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Am J Physiol Gastrointest Liver Physiol 291: G658-G665, 2006. First published February 23, 2006; doi:10.1152/ajpgi.00585.2005
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NEUROREGULATION AND MOTILITY

Convergence of sensory pathways in the development of somatic and visceral hypersensitivity

Klaus Bielefeldt,1 Kenneth Lamb,2 and G. F. Gebhart2

1Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; and 2Department of Pharmacology, University of Iowa, Iowa City, Iowa

Submitted 27 December 2005 ; accepted in final form 14 February 2006

Sensory neurons innervating different tissues converge onto second-order neurons in the spinal cord. We examined whether inflammation or transient overexpression of nerve growth factor (NGF) in one tissue triggers hypersensitivity in referral sites. Thresholds to mechanical and thermal stimulation of the hindpaw, visceromotor responses to colorectal distension, and cystometrograms were performed in appropriate controls and mice with experimentally induced cystitis, inflammation of the hindpaw or front paw, or injection of viral vectors encoding NGF or green fluorescent protein (GFP). Cystitis and NGF but not GFP overexpression in the bladder triggered bladder hyperactivity associated with mechanical and thermal hypersensitivity in cutaneous referral sites and enhanced responses to colorectal distension. Hindpaw inflammation and injection of the NGF- but not GFP-encoding viral vector or front paw inflammation induced mechanical and thermal hyperalgesia in the affected hindpaw and increased responses to colorectal distension without altering the micturition reflex. In conclusion, sensitization of sensory pathways by inflammation or NGF contributes to the development of hypersensitivity in neighboring organs and cutaneous referral sites and provides a potential mechanism underlying the coexistence of pain syndromes in patients with functional diseases.

visceral sensation; nerve growth factor; viscerosomatic convergence



Address for reprint requests and other correspondence: K. Bielefeldt, Div. of Gastroenterology, Dept. of Medicine, Univ. of Pittsburgh, 200 Lothrop St., Pittsburgh, PA 15213 (e-mail: bielefeldtk{at}dom.pitt.edu)




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