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Douleurs neuropathiques et inflammatoires: modèles animaux et rôles fonctionnels des neuropeptides

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Douleur et Analgésie

Résumé

Les douleurs chroniques, d’origine inflammatoire ou neuropathique, s’accompagnent de modifications cellulaires responsables d’une sensibilisation persistante et handicapante. L’étude de ces phénomènes de plasticité nécessite de disposer de modèles animaux fiables. De nombreux modèles existent qui ne font chacun que reproduire certains des symptômes douloureux. Leur choix dépend donc des pathologies étudiées. L’apparition de modèles génétiquement modifiés avait fait naître de grands espoirs mais les phénotypes apparents de ces animaux se révèlent souvent contradictoires, et difficiles à interpréter.

Une composante importante de la plasticité associée à la sensibilisation douloureuse concerne le contenu neurochimique des cellules localisées dans les ganglions rachidiens ou la corne dorsale de la moelle épinière. Cette plasticité neurochimique est illustrée par les variations d’expression de deux neuropeptides, la galanine et la cholécystokinine, ainsi que de leurs récepteurs. Au niveau du premier relais sensoriel, la galanine exercerait un effet essentiellement antinociceptif, à fortes doses, en conditions neuropathiques via son récepteur R1. A l’inverse, la cholécystokinine jouerait un rôle pronociceptif dans les neurones spinaux en s’opposant à l’action des opiacés endogènes via le récepteur CCK2.

La connaissance des mécanismes d’action des messagers est nécessaire à l’élaboration de traitements thérapeutiques innovants. Parmi les messagers chimiques impliqués dans la transmission douloureuse, les neuropeptides représentent une cible thérapeutique de choix en raison de leur caractère modulateur et de leur forte plasticité d’expression. Néanmoins, le développement d’analgésiques dérivés d’agonistes ou d’antagonistes de ces peptides nécessite encore de parfaire la connaissance de leurs mécanismes d’action et de leurs interactions et ces progrès requièrent l’utilisation de modèles animaux pertinents.

Summary

Chronic pain is associated with plastic changes responsible from a persitent sensitization in the spinal cords. The studies of these changes have benefit substantially from the development of experimental animal models. If genetically modified animals have carried a lot of new perspective and hopes, their practical use is difficult due to the important phenotypic variability seen amongst them. However, an important aspect of central sensitization is linked with the changes of expression of neuropeptide such as galanin and cholecystokinin and their receptors. In the dorsal horn, galanin has analgesic effects trough its receptor R1. Conversly, cholecystokinin induces pain via an inhibition of endogenous opioïds through the CCK2 receptor.

Future prospect in analgesic drugs requires a good knowledge about the biochemical cascades involved in the transmission of pain. Amongst these, neuropeptides are good candidate targets because they have a strong analgesic potential, and their expression is highly modulated in persistent pain syndromes. The development of this line of research is still pending on the use of appropriate animal models as well as a better knowledge about their mechanisms.

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    M. Landry & F. Nagy

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Landry, M., Nagy, F. Douleurs neuropathiques et inflammatoires: modèles animaux et rôles fonctionnels des neuropeptides. Doul. et Analg. 18, 151–158 (2005). https://doi.org/10.1007/BF03007280

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