Although inflammation-induced peripheral sensitization (i.e. increased sensitivity of sensory neurons) can resolve as an injury heals, under pathological conditions this sensitization is maintained and contributes to chronic inflammatory pain. Studies of the cellular mechanisms mediating this maintenance of peripheral sensitization have focused on transcriptional changes that alter protein expression or post-translational modulation of various proteins, especially ion channels. To date, however, these studies have not resulted in new therapeutic approaches for treating chronic inflammatory pain. For this R21 application, we propose a novel mechanism for maintaining sensitization of sensory neurons, i.e. inflammation-induced DNA damage. This damage could result in an alteration in the phenotype of neurons from normal to the sensitized state. Recent studies performed in our laboratory provide support for examining this mechanism, since we have shown that augmenting DNA repair mechanism reverses toxicity in sensory neurons induced by cancer therapies. Furthermore, our preliminary data suggest that inflammation and the inflammatory mediators LPS, MCP-1, and, PGE2, can produce DNA damage in sensory neurons. Thus, we hypothesize that inflammation and inflammatory mediators produce oxidative DNA damage in sensory neurons that contributes to hypersensitivity and that augmenting the base excision repair pathway protects neurons from this damage and thus attenuates the enhanced excitability. To test this hypothesis we propose two specific aims. In studies for the first aim, w will determine whether CFA-induced inflammation or long-term exposure to inflammatory mediators (LPS, MCP-1 or PGE2) in isolated sensory neurons produces reactive oxygen species (ROS) and DNA damage in sensory neurons. We also will determine whether antioxidants or increasing APE1 repair activity (by overexpressing it in sensory neurons) prevents or reverses the DNA damage.
In aim 2, we will determine whether augmenting APE1 activity with overexpression in sensory neurons prevents or reverses peripheral sensitization induced by CFA injection into the rat hindpaw or by long-term exposure to inflammatory mediators (LPS, MCP-1 or PGE2) in isolated sensory neurons. If we demonstrate that DNA repair reverses peripheral sensitization that occurs during inflammation, our findings have important implications for elucidating a novel therapeutic target for treating chronic pain.
The studies outlined in this proposal will examine whether DNA damage in sensory neurons is a novel way in which inflammation or inflammatory mediators will increase the excitability of sensory neurons. We will determine whether increasing DNA repair activity prevents or reverse the long-term increase in activity of sensory neurons that conduct pain signals. If successful, our results could lead to a new target for drug therapy to treat chronic inflammatory pain.