Methylglyoxal modification of Na v 1.8 facilitates nociceptive neuron firing and causes hyperalgesia in diabetic neuropathy

Angelika Bierhaus, Thomas Fleming, Stoyan Stoyanov, Andreas Leffler, Alexandru Babes, Cristian Neacsu, Susanne K. Sauer, Mirjam Eberhardt, Martina Schnölzer, Felix Lasischka, Winfried L. Neuhuber, Tatjana I. Kichko, Ilze Konrade, Ralf Elvert, Walter Mier, Valdis Pirags, Ivan K. Lukic, Michael Morcos, Thomas Dehmer, Naila RabbaniPaul J. Thornalley, Diane Edelstein, Carla Nau, Josephine Forbes, Per M. Humpert, Markus Schwaninger, Dan Ziegler, David M. Stern, Mark E. Cooper, Uwe Haberkorn, Michael Brownlee, Peter W. Reeh, Peter P. Nawroth

Research output: Contribution to journalArticle

277 Scopus citations

Abstract

This study establishes a mechanism for metabolic hyperalgesia based on the glycolytic metabolite methylglyoxal. We found that concentrations of plasma methylglyoxal above 600 nM discriminate between diabetes-affected individuals with pain and those without pain. Methylglyoxal depolarizes sensory neurons and induces post-translational modifications of the voltage-gated sodium channel Na v 1.8, which are associated with increased electrical excitability and facilitated firing of nociceptive neurons, whereas it promotes the slow inactivation of Na v 1.7. In mice, treatment with methylglyoxal reduces nerve conduction velocity, facilitates neurosecretion of calcitonin gene-related peptide, increases cyclooxygenase-2 (COX-2) expression and evokes thermal and mechanical hyperalgesia. This hyperalgesia is reflected by increased blood flow in brain regions that are involved in pain processing. We also found similar changes in streptozotocin-induced and genetic mouse models of diabetes but not in Na v 1.8 knockout (Scn10 -/-) mice. Several strategies that include a methylglyoxal scavenger are effective in reducing methylglyoxal-and diabetes-induced hyperalgesia. This previously undescribed concept of metabolically driven hyperalgesia provides a new basis for the design of therapeutic interventions for painful diabetic neuropathy.

Original languageEnglish (US)
Pages (from-to)926-933
Number of pages8
JournalNature Medicine
Volume18
Issue number6
DOIs
StatePublished - Jun 2012

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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    Bierhaus, A., Fleming, T., Stoyanov, S., Leffler, A., Babes, A., Neacsu, C., Sauer, S. K., Eberhardt, M., Schnölzer, M., Lasischka, F., Neuhuber, W. L., Kichko, T. I., Konrade, I., Elvert, R., Mier, W., Pirags, V., Lukic, I. K., Morcos, M., Dehmer, T., ... Nawroth, P. P. (2012). Methylglyoxal modification of Na v 1.8 facilitates nociceptive neuron firing and causes hyperalgesia in diabetic neuropathy. Nature Medicine, 18(6), 926-933. https://doi.org/10.1038/nm.2750