| 2. |
- Schmelz, M., et al.
(författare)
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Chemical response pattern of different classes of C-nociceptors to pruritogens and algogens
- 2003
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Ingår i: Journal of Neurophysiology. - Washington : The American Physiological Society. - 0022-3077 .- 1522-1598. ; 89:5, s. 2441-2448
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Tidskriftsartikel (refereegranskat)abstract
- Vasoneuroactive substances were applied through intradermal microdialysis membranes and characterized as itch- or pain-inducing in psychophysical experiments. Histamine always provoked itching and rarely pain, capsaicin always pain but never itching. Prostaglandin E[2] (PGE[2]) led preferentially to moderate itching. Serotonin, acetylcholine, and bradykinin induced pain more often than itching. Subsequently the same substances were used in microneurography experiments to characterize the sensitivity profile of human cutaneous C-nociceptors. The responses of 89 mechanoresponsive (CMH, polymodal nociceptors), 52 mechanoinsensitive, histamine-negative (CMi[H][i][s][-]), and 24 mechanoinsensitive, histamine-positive (CMi[H][i][s][+]) units were compared. CMi[H][i][s][+] units were most responsive to histamine and to PGE[2] and less to serotonin, ACh, bradykinin, and capsaicin. CMH units (polymodal nociceptors) and CMi[H][i][s] units showed significantly weaker responses to histamine, PGE[2], and acetylcholine. Capsaicin and bradykinin responses were not significantly different in the two classes of mechano-insensitive units. We conclude that CMi[H][i][s][+]units are "selective," but not "specific" for pruritogenic substances and that the pruritic potency of a mediator increases with its ability to activate CMi[H][i][s][+] units but decreases with activation of CMH and CMi[H][i][s] units.
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| 3. |
- Ørstavik, Kristin, et al.
(författare)
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Pathological C-fibres in patients with a chronic painful condition
- 2003
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Ingår i: Brain. - Oxford : Oxford University Press. - 0006-8950 .- 1460-2156. ; 126, s. 567-
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about the contribution of C-afferent fibres to chronic painful conditions in humans. We sought to investigate the role of C-fibres in the pathophysiology of pain and hyperalgesia in erythromelalgia as a model disease for chronic pain. Erythromelalgia is a condition characterized by painful, red and hot extremities, and patients often report tenderness on walking. We made microneurographic recordings from single C-fibres in cutaneous fascicles of the peroneal nerve in patients suffering from this disease. All patients had had a pain attack recently and psychophysical signs of allodynia and punctate hyperalgesia were found. We obtained recordings from a total of 103 C-fibres and found significantly lower conduction velocities and increased activity-dependent slowing of the conduction velocity of afferent C-fibres in the patients compared with healthy controls. Furthermore, several units with biophysical properties of mechano-insensitive fibres were pathological, being spontaneously active or sensitized to mechanical stimuli. Since these fibres also mediate the axon reflex flare, their hyperexcitability might account not only for ongoing pain and tenderness but also for redness and warming in this pain syndrome. The changes in conductive properties found in the C-fibres of these patients could be the first signs of a small-fibre neuropathy. This is the first systematic study of single C-fibres in patients and it shows an active contribution of mechano-insensitive fibres to chronic pain.
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