Populations of inhibitory interneurons in the dorsal horn of the spinal cord

Lead Research Organisation: University of Glasgow
Department Name: College of Medical, Veterinary, Life Sci

Abstract

Nerve fibres that enter the spinal cord carry various types of sensory information. Some of these fibres (nociceptors) respond selectively to tissue damaging stimuli. The signals conveyed by nociceptors are transmitted to local nerve circuits in the spinal cord that are responsible for withdrawal reflexes, and also to a group of nerve cells (projection neurons) that carry the information to the brain, where it is perceived as pain. The great majority of nerve cells in the spinal cord are only involved in local circuits, and these are defined as interneurons. Many of these cells release chemical messengers that reduce the activity of other nerve cells, and therefore have an inhibitory function. There are complex nerve circuits within the spinal cord that connect incoming sensory fibres with interneurons and projection neurons. These circuits play an important part in modulating the flow of sensory information and regulating the intensity of pain. For example it has been shown that blocking the function of inhibitory interneurons in the spinal cord causes excessive pain, and disorders affecting these cells can lead to chronic pain states. However, despite their great importance, we still know little about the organisation of the nerve circuits that process pain signals within the spinal cord. A major reason for this has been that spinal cord interneurons are very diverse in their appearance, and it has therefore been difficult to classify them into distinct functional populations. Until we can do this, it will not be possible to unravel the complex connections between the different types of nerve cell, and therefore to understand their roles in pain processing. We have found that several groups of inhibitory interneurons in the spinal cord can be recognised on the basis of different substances that they contain. The main aim of this project is to test whether these groups differ in their connections with other nerve cells, and therefore in their function. We will perform experiments on genetically altered mice in which a naturally fluorescent protein is present in these different groups of inhibitory interneurons. This will allow us to record the activity of these cells and to label them with another fluorescent dye, so that the structure and connections of each cell can be investigated. We have preliminary evidence that cells belonging to one of these groups are not activated by painful stimuli, and we will therefore test whether cells in this group receive fewer connections from nociceptors. We will use a powerful technique known as 'cluster analysis' to look at a large sample of cells pooled from each of these groups. Cluster analysis compares a wide range of measures obtained for each cell, and uses these to provide an objective assessment of the number of different populations within the sample. This technique has been used to define different functional populations of interneurons in several brain regions, but has not yet been applied to pain pathways in the spinal cord. We have also found that cells belonging to two of these chemically-defined groups provide a powerful inhibitory input to two different types of pain-activated projection neuron. We will therefore test whether these cells are activated by nociceptors, and whether they correspond to populations identified by the cluster analysis. The project will provide important information about the different types of inhibitory interneuron that are involved in regulating pain. By revealing their connections with incoming sensory fibres and projection neurons, it will add a great deal to our knowledge of how the nerve circuits in the spinal cord are organised. Identifying the interneurons that directly inhibit projection neurons may reveal new targets for the development of drugs designed to treat pain.

Technical Summary

GABAergic interneurons in the dorsal horn control nociceptive inputs to reflex pathways and to the projection neurons reponsible for pain perception. However, because of their morphological diversity and the resulting difficulty of identifying distinct functional populations among these cells, we still know little about their role in neuronal circuits. We have found that neuronal nitric oxide synthase (nNOS), galanin and neuropeptide Y (NPY) are present in non-overlapping groups that constitute over half of the GABAergic cells in laminae I-II in the rat. These groups also differ in their post-synaptic targets, and in their expression of activity-dependent markers following noxious stimulation. In this project we will perform patch-clamp recordings from GABAergic interneurons in each of these groups by using spinal cord slices from mice in which the cells contain green fluorescent protein. Recorded cells will be revealed with fluorescent dye to allow subsequent morphological and immunocytochemical analysis. We will test the hypothesis that NPY and galanin cells have a greater input from nociceptive primary afferents than nNOS cells. Cluster analysis has been used to define interneuron populations elsewhere in the CNS, and we will apply this to a wide range of anatomical and physiological parameters obtained from a large sample of cells. We will look for specific populations of GABAergic neurons and determine whether these map onto the neurochemical groups. Some NPY and nNOS cells innervate specific types of nociceptive projection neuron. We will test the hypothesis that these represent distinct subsets within the corresponding neurochemical groups as defined by cluster analysis, and will characterise them with respect to their morphology, laminar location and pattern of primary afferent input. The project will help to clarify the neuronal circuitry involving inhibitory interneurons and will identify those responsible for inhibiting nociceptive projection neurons.

Planned Impact

Pain represents a major cause of suffering for both humans and animals. For example, it has been estimated that 20% of adults in Europe suffer from chronic pain of moderate to severe intensity, and this proportion is likely to increase as the population ages. Chronic pain is often poorly treated and the main reason for this is the lack of suitable medications. This in turn results from our limited understanding of the underlying mechanisms, particularly in the case of the neuropathic pain that results from peripheral nerve damage or spinal cord injury. Chronic pain also has a massive societal and economic impact, since a substantial proportion of sufferers are unable to work, while many report a direct effect on their employment prospects. Who will benefit from this research? Those who will benefit indirectly include scientists in the pharmaceutical industry who are involved in the development of analgesics, human patients and animals suffering from chronic pain, and the clinicians responsible for their treatment. Improved treatments for chronic pain will also be of enormous economic benefit to society. How will they benefit from this research? Development of new drugs to treat chronic pain will depend to a large extent on our understanding of the neuronal pathways that underlie pain perception, from the peripheral receptors through to the various cortical areas involved. The dorsal horn of the spinal cord contains intrinsic inhibitory circuits that can powerfully suppress pain, and therefore provides important potential sites of action for new analgesics. However, the organisation of these circuits is still poorly understood. Identifying and characterising the different components in dorsal horn pain pathways is likely to lead to the discovery of novel targets for analgesics. For example, certain ion channels and receptors are selectively expressed by subpopulations of neurons within the dorsal horn. Determining the neuronal types that express these channels/receptors will indicate whether activating or inhibiting them is likely to be anti-nociceptive (e.g. by increasing excitability of inhibitory interneurons, or by suppressing the activity of excitatory interneurons or projection cells). In addition, identifying changes in neuronal function and circuitry that occur in chronic pain states will be important for the development of new treatments, and this will require a greatly improved understanding of the normal organisation of pain pathways. Work from our laboratory has already generated important insights into the mechanisms underlying neuropathic pain following peripheral nerve injury, by demonstrating that several mechanisms that had been proposed (dorsal sprouting of low-threshold mechanoreceptive A-beta afferents, up-regulation of substance P in the central terminals of these afferents and death of inhibitory interneurons) are not necessary for the development of neuropathic pain. These results have shown that these proposed mechanisms are unlikely to provide useful targets for developing treatments for neuropathic pain. This proposal is in line with BBSRC policy, since 'mechanisms underlying pain' is identified as an important area within the 'Welfare of managed animals' priority.

Publications

10 25 50
 
Description Main Achievements: Around one third of the nerve cells in the dorsal part of the spinal cord release chemical messengers that inhibit other nerve cells. These cells, which are known as inhibitory interneurons, have several important functions that include suppressing pain and itch, and increasing the accuracy with which sensory stimuli can be detected. It is generally believed that these functions are performed by distinct populations of interneurons that differ in their inputs and outputs. However, it was not known how these populations could be identified, and this restricted our understanding of the nerve circuits that controlled sensory transmission. The main findings of the award are listed below: 1) We demonstrated that several different functional populations could be identified among the inhibitory interneurons, based on their expression of particular neurochemical markers (e.g. neuropeptides). We also showed that these populations differed in their responses to painful stimuli, and that this was related to the types of sensory nerve fibre from which they received synapses. 2) However, we found that it was not possible to define these populations based on the shapes of their cell bodies or the branching pattern of their dendrites or axons, since a statistical test (cluster analysis) failed to separate cells belonging to 2 different populations based on these morphological parameters. This is important, because previous studies have generally used morphological criteria to define neuron populations. This finding also opens up the possibility of directly testing the function of these different populations, because the neurochemical markers that define them can be targeted with modern techniques based on molecular genetics. 3) One of our hypotheses was that there would be specific types of inhibitory interneuron that specifically targeted those nerve cells that transmitted pain information to the brain (projection cells). We showed that this was correct, but that most of the synapses formed by these cells were with other interneurons. This indicates that the organisation of sensory pathways in the spinal cord is highly complex. (4) We also investigated a mutant mouse that has been shown to develop chronic itch, and found that it specifically lacks 2 of the populations of inhibitory interneurons that we had identified. This is very important, firstly because it indicates that one or both of these populations are responsible for blocking itch (e.g. following scratching) and secondly because one of the chemical messengers released by these cells is the opioid peptide dynorphin. Chronic itch remains an unmet clinical need, but one of the few drugs licensed for treatment is nalfurafine, which acts on the same receptor as dynorphin. Our finding helps to explain the mechanism of action of nalfurafine, and may lead to the development of other drugs for treatment of chronic itch. The work performed under this award also led to the formation of a new collaborative network, funded by a Wellcome Trust Strategic Award, which includes investigators from London (UCL, KCL), Oxford, Glasgow and San Francisco, and which aims to define the neuronal circuitry underlying pain in health and disease.
Exploitation Route As stated in the Pathways to Impact statement, the findings have been disseminated through peer-reviewed articles and reviews, several book chapters, as well as seminars and talks at international meetings, including those targeted at clinicians and/or the pharmaceutical industry. We continue to interact with clinicians at the Queen Elizabeth National Spinal Injuries Unit who manage pain in spinal cord-injured patients. This has led to a clinical research proposal aimed at investigating mechanisms underlying central neuropathic pain in these patients and developing prognostic tests, which, when performed acutely after injury, can predict those in whom this type of pain will develop. Our finding that spinal inhibitory interneurons that suppress itch release the kappa opioid agonist dynorphin provides a mechanistic understanding of how kappa opioids (e.g. Nalfurafine) inhibit itch. At present Nalfurafine is clinically approved in Japan for the treatment of uraemic and cholestatic pruritus. However, there are no clinically approved drugs for treatment of itch in North America or Europe. Our preclinical work may lead to the testing of kappa opioid agonists in other types of pruritus. Since part of the action of dynorphin may be directly on pruriceptive afferents, our findings might also lead to the adoption of peripherally-acting kappa agonists, which could be used to treat itch without the unwanted symptoms that can occur with systemic treatment.
Sectors Healthcare,Pharmaceuticals and Medical Biotechnology

 
Description Findings from this grant have been reported at several meetings, including those attended by clinicians and those involved in developing treatments for pain. This will have resulted in improved understanding of pain mechanisms by these groups. The PI has recently taken on a consultative role with a commercial company that is involved in the development and use of spinal cord stimulators for chronic pain (Saluda Medical). This has so far involved providing training to those in the company and to clinicians using spinal cord stimulation at two "masterclasses".
First Year Of Impact 2012
Sector Healthcare,Pharmaceuticals and Medical Biotechnology
Impact Types Societal

 
Description Spinal inhibitory interneurons that suppress itch
Amount £438,890 (GBP)
Funding ID MR/L003430/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 10/2013 
End 09/2016
 
Description Wellcome Trust Strategic Award
Amount £5,287,909 (GBP)
Funding ID 102645 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2014 
End 02/2019
 
Description Explorathon Scotland 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact ~3000 members of the general public attend an "open evening" or "open day" at the Glasgow Science Centre, or the Riverside Museum. Several staff from our group contribute to these events.
Year(s) Of Engagement Activity 2014,2015,2019
URL http://www.explorathon.co.uk/glasgow
 
Description Nuffield Research Placement Scotland 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact School pupil hosted for summer project placement under the Nuffield Research Placements Scotland scheme on several occasions
Year(s) Of Engagement Activity 2013,2014,2015,2017,2018,2019
URL http://www.nuffieldresearchplacements.org/