Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency

doi:10.1186/s12871-015-0071-3

. 2015 Jun 16:15:92.

doi: 10.1186/s12871-015-0071-3.

Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency

Chun-Chang Yeh^{1

2

3}, Zhi-Fu Wu², Jui-Chieh Chen⁴, Chih-Shung Wong^{2

5}, Chi-Jung Huang^{1

6

7}, Jinn-Shyan Wang⁸, Chih-Cheng Chien^{9

10

11}

Affiliations

¹ School of Medicine, Fu Jen Catholic University, New Taipei, 24205, Taiwan.
² Department of Anesthesiology & Integrated Pain Management Center, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
³ Department of Chemistry, Fu-Jen Catholic University and Graduate Institute of Basic Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
⁴ Department of Biochemical Science and Technology, National Chiayi University, Chiayi, Taiwan.
⁵ Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.
⁶ Department of Medical Research, Cathay General Hospital, Taipei, Taiwan.
⁷ Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan.
⁸ School of Medicine, Fu Jen Catholic University, New Taipei, 24205, Taiwan. [email protected].
⁹ School of Medicine, Fu Jen Catholic University, New Taipei, 24205, Taiwan. [email protected].
¹⁰ Department of Anesthesiology, Sijhih Cathay General Hospital, New Taipei, Taiwan. [email protected].
¹¹ Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan. [email protected].

PMID: 26077473
PMCID: PMC4467050
DOI: 10.1186/s12871-015-0071-3

Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency

Chun-Chang Yeh et al. BMC Anesthesiol. 2015.

. 2015 Jun 16:15:92.

doi: 10.1186/s12871-015-0071-3.

Authors

Chun-Chang Yeh^{1

2

3}, Zhi-Fu Wu², Jui-Chieh Chen⁴, Chih-Shung Wong^{2

5}, Chi-Jung Huang^{1

6

7}, Jinn-Shyan Wang⁸, Chih-Cheng Chien^{9

10

11}

Affiliations

¹ School of Medicine, Fu Jen Catholic University, New Taipei, 24205, Taiwan.
² Department of Anesthesiology & Integrated Pain Management Center, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
³ Department of Chemistry, Fu-Jen Catholic University and Graduate Institute of Basic Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
⁴ Department of Biochemical Science and Technology, National Chiayi University, Chiayi, Taiwan.
⁵ Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.
⁶ Department of Medical Research, Cathay General Hospital, Taipei, Taiwan.
⁷ Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan.
⁸ School of Medicine, Fu Jen Catholic University, New Taipei, 24205, Taiwan. [email protected].
⁹ School of Medicine, Fu Jen Catholic University, New Taipei, 24205, Taiwan. [email protected].
¹⁰ Department of Anesthesiology, Sijhih Cathay General Hospital, New Taipei, Taiwan. [email protected].
¹¹ Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan. [email protected].

PMID: 26077473
PMCID: PMC4467050
DOI: 10.1186/s12871-015-0071-3

Abstract

Background: The application of pulsed radiofrequency (PRF) close to the dorsal root ganglia, or peripheral nerves, has been demonstrated to be effective for the treatment of chronic neuropathic pain conditions. The goal of this study was to investigate the analgesic effect of immediate PRF treatment after nerve injury and its possible cellular alterations in the dorsal horn of the spinal cord in rats with spared nerve injury (SNI).

Methods: Neuropathic pain was achieved in a SNI neuropathic pain model by ligating and cutting the common peroneal and tibial branches of the left sciatic nerve, leaving the sural nerve intact. Wistar rats were divided into four groups that received different treatments, i.e., SNI and PRF for 6 min at 45 V (SNI + PRF-45 V), at 60 V (SNI + PRF-60 V), SNI alone, and sham groups. After the SNI surgery, each rat was immediately given the PRF treatment (500 kHz, rate of 2 Hz, 20 ms duration, temperature below 42 °C) on the left sciatic nerve 0.3-0.4 cm proximal to the injured site. The behavioral measurements included mechanical allodynia and cold allodynia of the ipsilateral hind paw and were performed during the 28 days that followed the SNI surgery and PRF treatment. Total extracellular signal-regulated kinase 1 and 2 (ERK1/2) and phospho-ERK1/2 were measured using Western blot in the ipsilateral spinal cord from animals in the different groups.

Results: The three groups of rats with nerve injuries manifested a lower paw withdrawal threshold (PWT) in the behavioral measurement of mechanical allodynia and a shorter painful-behavior duration in the cold allodynia test over 28 days. Mechanical allodynia measurement showed that both the PRF-45 V and PRF-60 V treatment groups exhibited a more prominent antiallodynic effect than did the SNI group from days 1 to 28 after surgery. Similarly, in comparison with the SNI group, both the SNI + PRF-45 V and SNI + PRF-60 V groups had significant inhibition on the cold allodynia measurement from days 1 to 28 after surgery. Furthermore, the activation of the extracellular signal-regulated kinase 1 and 2 (ERK1/2) in the ipsilateral spinal dorsal horn of SNI rats was effectively inhibited in the SNI + PRF-45 V and SNI + PRF-60 V groups for 28 days after surgery.

Conclusions: Immediate PRF application on the proximal nerve injury site provided a significant inhibition of neuropathic pain formation, accompanied by the inhibition of ERK activation.

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Figures

**Fig 1**
Application of pulsed radiofrequency (PRF) in a model of spared nerve injury (SNI). a. Diagram. b. Actual application of PRF immediately after SNI surgery

**Fig 2**
Paw withdrawal test of mechanical allodynia. The paw withdrawal threshold in rats that were subjected to the sham operation, SNI without PRF (SNI group), or SNI plus either 45 V PRF or 60 V PRF (SNI + PRF-45 V and SNI + PRF-60 V groups, respectively). Mechanical allodynia was evaluated using dynamic plantar aesthesiometry. The data presented above were examined by ANOVA followed by Bonferroni test. D, day. #P < 0.05, ##P < 0.01 SNI, SNI + PRF-45 V, and SNI + PRF-60 V compared with the sham. *P < 0.05, **P < 0.01 SNI + PRF-45 V and SNI + PRF-60 V compared with SNI

**Fig. 3**
Paw withdrawal test of cold allodynia. Behavioral response in rats subjected to sham operation or SNI without PRF (SNI group) or SNI plus either 45 V PRF or 60 V PRF (SNI + PRF-45 V and SNI + PRF-60 V groups, respectively). Cold allodynia was evaluated by the acetone spray test. The data presented above were examined by ANOVA followed by Bonferroni test. D, day. #P < 0.05, ##P < 0.01 SNI, SNI + PRF-45 V, and SNI + PRF-60 V compared with the sham. *P < 0.05, **P < 0.01 SNI + PRF-45 V and SNI + PRF-60 V compared with SNI

**Fig 4**
Effect of pulse repetition frequency on ERK1/2 expression in the spinal dorsal horn of rats with spared nerve injury. A. Representative Western blot showing upregulation of pERK1/2 and total ERK1/2 in the ipsilateral spinal cord at day 28 in various conditions (sham-operated control, SNI, and SNI + PRF-45 V). B. Histograms showing the results of a quantitative densitometric analysis of the pERK1/2 to ERK1/2 expression ratio. n = 4–6/group, *P < 0.05 compared with the sham control or PRF-45 V-treated rats. The data are expressed as the mean ± SEM. Differences between experimental groups were assessed by one-way ANOVA followed by Newman–Keuls multiple comparisons

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References

1. Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–1635. doi: 10.1212/01.wnl.0000282763.29778.59. - DOI - PubMed
1. O'Connor AB. Neuropathic pain: quality-of-life impact, costs and cost effectiveness of therapy. Pharmacoeconomics. 2009;27:95–112. doi: 10.2165/00019053-200927020-00002. - DOI - PubMed
1. Cavenagh J, Good P, Ravenscroft P. Neuropathic pain: are we out of the woods yet? Intern Med J. 2006;36:251–255. doi: 10.1111/j.1445-5994.2006.01046.x. - DOI - PubMed
1. Finnerup NB, Sindrup SH, Jensen TS. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010;150:573–581. doi: 10.1016/j.pain.2010.06.019. - DOI - PubMed
1. Cosman ER. A comment on the history of the pulsed radiofrequency technique for pain therapy. Anesthesiology. 2005;103:1312. doi: 10.1097/00000542-200512000-00028. - DOI - PubMed

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[1] Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–1635. doi: 10.1212/01.wnl.0000282763.29778.59. - DOI - PubMed

[2] Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–1635. doi: 10.1212/01.wnl.0000282763.29778.59. - DOI - PubMed

[3] O'Connor AB. Neuropathic pain: quality-of-life impact, costs and cost effectiveness of therapy. Pharmacoeconomics. 2009;27:95–112. doi: 10.2165/00019053-200927020-00002. - DOI - PubMed

[4] O'Connor AB. Neuropathic pain: quality-of-life impact, costs and cost effectiveness of therapy. Pharmacoeconomics. 2009;27:95–112. doi: 10.2165/00019053-200927020-00002. - DOI - PubMed

[5] Cavenagh J, Good P, Ravenscroft P. Neuropathic pain: are we out of the woods yet? Intern Med J. 2006;36:251–255. doi: 10.1111/j.1445-5994.2006.01046.x. - DOI - PubMed

[6] Cavenagh J, Good P, Ravenscroft P. Neuropathic pain: are we out of the woods yet? Intern Med J. 2006;36:251–255. doi: 10.1111/j.1445-5994.2006.01046.x. - DOI - PubMed

[7] Finnerup NB, Sindrup SH, Jensen TS. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010;150:573–581. doi: 10.1016/j.pain.2010.06.019. - DOI - PubMed

[8] Finnerup NB, Sindrup SH, Jensen TS. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010;150:573–581. doi: 10.1016/j.pain.2010.06.019. - DOI - PubMed

[9] Cosman ER. A comment on the history of the pulsed radiofrequency technique for pain therapy. Anesthesiology. 2005;103:1312. doi: 10.1097/00000542-200512000-00028. - DOI - PubMed

[10] Cosman ER. A comment on the history of the pulsed radiofrequency technique for pain therapy. Anesthesiology. 2005;103:1312. doi: 10.1097/00000542-200512000-00028. - DOI - PubMed

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Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency

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Association between extracellular signal-regulated kinase expression and the anti-allodynic effect in rats with spared nerve injury by applying immediate pulsed radiofrequency

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