Fatty acid suppression of glial activation prevents central neuropathic pain after spinal cord injury

Marieta Georgieva, Yuting Wei, Maria Dumitrascuta, Roger Pertwee, Nanna B. Finnerup, Wenlong Huang (Corresponding Author)

Research output: Contribution to journalArticle

Abstract

About half of spinal cord injury (SCI) patients develop debilitating central neuropathic pain (CNP), with no effective treatments. Thus, effective, safe, and novel therapies are needed urgently. Previously, docosahexaenoic acid (DHA) was reported to confer neuroprotection in preclinical SCI models. However, its therapeutic potential on SCI-CNP remains to be elucidated. Here, we demonstrated for the first time that intravenous DHA administrations with 3-day intervals (250 nmol/kg; starting 30 minutes post-injury and maintained for 6 weeks), effectively prevented SCI-CNP development in a clinically relevant rat contusion model. SCI-CNP was assessed by a novel sensory profiling approach combining evoked pain measures and pain-related ethologically relevant rodent behaviours (burrowing, thigmotaxis, and place/escape avoidance) to mimic those for measuring human (sensory, affective, cognitive, and spontaneous) pain. Strikingly, already established SCI-CNP could be abolished partially by similar DHA administrations, starting from the beginning of week 4 post-injury and maintained for 4 weeks. At spinal (epicenter and L5 dorsal horns) and supra-spinal (anterior cingulate cortex) levels, both treatment regimens potently suppressed microglial and astrocyte activation, which underpins SCI-CNP pathogenesis. Spinal microgliosis, a known hallmark associated with neuropathic pain behaviours, was reduced by DHA treatments. Finally, we revealed novel potential roles of peroxisome proliferator-activated and retinoid X receptors and docosahexaenoyl ethanolamide (DHA’s metabolite) in mediating DHA’s effects on microglial activation. Our findings, coupled with the excellent long-term clinical safety of DHA even in surgical and critically ill patients, suggest that systemic DHA treatment is a translatable, effective, safe, and novel approach for preventing and managing SCI-CNP.

Original languageEnglish
JournalPain
Early online date29 Jul 2019
DOIs
Publication statusE-pub ahead of print - 29 Jul 2019

Fingerprint

Neuralgia
Spinal Cord Injuries
Neuroglia
Docosahexaenoic Acids
Fatty Acids
Pain
Therapeutics
Peroxisome Proliferators
Retinoid X Receptors
Contusions
Gyrus Cinguli
Wounds and Injuries
Critical Illness
Astrocytes
Rodentia
Safety

Keywords

  • central neuropathic pain
  • spinal cord injury
  • DHA
  • burrowing
  • thigmotaxis
  • PEAP

Cite this

Fatty acid suppression of glial activation prevents central neuropathic pain after spinal cord injury. / Georgieva, Marieta; Wei, Yuting; Dumitrascuta, Maria; Pertwee, Roger; Finnerup, Nanna B. ; Huang, Wenlong (Corresponding Author).

In: Pain, 29.07.2019.

Research output: Contribution to journalArticle

Georgieva, Marieta ; Wei, Yuting ; Dumitrascuta, Maria ; Pertwee, Roger ; Finnerup, Nanna B. ; Huang, Wenlong. / Fatty acid suppression of glial activation prevents central neuropathic pain after spinal cord injury. In: Pain. 2019.
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abstract = "About half of spinal cord injury (SCI) patients develop debilitating central neuropathic pain (CNP), with no effective treatments. Thus, effective, safe, and novel therapies are needed urgently. Previously, docosahexaenoic acid (DHA) was reported to confer neuroprotection in preclinical SCI models. However, its therapeutic potential on SCI-CNP remains to be elucidated. Here, we demonstrated for the first time that intravenous DHA administrations with 3-day intervals (250 nmol/kg; starting 30 minutes post-injury and maintained for 6 weeks), effectively prevented SCI-CNP development in a clinically relevant rat contusion model. SCI-CNP was assessed by a novel sensory profiling approach combining evoked pain measures and pain-related ethologically relevant rodent behaviours (burrowing, thigmotaxis, and place/escape avoidance) to mimic those for measuring human (sensory, affective, cognitive, and spontaneous) pain. Strikingly, already established SCI-CNP could be abolished partially by similar DHA administrations, starting from the beginning of week 4 post-injury and maintained for 4 weeks. At spinal (epicenter and L5 dorsal horns) and supra-spinal (anterior cingulate cortex) levels, both treatment regimens potently suppressed microglial and astrocyte activation, which underpins SCI-CNP pathogenesis. Spinal microgliosis, a known hallmark associated with neuropathic pain behaviours, was reduced by DHA treatments. Finally, we revealed novel potential roles of peroxisome proliferator-activated and retinoid X receptors and docosahexaenoyl ethanolamide (DHA’s metabolite) in mediating DHA’s effects on microglial activation. Our findings, coupled with the excellent long-term clinical safety of DHA even in surgical and critically ill patients, suggest that systemic DHA treatment is a translatable, effective, safe, and novel approach for preventing and managing SCI-CNP.",
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