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La polyarthrite rhumatoïde est une pathologie auto-immune qui affecte près de 1% de la population mondiale et se caractérise par une inflammation articulaire, des altérations cartilagineuses et osseuses notamment associées à des douleurs chroniques articulaires, souvent résistantes aux thérapeutiques actuelles. Que ce soit à un stade préclinique, où l’on parle d’arthralgie, ou à un stade établi de la pathologie, ces douleurs constituent un réel handicap pour les patients atteints avec plus de 60% d’entre eux insatisfaits de sa prise en charge. La présence d’une synovite étant nécessaire au diagnostic de la PR, aucune stratégie thérapeutique n’est mise en place à un stade préclinique. En outre, à un stade établi, la stratégie actuelle vise en premier lieu à diminuer l’activité de la pathologie sans prise en charge de la douleur en tant que telle. Parmi les acteurs de la synovite dans la PR, un rôle essentiel est attribué au facteur de croissance des nerfs ou Nerve Growth Factor dans la mise en place et le maintien des symptômes douloureux. Les anti-NGF sont connus comme des molécules antalgiques prometteuses. Néanmoins, de par son action pléiotropique, cibler cette neurotrophine conduit à des effets indésirables potentiellement importants. Dans la première partie de ce travail, nous avons cherché à mieux caractériser l’implication spécifique des voies de signalisation intracellulaires au récepteur tyrosine kinase de type A (TrkA) de haute affinité au NGF, dans un contexte de douleur articulaire inflammatoire (arthrite) mais aussi de douleurs somatique et viscérale. Un modèle de knock-out total pour le récepteur TrkA n’étant pas viable, nous avons réalisé une étude multimodale chez des souris knock-in TrkA/C, exprimant un récepteur chimérique composé de la partie extracellulaire native du récepteur TrkA et des parties transmembranaire et intracellulaire fonctionnelles du récepteur à la neurotrophine 3 : le récepteur TrkC. Ce dernier n’étant que peu ou pas impliqué dans la douleur inflammatoire. Ainsi, le NGF pourra se lier normalement au récepteur TrkA/C mais activera les voies de signalisation intracellulaires du récepteur TrkC. Les résultats de nos études ont mis en évidence qu’une absence d’activation de certaines voies en aval de TrkA (i.e. c-Jun et p38 MAPK) au niveau des DRGs chez les souris TrkA/C, impacte significativement la mise en place des symptômes douloureux, en particulier l’hypersensibilité mécanique, que ce soit dans un contexte de douleur articulaire, somatique ou viscérale, sans affecter l’hyperalgie thermique au chaud. Ces résultats résultent d’une part de la diminution de la néo-innervation CGRP+ mais aussi de changements transcriptionnels de certains neurotransmetteurs et mécanotransducteurs dont le canal ionique sensible aux protons : ASIC3. De plus, un lien entre NGF/TrkA et le remodelage osseux, en particulier, l’activation ostéoclastique, a été démontré mettant en avant un rôle doublement bénéfique de l’inhibition de certaines voies associées à TrkA, à la fois dans certains symptômes douloureux et l’érosion osseuse retrouvée dans la PR. Dans un deuxième temps, nous nous sommes intéressés aux mécanismes impliqués dans l’arthralgie induite par l’injection d’autoanticorps anti-peptides citrullinées (ACPA). La majorité des patients PR sont positifs pour les ACPA qui peuvent être produits des mois voire des années, avant son diagnostic et semblent être directement associés au développement des symptômes douloureux. Cette arthralgie constitue l’un des premiers signes d’une PR émergente et peu persister, même suite à la prise en charge thérapeutique des patients PR. Tout d’abord, nous avons confirmé que les sous-types monoclonaux IgG1 ACPA diffèrent par leurs propriétés pronociceptives et érosives de l’os, certainement liées à leurs différentes réactivités vis-à-vis des épitopes citrullinés. (...) / Rheumatoid arthritis is an autoimmune disease that affects nearly 1% people worldwide and is characterized by joint inflammation, cartilage and bone damages, associated with chronic joint pain, often resistant to current therapies. Whether at a preclinical stage, where we talk about arthralgia, or at an established stage of the pathology, pain constitutes a real burden for the patients with more than 60% rating their pain management has unsatisfactory. The presence of synovitis is necessary for the diagnosis of established RA, therefore, no real therapeutic strategy is used at a preclinical stage. In addition, at an established stage, the current strategy aimed primarily at reducing the activity of the pathology without an actual management of the pain as such. Among the actors of synovitis in RA, Nerve Growth Factor plays a critical role in the establishment and maintenance of painful symptoms. Anti-NGF are known as promising analgesic drugs. Nevertheless, due to pleiotropic effects of NGF, targeting this neurotrophin leads to significant adverse effects. In the first part of this work, we sought to better characterize the specific involvement of intracellular signaling pathways of the high affinity tyrosine kinase A (TrkA) receptor of NGF in a context of inflammatory joint pain (arthritis), but also of somatic and visceral pain. Since a total knockout of TrkA receptor in mice is not viable, we performed a multimodal study in TrkA/C knock-in mice, expressing a chimeric receptor composed of the native extracellular part of TrkA receptor and, the transmembrane and intracellular functional parts of the neurotrophin 3 receptor: TrkC receptor, which is not really involved in inflammatory pain. Thus, NGF can bind normally to the TrkA/C receptor but activates the intracellular signaling pathways downstream of TrkC receptor. Our results have shown that a lack of activation of certain TrkA pathways (i.e. c-Jun and p38 MAPK) in the DRGs of TrkA/C mice, has a significant impact on the development of painful symptoms, especially mechanical hypersensitivity in a context of articular, somatic, or visceral pain, without affecting heat thermal hyperalgesia. These effects result, on one hand, from the decrease of CGRP+ nerve sprouting and in another hand, from the transcriptional changes of some neurotransmitters and mechanotransducers including the proton-sensitive ion channel: ASIC3. In addition, our studies highlight a direct link between NGF/TrkA and bone remodeling, in particular, osteoclastic activity, suggesting a beneficial role of the inhibition of some specific TrkA-associated pathways, in both mechanical hypersensitivity and bone erosion found in RA.In a second part of our work, we investigated the mechanisms involved in arthralgia induced by the injection of autoantibodies against citrullinated peptides (ACPA). The majority of RA patients is positive for ACPA that can be produced months to years before RA diagnosis and appear to be directly associated with the development of pain. Arthralgia is one of the first signs of an emerging RA and can persist even following RA treatment. First, we confirmed that monoclonal ACPA IgG1 subtypes differ in their pronociceptive and bone erosive properties certainly link to their reactivity patterns against citrullinated epitopes on different targets especially those engaging osteoclast activity. Thus, the combination of B02/B09 ACPA clones induced pain like behaviour without any inflammation, but is associated with an alteration of bone homeostasis in injected mice. We suggest that as a result of ACPA-induced osteoclast activation, certain factors (e.g. protons and/or lipids) are released, which sensitize ASIC3, ultimately leading to pain.

The trigeminal ganglion (TG) is a complex sensory structure and multiple lines of evidence suggest that significant differences exist in anatomical, neurochemical and physiological properties between it and its equivalent structure in the somatosensory system, the dorsal root ganglion (DRG). This is likely to be a reflection, first on the unique areas of tissue innervation of the TG and second, on the unusual responses to injury which give rise to distinct pain symptoms such as toothache, migraine and temporomandibular joint disorders. In an attempt to address this disparity in knowledge, we have carried out an in-depth in vivo study investigating neurochemical populations and cell size distributions of sensory neurons within the rat TG. We have performed a detailed analysis of expression patterns for receptor components of important inflammatory mediators, NGF (TrkA), TNFα (p55) and IL-6 (gp130), along with the thermo-transducers TRPV1 and TRPM8. For each analysis we have compared our findings with those of the rat DRG. We have shown a significantly larger population of NF200+ neurons within the TG (51%) compared to the DRG (40%), and most interestingly, the majority of NF200+ neurons in the TG were within the small to medium cell size range, conferring a nociceptive phenotype. We have for the first time, determined expression of p55 and gp130 protein levels within neurochemically defined subpopulations of the TG. We show that a large proportion (33%) of TG neurons, in particular 27% of NF200+ neurons co-express p55, and thereby have the potential to respond directly to TNFα. Furthermore, we have observed gp130 protein expression to be ubiquitous within the TG, suggesting all neurons, including non-nociceptors, could respond to IL-6. In addition, we have utilised biochemical and electrophysiological techniques in vitro to measure the functional outcome of exposure of TG neurons to IL-6. We have demonstrated that IL-6 activates the JAK/STAT signalling pathway, preferentially within NF200+ neurons. Furthermore, we have shown that IL-6 sensitises the response of TG neurons to the TRPV1 agonist capsaicin, altering the gating properties and prolonging the opening time of the channel. Taken together, our findings support the emerging picture of a complex combinatorial pattern of co-expression of sensory neurochemicals, transducers and receptor components that help to define TG neuronal modality and function. We would advocate caution in making generalisations across sensory ganglia in particular in extrapolating data from the DRG to the trigeminal ganglion.

Neurotrophins and their receptors are key molecules in the development of thenervous system. Neurotrophin-3 binds preferentially to its high-affinity receptorNTRK3, which exists in two major isoforms in humans, the full-length kinaseactiveform (150 kDa) and a truncated non-catalytic form (50 kDa). The twovariants show different 3'UTR regions, indicating that they might be differentiallyregulated at the post-transcriptional level. In this work we explore howmicroRNAs take part in the regulation of full-length and truncated NTRK3,demonstrating that the two isoforms are targeted by different sets of microRNAs.We analyze the physiological consequences of the overexpression of some of theregulating microRNAs in human neuroblastoma cells. Finally, we providepreliminary evidence for a possible involvement of miR-124 - a microRNA with noputative target site in either NTRK3 isoform - in the control of the alternativespicing of NTRK3 through the downregulation of the splicing repressor PTBP1. / Las neurotrofinas y sus receptores constituyen una familia de factores crucialespara el desarrollo del sistema nervioso. La neurotrofina 3 ejerce su funciónprincipalmente a través de una unión de gran afinidad al receptor NTRK3, del cualse conocen dos isoformas principales, una larga de 150KDa con actividad de tipotirosina kinasa y una truncada de 50KDa sin dicha actividad. Estas dos isoformasno comparten la misma región 3'UTR, lo que sugiere la existencia de unaregulación postranscripcional diferente. En el presente trabajo se ha exploradocomo los microRNAs intervienen en la regulación de NTRK3, demostrando que lasdos isoformas son reguladas por diferentes miRNAs. Se han analizado lasconsecuencias fisiológicas de la sobrexpresión de dichos microRNAs utilizandocélulas de neuroblastoma. Finalmente, se ha estudiado la posible implicación delmicroRNA miR-124 en el control del splicing alternativo de NTRK3 a través de laregulación de represor de splicing PTBP1.