cancer pain and neuropathic pain in orofacial region

本研究旨在探讨三叉神经束核特定神经细胞损伤特征的表现（c-fos表现-凋亡）及对口面部肿瘤和神经性疼痛的治疗。用高效液相色谱- ecd法检测了肿瘤（上颌骨溶瘤细胞注射）和神经性疼痛（下颌神经槽管硅注射）患者下唇痛觉过敏及脑脊液谷氨酸水平。组织病理学检查，取三叉脊髓束核，冷冻后做组织移植（神经性疼痛模型：5、10天，癌性疼痛模型：20、25天）。对这些组织移植物进行c-fos基因表达（原位杂交法）和TUNEL染色，以明确其与程序性细胞死亡的关系。神经性疼痛模型第3 ~ 25天出现痛觉过敏，癌性疼痛模型第18 ~ 25天出现痛觉过敏。神经性疼痛模型第10天脑脊液谷氨酸水平升高20%，癌性疼痛模型第20天脑脊液谷氨酸水平升高30%以上。神经性疼痛模型第5天出现c-fos蛋白升高，第10天出现坏死增加，三叉脊髓束核病理改变。癌性疼痛模型第20天c-fos蛋白升高，出现坏死。在神经性疼痛模型中，给予N型ca2 +通道抑制剂或5-HT2A抑制剂可抑制痛阈的下降，抑制c-fos蛋白的增加和坏死。在此基础上，癌性疼痛和神经性疼痛的程序性细胞死亡变得清晰，N型Ca2+通道抑制剂和5-HT2A抑制剂有作用，并显示出治疗癌性疼痛和神经性疼痛的方向性。

This study was to investigated the manifestation of injury characteristics of a specific nerve cell of a trigeminal spinal tract nucleus (c-fos manifestation -apoptosis) and the therapy about cancer and neuropathic pain in a orofacial region.Hyperalgesia for pain sensation to lower lip and glutamate level in cerebrospinal fluid (HPLC-ECD method) were examined in cancer (lytic tumor cell injection to maxillary bone) and neuropathic pain (silicon injection in nurvus alveolar mandibular pipe). For histopathological examination, a trigeminal spinal tract nucleus were removed and frozed up and made a tissue graft (neuropathic pain model : after 5, 10th days, cancer pain model : after 20, 25th days).For these tissue grafts, c-fos gene expression (in situ hybridization method) and TUNEL dyeing were done to make clear for relation to programmed cell death.Hyperalgesia was appeared from 3rd to 25th day in the neuropathic pain model, and from 18td to 25th day in the cancer pain model.As for the glutamate level incerebrospinal fluid, increase 20% was recognized in the neuropathic pain model on the 10th day, and more than 30% increase in cancer pain model on the 20th day.And in a histopathological change of a trigeminal spinal tract nucleus, the increase of c-fos protein was appeared on 5th, and increase of necrosis was recognized on 10th days in the neuropathic pain model.Increase of c-fos protein and necrosis were acceptation the 20th day in a cancer pain model.Administration of N type Ca 2+ channel inhibitors or 5-HT2A inhibitor inhibited the decline of pain threshold and increase of c-fos protein and necrosis were restrained in the neuropathic pain model.Above this, programmed cell death by cancer pain and neuropathic pain were become clear, and N type Ca2+ channel inhibitors and 5-HT2A inhibitor have a effects, and be shown the directionality of a therapy in cancer pain and neuropathic pain.