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An ultrafast system for signaling mechanical pain in human skin

Artikel i vetenskaplig tidskrift
Författare S. S. Nagi
A. G. Marshall
A. Makdani
E. Jarocka
Jaquette Liljencrantz
M. Ridderstrom
S. Shaikh
F. O'Neill
D. Saade
S. Donkervoort
A. R. Foley
J. Minde
M. Trulsson
J. Cole
C. G. Bonnemann
A. T. Chesler
M. C. Bushnell
F. McGlone
H. Olausson
Publicerad i Science Advances
Volym 5
Nummer/häfte 7
ISSN 2375-2548
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Språk en
Länkar dx.doi.org/10.1126/sciadv.aaw1297
Ämnesord a-delta-fibers, unmyelinated tactile afferents, sensory nerve-endings, hairy skin, intraneural microstimulation, conduction velocities, nociceptive messages, cutaneous afferents, response properties, stimulation, Science & Technology - Other Topics
Ämneskategorier Neurovetenskaper

Sammanfattning

The canonical view is that touch is signaled by fast-conducting, thickly myelinated afferents, whereas pain is signaled by slow-conducting, thinly myelinated ("fast" pain) or unmyelinated ("slow" pain) afferents. While other mammals have thickly myelinated afferents signaling pain (ultrafast nociceptors), these have not been demonstrated in humans. Here, we performed single-unit axonal recordings (microneurography) from cutaneous mechanoreceptive afferents in healthy participants. We identified A-fiber high-threshold mechanoreceptors (A-HTMR5) that were insensitive to gentle touch, encoded noxious skin indentations, and displayed conduction velocities similar to A-fiber low-threshold mechanoreceptors. Intraneural electrical stimulation of single ultrafast A-HTMRs evoked painful percepts. Testing in patients with selective deafferentation revealed impaired pain judgments to graded mechanical stimuli only when thickly myelinated fibers were absent. This function was preserved in patients with a loss-of-function mutation in mechanotransduction channel PIEZO2.These findings demonstrate that human mechanical pain does not require PIEZO2 and can be signaled by fast-conducting, thickly myelinated afferents.

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