Chronic Pain Alleviation after SCI
Dr. Ching-Yi Lin, Ph.D.
Lerner Research Institute, Neurosciences, Cleveland, Ohio, United States; email@example.com
Dr. Yu-Shang Lee
Lerner Research Institute, Neurosciences, Cleveland, Ohio, United States; firstname.lastname@example.org
Dr. Vernon W. Lin
Cleveland Clinic, Physical Medicine and Rehabilitation, Cleveland, Ohio, United States; email@example.com
Dr. Jerry Silver
Case Western Reserve University, Neuroscience, Cleveland, Ohio, United States; firstname.lastname@example.org
Chronic pain following spinal cord injury (SCI) is a highly prevalent clinical condition that is difficult to treat. Using both von Frey filaments and radiant infrared heat to assess mechanical allodynia and thermal hyperalgesia, respectively, we have demonstrated that a one-time injection of fibronectin (50 μg/ml) into spinal dorsal column (1 μl/min each injection for total 5 μl) immediately after SCI inhibits the development of mechanical allodynia (but not thermal hyperalgesia) over an 8-month observation period following spinal cord dorsal column crush (DCC). DCC will only induce mechanical allodynia but not thermal hyperalgesia nor overt motor deficits. By applying various fibronectin fragments as well as competitive inhibitors, these effects were shown to be dependent on the CS-1 motif of fibronectin. Furthermore, we found that acute fibronectin treatment diminished inflammation and blood spinal cord barrier permeability which, in turn, leads to enhanced fiber sparing and sprouting. In particular, the reduction of 5-HT in the superficial dorsal horn, an important descending brainstem system in the modulation of pain, was blocked with fibronectin treatment. We conclude that treatment of SCI with fibronectin preserves sensory regulation and prevents the development of chronic allodynia, providing a potential therapeutic intervention to treat chronic pain following SCI.