Spinal cord microglia drive sex differences in ethanol-mediated PGE2-induced allodynia, 2024, Alexander et al.

SNT Gatchaman

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Spinal cord microglia drive sex differences in ethanol-mediated PGE2-induced allodynia
Alexander; Reed; Burton

The mechanisms of how long-term alcohol use can lead to persistent pain pathology are unclear. Understanding how earlier events of short-term alcohol use can lower the threshold of non-painful stimuli, described as allodynia could prove prudent to understand important initiating mechanisms. Previously, we observed that short-term low-dose alcohol intake induced female-specific allodynia and increased microglial activation in the spinal cord dorsal horn. Other literature describes how chronic ethanol exposure activates Toll-like receptor 4 (TLR4) to initiate inflammatory responses. TLR4 is expressed on many cell types, and we aimed to investigate whether TLR4 on microglia is sufficient to potentiate allodynia during a short-term/low-dose alcohol paradigm.

Our study used a novel genetic model where TLR4 expression is removed from the entire body by introducing a floxed transcriptional blocker (TLR4-null background (TLR4LoxTB)), then restricted to microglia by breeding TLR4LoxTB animals with Cx3CR1:CreERT2 animals.

As previously reported, after 14 days of ethanol administration alone, we observed no increased pain behavior. However, we observed significant priming effects 3 hours post intraplantar injection of a subthreshold dose of prostaglandin E2 (PGE2) in wild-type and microglia-TLR4 restricted female mice. We also observed a significant female-specific shift to pro-inflammatory phenotype and morphological changes in microglia of the lumbar dorsal horn. Investigations in pain priming-associated neuronal subtypes showed an increase of c-Fos and FosB activity in PKCγ interneurons in the dorsal horn of female mice directly corresponding to increased microglial activity.

This study uncovers celland female-specific roles of TLR4 in sexual dimorphisms in pain induction among nonpathological drinkers.

Link | PDF (Brain, Behavior, and Immunity)
 
we confirmed our hypothesis that a paradigm of 5% EtOH diet over a 2-week period is sufficient to induce PGE2-mediated pain sensitization in female mice when TLR4 is activated on microglia only.

Results highlight that microglial TLR4 facilitates increased neuroimmune communication to drive pain sensitivity. Findings also implicate TLR4-related pro-inflammatory marker expression in inducing morphological changes of microglia and influencing pain outcomes.

These results effectively illustrate that a small amount of EtOH within a short term is sufficient to facilitate hyperalgesic priming of neurons thereby reducing mechanical pain thresholds. The involvement of PKCγ interneurons in mediating mechanical allodynia and their interaction with microglia underscore the importance of neuronal microglial crosstalk in pain sensitization. Furthermore, we have shown for the first time that alcohol-induced pain is driven by TLR4 on microglia in female mice.

The sex-dependent differences observed in pain responses and microglial activation highlight the complexity of neuroimmune interactions underlying pain processing.
 
Pretty ingenious experiment. But proving something is sufficient is not much of a value. Proving it necessary is. They can't point to microglia as a key mechanism till they can prove that TLR4 expression on them is necessary for allodynia or female bias. For all we know, TLR4 in guts could do the same thing.
 
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