Pain is a complex phenomenon and the disentangling of the underlying mechanisms, in which peripheral and central inflammation play an important role, leads to new insights and new therapeutic options. Peripheral inflammation is characterised by the release of a great variety of substances and inflammatory mediators, such as prostaglandines, cytokines and growth factors. The nociceptors at the extreme ends of the C-fibers register changes in the local milieu. It is the specific receptors and transducer proteins located on the nociceptor that cause a depolarisation and in that way send an action potential via the C-fibres to the central nervous system. Upon arrival of this action potential, an inflammatory response will also develop in the central nervous system in which microglial cells play a pivotal role. The interaction between the activated microglial cells and the central sensitization process (NMDA receptor) may result in chronification of the pain.
Introduction: Bromodeoxyuridine (BrdU) can be used to label proliferation and differentiation of progenitor cells in the adult rat spinal cord. In this study we wanted to investigate if radiofrequency (RF) and pulsed radiofrequency (PRF) treatment adjacent to the cervical dorsal root ganglion would lead to an increased proliferation of cells in the spinal cord. The present pilot study is performed as an extension of a previous experiment in which late cellular activity was demonstrated in the rat dorsal horn, by means of c-Fos immunochemistry after pulsed and continuous RF and not after sham.Methods: Cervical laminectomy at C5-C6 was performed in 19 male Wistar rats. The cervical dorsal root ganglion was randomly exposed to one of the four interventions: sham, continuous radiofrequency current at 67°C, pulsed radiofrequency current for 120 seconds or 8 minutes. One hour after the lesion animals received an intraperitoneal injection with 100 mg/kg BrdU (Sigma) in 0.9 % NaCl. The animals were sacrificed 7 days after the intervention and the spinal cord was prepared for BrdU labelling; after a pre-treatment with 2N HCl and Sodium tetraboraat, 30 m free floating cryostat sections were incubated using goat anti BrdU (1:5000, Abcam). Quantification of BrdU labelled cells in the dorsal horn was performed for each animal in one section (30 m) of level C5 and C6, both ipsi-and contralateral. Counting was done by a blinded and experienced investigator (W.H.). For statistical evaluation Student-t test was used Results: The BrdU labelled cells were easily recognizable due to the intense staining of the nucleus. Immonopositive cells were randomly distributed throughout the spinal cord section. Data of our quantitative analysis are shown in table 1.
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