending facilitatory and weakening of descending inhibitory modulations, resulting in initiating the ‘potential’ myofascial trigger points to be active, and cause chronicity of muscle pain. Based on the simultaneous recording model: spinal dorsal horn nociceptive neuron-thalamic MD/VM nuclei-gastrocnemius electromyogram (EMG), combing behavioral, morphological immunochemical, and molecular biological methods, the present study will explore and reveal the roles of central P2X receptor in development and chronicity of muscle pain and its treatment by means of warm-needle stimulation. The current application has important theoretical significance in providing new evidence in exploration of mechanisms and clinical rehabilitation for muscle pain.