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1 Physiology, Chung-Shan Medical University, Taichug, Taiwan - Republic of China; Veterinary Medicine, National Chung-Hsing University, Taichug, Taiwan - Republic of China
2 Chung-Shan Medical University, Department of Anatomy, United States
3 Department of Chemistry, Tunghai University, United States
4 Veterinary Medicine, National Chung-Hsing University, Taichug, Taiwan - Republic of China
5 School of Physical Therapy, China Medical University, Taichung, Taiwan - Republic of China; , Taiwan - Republic of China
6 Physiology, Chung-Shan Medical University, Taichung , Taiwan - Republic of China
7 Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan - Republic of China; , Taiwan - Republic of China
8 Department of Obstetrics and Gynecology, Chung-Shan Medical University Hospital, Taiwan - Republic of China
9 Physiology, Chung-Shan Medical University, Taichug, Taiwan - Republic of China
* To whom correspondence should be addressed. E-mail: tblin{at}csmu.edu.tw.
Spinal cord-mediated cross-organ sensitization between the uterus and the lower urinary tract may underlie the high concurrence of obstetrical/gynecological inflammation and chronic pelvic pain syndrome characterized by urogenital pain. However, the neural pathway and the neurotransmitters involved are still unknown. We tested the hypothesis that the excitation of capsaicin-sensitive primary afferent fibers arising from the uterus through the stimulation of transient receptor potential vanilloid 1 (TRPV1), induces cross-organ sensitization on the pelvic-urethra reflex activity. Capsaicin (1-1000 uM, 0.05 cc) was instilled into the uterus to induce cross-organ reflex sensitization. Activation of capsaicin-sensitive primary afferent fibers by capsaicin instillation into the uterine horn sensitized the pelvic-urethra reflex activity that was reversed by an intra-uterine pretreatment with capsaizepine, a TRPV1-selective antagonist. Intrathecal injection of AP5, a glutamatergic N-methyl-D-aspartate (NMDA) antagonist, and Co-101244, an NMDA NR2B-selective antagonist, both abolished the cross-organ reflex sensitization caused by capsaicin instillation. These results demonstrated that TRPV1 plays a crucial role in contributing to the capsaicin-sensitive primary afferent fibers mediating the glutamatergic NMDA-dependent cross-organ sensitization between the uterus and the lower urinary tract when there is a tissue injury.
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