Parabrachial Pituitary Adenylate Cyclase-Activating Polypeptide Activation of Amygdala Endosomal Extracellular Signal–Regulated Kinase Signaling Regulates the Emotional Component of Pain



      Chronic pain and stress-related psychopathologies, such as depression and anxiety-associated abnormalities, are mutually reinforcing; however, the neuronal circuits and mechanisms that underlie this reinforcement are still not well understood. Pituitary adenylate cyclase-activating polypeptide (PACAP; Adcyap1) and its cognate PAC1 receptor (Adcyap1r1) are expressed in peripheral nociceptive pathways, participate in anxiety-related responses and have been have been linked to posttraumatic stress disorder and other mental health afflictions.


      Using immunocytochemistry, pharmacological treatments and behavioral testing techniques, we have used a rodent partial sciatic nerve chronic constriction injury model (n = 5–8 per group per experiment) to evaluate PACAP plasticity and signaling in nociceptive and stress-related behaviors.


      We show that chronic neuropathic pain increases PACAP expression at multiple tiers along the spinoparabrachioamygdaloid tract. Furthermore, chronic constriction injury bilaterally augments nociceptive amygdala (in the central nucleus of the amygdala [CeA]) PACAP immunoreactivity, extracellular signal–regulated kinase phosphorylation, and c-Fos activation, in parallel with heightened anxiety-like behavior and nociceptive hypersensitivity. Acute CeA infusions with the PACAP receptor antagonist PACAP(6-38) blocked chronic constriction injury–induced behavioral responses. Additionally, pretreatments with inhibitors of mitogen-activated protein kinase enzymes or endocytosis to block endosomal PACAP receptor extracellular signal–regulated kinase signaling attenuated PACAP-induced CeA neuronal activation and nociceptive responses.


      Our data suggest that chronic pain-induced PACAP neuroplasticity and signaling in spinoparabrachioamygdaloid projections have an impact on CeA stress- and nociception-associated maladaptive responses, which can be ameliorated upon receptor antagonism even during injury progression. Thus, the PACAP pathway provides for an important mechanism underlying the intersection of stress and chronic pain pathways via the amygdala.


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      Linked Article

      • Extracellular Signal–Regulated Kinases: A Role for Mood Disorders and the Emotional Component of Pain?
        Biological PsychiatryVol. 81Issue 8
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          Mood disorders such as depression and anxiety disorders are frequent and disabling disorders with great socioeconomic impact. It is intriguing that there is a great degree of comorbidity of mood disorders with pain syndromes, which may be a consequence of a variety of disorders. Clinically, it is of note that a prevailing mood disorder can lead to a reinforcement of pain perception, whereas the experience of pain may cause or worsen mood disturbances. Such a vicious circle is a challenge for clinical management of comorbid patients but also for research dealing with its underlying pathophysiology.
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