定量温度觉检测结合瞬时受体电位通道激动剂动态评估温度觉敏感神经纤维功能

Dynamic evaluation of thermal-sensitive sensory nerve fiber function using quantitative thermal testing combined with transient receptor potential channel agonists

摘要:

目的利用定量温度觉检测(quantitative thermal testing, QTT)结合特异性瞬时受体电位(transient receptor potential, TRP)通道激动剂，动态评估健康人温度觉敏感神经纤维功能状态。 方法招募72名健康受试者(20~35岁，男性42名，女性30名)，采用QTT测量胸、腹部的温觉阈值(warm detection threshold, WDT)、凉觉阈值(cold detection threshold, CDT)和热痛觉阈值(heat pain threshold, HPT)。在胸部局部分别应用瞬时受体电位M8(transient receptor potential melastatin 8, TRPM8)激动剂薄荷醇和瞬时受体电位V1(transient receptor potential vanilloid 1, TRPV1)激动剂辣椒素后，重复进行QTT。使用非参数检验比较TRP通道激动剂干预前后温度觉阈值变化。 结果女性胸部的CDT为1.08(0.80，1.46) ℃，显著低于男性的1.49(1.05，2.10) ℃，差异有统计学意义(P<0.05)；女性腹部的CDT为0.97(0.83，1.42) ℃，显著低于男性的1.26(1.17，1.95) ℃，差异有统计学意义(P<0.05)；女性的HPT为38.88(38.12，41.42) ℃，显著低于男性的40.19(38.45，42.80) ℃，差异有统计学意义(P<0.05)。与空白组相比，应用薄荷醇后胸腹部凉觉敏感性增强，男性由1.49 ℃(1.05，2.10)降低至0.96 ℃(0.70，1.25)，女性由1.08 ℃(0.80，1.46)降低至0.77(0.59，1.25) ℃，差异均有统计学意义(均P＜0.05)；应用辣椒素后热痛觉敏感性增强，男性由39.97 ℃(38.62，41.71)降低至38.67 ℃(37.49，40.29)，女性由39.34 ℃(38.36，40.93)降低至38.66 ℃(37.47，40.12)，差异均有统计学意义(均P＜0.05)。 结论QTT结合TRPV1和TRPM8通道激动剂，可用于动态评估健康人温度觉敏感神经纤维的功能状态。

Abstract:

ObjectiveTo dynamically evaluate the functional status of thermal-sensitive sensory nerve fibers in healthy individuals with quantitative thermal testing(QTT) and specific transient receptor potential(TRP) channel agonists. MethodsSeventy-two healthy volunteers(42 males, aged 20-35 years) were recruited. The QTT was used to measure warm detection threshold(WDT), cold detection threshold(CDT), and heat pain threshold(HPT) at the chest(T5) and abdomen(T10). The TRPM8 agonist menthol and transient receptor potential vanilloid 1(TRPV1) agonist capsaicin were topically applied to the T5 area, followed by repeated QTT measurements. The non-parametric tests were used to compare the changes in thermal thresholds before and after TRP channel agonist interventions. ResultsAt the T5 site, female participants showed significantly lower CDT than males [1.08(0.80, 1.46) ℃ vs 1.49(1.05, 2.10) ℃, P < 0.05]. At the T10 site, CDT and HPT in females were both significantly lower than those in males [0.97(0.83, 1.42) ℃ vs 1.26(1.17, 1.95) ℃, 38.88(38.12, 41.42) ℃ vs 40.19(38.45, 42.80) ℃, both P<0.05]. After menthol application, the cold detection increased: in males, CDT decreased from 1.49(1.05, 2.10) ℃ to 0.96(0.70, 1.25) ℃(P < 0.05); in females, it decreased from 1.08(0.80, 1.46) ℃ to 0.77(0.59, 1.25) ℃(P < 0.05). After capsaicin application, the heat pain detection increased: in males, HPT decreased from 39.97(38.62, 41.71) ℃ to 38.67(37.49, 40.29) ℃(P<0.05); in females, it decreased from 39.34(38.36, 40.93) ℃ to 38.66(37.47, 40.12) ℃(P < 0.05). ConclusionQTT combined with TRPV1 and TRPM8 agonists is a useful approach for dynamically evaluating the functional status of thermal-sensitive sensory nerve fibers in healthy individuals.