The first nociceptive synapse in the spinal cord dorsal horn represents an important site, where nociceptive synaptic transmission can be modulated under pathological conditions. One of the modulatory mechanism involves activation of the transient receptor potential vanilloid 1 (TRPV1) that is expressed on central terminals of primary nociceptive neurons, where it regulates release of neurotransmitters and neuromodulators. Previous studies suggested that changes in TRPV1 activity may be related to effects of chemokine CCL2 (C-C motif ligand 2) and may be also involved in synaptic transmission modulation after µ-opioid receptors (MOP-R) activation. Because CCL2 receptors CCR2 often co-localize with TRPV1 and MOP-R, the goal of this work was to studypossible interactions of these receptors on the pre-synaptic endings of primaryafferents in the spinal cord dorsal horn and their role in nociceptive signalling under pathological conditions. The presented thesis focused on the effect of CCL2 during peripheral neuropathy and its interference with µ-opioid receptor activation. To studysynaptic transmission at the spinal cord level, patch-clamp recordings of excitatory post-synaptic currents (EPSC) in superficial spinal cord dorsal horn neurons in acute lumbar spinal cord slices from rats was used....

Modulation of a synaptic transmission in the spinal cord dorsal horn plays a key role in nociceptive signalling, especially in states of pathological pain. The goal of this study was to develop a method for calcium imaging in spinal cord slices in vitro. This method allowed us to record changes of intracellular free calcium ions concentration (iCa2+ ), that are a major mediator of neuronal plasticity. In this work, we have focused on application of this method in a conventional fluorescence microscope and on the role of different neuromodulators of synaptic activity. Changes of iCa2+ induced by dorsal root electrical stimulation were recorded altogether in 744 dorsal horn (lamina I and II) neurons. In the first series of experiments, stimulation protocols activating preferentially A and A + C dorsal root fibers were used and long-term stability of the calcium responses was verified. The dorsal root stimulation induced in the neurons fast and delayed type of calcium response. Application of AMPA and NMDA receptors antagonists, CNQX (50μM) and MK801 (45μM), reduced the calcium response amplitude and confirmed the importance of glutamate receptors in synaptic activation. In several experiments the effect of capsaicin a TRPV1 receptors agonist, application was tested. Application of even low...

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This thesis examined how and why TRPV1 function is being modulated in sensory neuropathy and explored the potential of its rescue in the urinary bladder of STZ-­‐induced diabetic rats. Diabetes induced a rapid decline in TRPV1 function and changes in neurogenically mediated electrically-­‐evoked responses together with a gradual decline in muscarinic function. Diabetic bladder was also deficient in muscarinic and TRPV1 organ bath temperature-­‐induced changes but not in those affecting spontaneous contractile activity. Exposure to a potential neuropathy causative agent, methylglyoxal was studied and its mechanism of action explored through the use of TRPA1 ligands. Methylglyoxal exposure mimicked some of the effects of diabetes on TRPV1, neurogenic electrically evoked responses and muscarinic function. Methylglyoxal effects were seen to be partly through TRPA1 receptor activation but other as yet undefined pathways were also involved. Use of TRPA1 ligands revealed an unexpected complexity of the interaction of the TRPA1 receptor with TRPV1. Finally the potential of reversing the diminished TRPV1 response was examined through the use of three known sensitising agents, bradykinin, NGF and insulin. Bradykinin was the only agent seen to reverse the TRPV1 diminished response back up to to control equivalent levels and through the use of bradykinin selective ligands, it was seen that the dual activation of BK-­‐1 and BK-­‐2 receptor was necessary to rescue the TRPV1 response. The likely mechanism of action of bradykinin was through prostaglandin production as indomethacin blocked TRPV1 rescue. In the acute stage of diabetes, TRPV1 function is downregulated and may be caused by exposure to a neuropathy-­‐causing metabolite such as methylglyoxal. The TRPV1 function still retains plasticity at this acute stage because function could be enhanced back to control levels by bradykinin receptor activation : a potential for early therapeutic intervention.

Les kinines sont des peptides neuro- et vaso- actifs impliqués dans les processus hémodynamiques, inflammatoires et douloureux. Leurs effets biologiques sont produits par l’entremise de deux types de récepteurs couplés aux protéines G, soit B1 (B1R) et B2 (B2R). Le B1R est inductible, son expression est augmentée à la suite d’un dommage tissulaire ou de l’exposition à des endotoxines bactériennes (lipopolysaccharide bactérien (LPS)), à des cytokines pro-inflammatoires (interleukine-1β (IL-1β), facteur de nécrose tumorale-α (TNF-α)) ou à des espèces réactives oxygénées (ROS). Les travaux présentés dans cette thèse avaient pour objectif d’élucider et/ou de raffiner les connaissances sur 1) la localisation, 2) le mécanisme d’induction et 3) le rôle physiopathologique du B1R dans des modèles expérimentaux de douleur chez le rat. Nos données ont permis de démontrer pour la première fois que le B1R est augmenté de façon significative dans la moelle épinière du rat diabétique de type 1 où il est localisé sur les fibres sensorielles de type C, les astrocytes et les cellules de la microglie (1er article). Également, l’inhibition de l’activation des cellules de la microglie supprime les neuropathies diabétiques, l’expression de médiateurs pro-inflammatoires ainsi que l’activité pro-nociceptive du B1R (2e et 3e articles). Finalement, nous avons démontré que la stimulation systémique du TRPV1 par la capsaïcine induit une surexpression du B1R au niveau microgliale, via un mécanisme impliquant l’augmentation de la production de ROS et possiblement de cytokines (4e article). Ces données nous permettent de mieux comprendre les mécanismes impliqués dans l’expression et l’activité du B1R. Aussi, elles nous permettent d’imaginer de nouvelles stratégies pour prévenir l’induction du B1R (inhibition du TRPV1) ou son activité délétère (inhibition de l’activation des cellules de la microglie) dans la douleur inflammatoire et neuropathique. / Kinins are vaso- and neuro-active peptides involved in hemodynamic, inflammatory and pain processes. Their biological effects are mediated by two G Protein Coupled Receptors (GPCR), termed B2R (constitutive) and B1R (inducible). B1R is expressed following tissue damage or exposure to bacterial endotoxin (LPS), pro-inflammatory cytokines (IL-1β, TNF-α) and increased reactive oxygen species (ROS) levels. The objectives of this doctoral thesis were to define 1) the localisation, 2) the mechanism of induction and 3) the pathophysiological role of B1R in experimental models of pain in rat. Our data showed that B1R is significantly upregulated on sensory C fibers, astrocytes and microglia in spinal cord of type 1 diabetic rat (paper #1). Moreover, pharmacological inhibition of microglia reversed diabetic pain neuropathy, reduced levels of pro-inflammatory mediators and prevented B1R pro-nociceptive activity (papers #2 and 3). Finally, our data showed that systemic stimulation of TRPV1 with capsaicin upregulated B1R expression, mainly on microglia, through the increase of ROS and possibly cytokines (paper #4). Altogether, these data increased our knowledge related to B1R mechanism of induction and B1R activity. Also, these data shed light on new strategies to prevent B1R expression (TRPV1 blockade) and B1R deleterious activity (inhibition of microglia activation) in inflammatory and neuropathic pain.

Štěpána Boukalová Mechanisms of activation and modulation of vanilloid TRP channels TRPV1 and TRPV3 are thermosensitive ion channels from the vanilloid subfamily of TRP receptors. TRPV1, which is primarily expressed in nociceptive sensory neurons, is an important transducer of painful stimuli and is also involved in the detection of noxious heat. TRPV3 is expressed mainly in the skin where it regulates proliferation and differentiation of keratinocytes. Similarly to voltage-dependent potassium (Kv) channels, TRP receptors are comprised of four subunits, each with six transmembrane segments (S1-S6). Using mutational approach, we tried to elucidate the role of S1 in TRPV1 functioning. Our results indicate that the extracellular portion of S1 plays a crucial role in TRPV1 gating. TRPV1 channels with a conservative mutation of positively charged residue in this region (R455K substitution) were overactive. However, they were neither activated nor potentiated by low pH; on the contrary, protons stabilized the closed conformation of this mutant channel. Very similar phenotypic properties were found in other TRPV1 mutants with substitution in S4/S5-S5 region and in the pore helix. In Kv channels, extracelular portion of S1 forms a small contact surface with the pore helix, which allows efficient transmission of...

Les kinines sont des peptides neuro- et vaso- actifs impliqués dans les processus hémodynamiques, inflammatoires et douloureux. Leurs effets biologiques sont produits par l’entremise de deux types de récepteurs couplés aux protéines G, soit B1 (B1R) et B2 (B2R). Le B1R est inductible, son expression est augmentée à la suite d’un dommage tissulaire ou de l’exposition à des endotoxines bactériennes (lipopolysaccharide bactérien (LPS)), à des cytokines pro-inflammatoires (interleukine-1β (IL-1β), facteur de nécrose tumorale-α (TNF-α)) ou à des espèces réactives oxygénées (ROS). Les travaux présentés dans cette thèse avaient pour objectif d’élucider et/ou de raffiner les connaissances sur 1) la localisation, 2) le mécanisme d’induction et 3) le rôle physiopathologique du B1R dans des modèles expérimentaux de douleur chez le rat. Nos données ont permis de démontrer pour la première fois que le B1R est augmenté de façon significative dans la moelle épinière du rat diabétique de type 1 où il est localisé sur les fibres sensorielles de type C, les astrocytes et les cellules de la microglie (1er article). Également, l’inhibition de l’activation des cellules de la microglie supprime les neuropathies diabétiques, l’expression de médiateurs pro-inflammatoires ainsi que l’activité pro-nociceptive du B1R (2e et 3e articles). Finalement, nous avons démontré que la stimulation systémique du TRPV1 par la capsaïcine induit une surexpression du B1R au niveau microgliale, via un mécanisme impliquant l’augmentation de la production de ROS et possiblement de cytokines (4e article). Ces données nous permettent de mieux comprendre les mécanismes impliqués dans l’expression et l’activité du B1R. Aussi, elles nous permettent d’imaginer de nouvelles stratégies pour prévenir l’induction du B1R (inhibition du TRPV1) ou son activité délétère (inhibition de l’activation des cellules de la microglie) dans la douleur inflammatoire et neuropathique. / Kinins are vaso- and neuro-active peptides involved in hemodynamic, inflammatory and pain processes. Their biological effects are mediated by two G Protein Coupled Receptors (GPCR), termed B2R (constitutive) and B1R (inducible). B1R is expressed following tissue damage or exposure to bacterial endotoxin (LPS), pro-inflammatory cytokines (IL-1β, TNF-α) and increased reactive oxygen species (ROS) levels. The objectives of this doctoral thesis were to define 1) the localisation, 2) the mechanism of induction and 3) the pathophysiological role of B1R in experimental models of pain in rat. Our data showed that B1R is significantly upregulated on sensory C fibers, astrocytes and microglia in spinal cord of type 1 diabetic rat (paper #1). Moreover, pharmacological inhibition of microglia reversed diabetic pain neuropathy, reduced levels of pro-inflammatory mediators and prevented B1R pro-nociceptive activity (papers #2 and 3). Finally, our data showed that systemic stimulation of TRPV1 with capsaicin upregulated B1R expression, mainly on microglia, through the increase of ROS and possibly cytokines (paper #4). Altogether, these data increased our knowledge related to B1R mechanism of induction and B1R activity. Also, these data shed light on new strategies to prevent B1R expression (TRPV1 blockade) and B1R deleterious activity (inhibition of microglia activation) in inflammatory and neuropathic pain.

Introduction: Cough is the commonest reason for which medical advice is sought. In assessment of chronic cough and in developing anti-tussive medications, inhalational cough challenges with capsaicin and citric acid are commonly employed. However the ability of these inhalational cough challenges to distinguish health and disease is not clear and it is not known which end point is best in making such assessments. Methods: Subjects belonging to five different categories (healthy volunteers, subjects with COPD, asthma, healthy current smokers and chronic cough) were compared with each another by using the standard cough challenges employing Capsaicin and Citric acid and also by using newer inhalational cough challenge agents such as prostaglandin E2 and bradykinin. In addition adaptation to repeated inhalations of tussive agents was also assessed. The relationship between the cough reflex sensitivity as gauged by using inhalational cough challenge tests and objective cough recording was explored in all five groups. Finally the change in C5 in Capsaicin evoked cough by using a substance to block TRPV1 channel and its effect on objective cough recording was assessed in subjects with chronic cough. Results: Different tussive agents have different abilities to distinguish between different diagnostic categories and a combination of inhalational cough challenge tests have a better accuracy of predicting diagnostic groups as compared to one on its own. There are significant differences in the rates of adaptation to repeated inhalations of PGE2 and there is a significant reduction in cough response over period of time in all disease groups. Using the TRPV1 antagonist resulted in a modest increase in the Log C5 concentration of capsaicin but this was not matched by a change in objective cough recording or CQLQ scores. Conclusions: The different abilities of tussive agents to distinguish between different diagnostic categories suggest that the information conveyed by the one inhalational cough challenge test is different from that by another test. The choice of the inhalational cough challenge test should therefore depend on which groups are included in the study. There was no significant difference in the rate of adaptation to prolonged challenge with citric acid or capsaicin and no significant correlation of the magnitude of adaptation with objective cough recording suggesting that this is unlikely to be responsible for the increased cough rates seen in diseases such as chronic cough, COPD or asthma. The TRPV1 antagonist did not result in a significant change in objective cough recording or CQLQ scores. The change in C5 with the TRPV1 antagonist was however modest and this may be reason for this study failing to show a relationship between these different measures.