Cyclic nucleotide signaling in sensory neuron hyperexcitability and chronic pain after nerve injury

Abstract

The cyclic nucleotide signaling, including cAMP-PKA and cGMP-PKG pathways, has been well known to play critical roles in regulating cellular growth, metabolism and many other intracellular processes. In recent years, more and more studies have uncovered the roles of cAMP and cGMP in the nervous system. The cAMP and cGMP signaling mediates chronic pain induced by different forms of injury and stress. Here we summarize the roles of cAMP-PKA and cGMP-PKG signaling pathways in the pathogenesis of chronic pain after nerve injury. In addition, acute dissociation and chronic compression of the dorsal root ganglion (DRG) neurons, respectively, leads to neural hyperexcitability possibly through PAR2 activation-dependent activation of cAMP-PKA pathway. Clinically, radiotherapy can effectively alleviate bone cancer pain at least partly through inhibiting the cancer cell-induced activation of cAMP-PKA pathway. Roles of cyclic nucleotide signaling in neuropathic and inflammatory pain are also seen in many other animal models and are involved in many pro-nociceptive mechanisms including the activation of hyperpolarization-activated cyclic nucleotide (HCN)-modulated ion channels and the exchange proteins directly activated by cAMP (EPAC). Further understanding the roles of cAMP and cGMP signaling in the pathogenesis of chronic pain is theoretically significant and clinically valuable for treatment of chronic pain.

Fig. 1

Schematic representation of the roles of the cAMP-PKA and cGMP-PKG pathway in DRG neuron hyperexcitability after peripheral injury or injury- related stress including chronic compression of DRG (CCD) and acute dissociation of DRG (ADD). The activation of PKA-dependent cAMP-PKA pathway may be mediated, at least partly, by PAR2 activation. PKA-independent cAMP-EPAC and cGMP-cGKII pathways also contribute to the neuronal hyperexcitability following peripheral injury.