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Histone Methyltransferase G9a in Primary Sensory Neurons Promotes Inflammatory Pain and Transcription of Trpa1 and Trpv1 via Bivalent Histone Modifications
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作者:

Ghosh, Krishna
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Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA

Huang, Yuying
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Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA

Jin, Daozhong
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Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA

Chen, Shao-Rui
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Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA

Pan, Hui-Lin
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机构:
Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA
机构:
[1] Univ Texas MD Anderson Canc Ctr, Ctr Neurosci & Pain Res, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA
基金:
美国国家卫生研究院;
关键词:
bivalent histone modifications;
chromatin plasticity;
dorsal root ganglion;
epigenetics;
histone lysine methyltransferase;
histone methylation;
MU-OPIOID RECEPTORS;
COACTIVATOR;
PROTEIN;
HYPERALGESIA;
CONTRIBUTES;
MAINTENANCE;
METHYLATION;
EXPRESSION;
ALLODYNIA;
ANALGESIA;
D O I:
10.1523/JNEUROSCI.1790-24.2024
中图分类号:
Q189 [神经科学];
学科分类号:
071006 ;
摘要:
Transient receptor potential ankyrin 1 (TRPA1) and vanilloid 1 (TRPV1) channels are crucial for detecting and transmitting nociceptive stimuli. Inflammatory pain is associated with sustained increases in TRPA1 and TRPV1 expression in primary sensory neurons. However, the epigenetic mechanisms driving this upregulation remain unknown. G9a (encoded by Ehmt2) catalyzes H3K9me2 and generally represses gene transcription. In this study, we found that intrathecal administration of UNC0638, a specific G9a inhibitor, or G9a-specific siRNA, substantially reduced complete Freund's adjuvant (CFA)-induced pain hypersensitivity. Remarkably, CFA treatment did not induce persistent pain hypersensitivity in male and female mice with conditional Ehmt2 knock-out in dorsal root ganglion (DRG) neurons. RNA sequencing and quantitative PCR analyses showed that CFA treatment caused a sustained increase in mRNA levels of Trpa1 and Trpv1 in the DRG. Ehmt2 knock-out in DRG neurons elevated baseline Trpa1 and Trpv1 mRNA levels but notably reversed CFA-induced increases in their expression. Chromatin immunoprecipitation revealed that CFA treatment reduced G9a and H3K9me2 levels while increasing H3K9ac and H3K4me3-activating histone marks-at Trpa1 and Trpv1 promoters in the DRG. Strikingly, conditional Ehmt2 knock-out in DRG neurons not only diminished H3K9me2 but also reversed CFA-induced increases in H3K9ac and H3K4me3 at Trpa1 and Trpv1 promoters. Our findings suggest that G9a in primary sensory neurons constitutively represses Trpa1 and Trpv1 transcription under normal conditions but paradoxically enhances their transcription during tissue inflammation. This latter action accounts for inflammation-induced TRPA1 and TRPV1 upregulation in the DRG. Thus, G9a could be targeted for alleviating persistent inflammatory pain.
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共 66 条
- [1] Inhibition of class II histone deacetylases in the spinal cord attenuates inflammatory hyperalgesia[J]. MOLECULAR PAIN, 2010, 6Bai, Guang论文数: 0 引用数: 0 h-index: 0机构: Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USA Univ Maryland, Sch Dent, Program Neurosci, Baltimore, MD 21117 USA Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USAWei, Dong论文数: 0 引用数: 0 h-index: 0机构: Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USA Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USAZou, Shiping论文数: 0 引用数: 0 h-index: 0机构: Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USA Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USARen, Ke论文数: 0 引用数: 0 h-index: 0机构: Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USA Univ Maryland, Sch Dent, Program Neurosci, Baltimore, MD 21117 USA Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USADubner, Ronald论文数: 0 引用数: 0 h-index: 0机构: Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USA Univ Maryland, Sch Dent, Program Neurosci, Baltimore, MD 21117 USA Univ Maryland, Dept Neural & Pain Sci, Baltimore, MD 21117 USA
- [2] TRPA1 mediates the inflammatory actions of environmental irritants and proalgesic agents[J]. CELL, 2006, 124 (06) : 1269 - 1282Bautista, DM论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USAJordt, SE论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USANikai, T论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USATsuruda, PR论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USARead, AJ论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USAPoblete, J论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USAYamoah, EN论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USABasbaum, AI论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USAJulius, D论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USA Univ Calif San Francisco, Dept Cellular & Mol Pharmacol, San Francisco, CA 94143 USA
- [3] A bivalent chromatin structure marks key developmental genes in embryonic stem cells[J]. CELL, 2006, 125 (02) : 315 - 326Bernstein, BE论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USA Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAMikkelsen, TS论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAXie, XH论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAKamal, M论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAHuebert, DJ论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USACuff, J论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAFry, B论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAMeissner, A论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAWernig, M论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAPlath, K论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAJaenisch, R论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAWagschal, A论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USAFeil, R论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USASchreiber, SL论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USALander, ES论文数: 0 引用数: 0 h-index: 0机构: Massachusetts Gen Hosp, Mol Pathol Unit, Charlestown, MA 02129 USA
- [4] The Bivalent Genome: Characterization, Structure, and Regulation[J]. TRENDS IN GENETICS, 2020, 36 (02) : 118 - 131Blanco, Enrique论文数: 0 引用数: 0 h-index: 0机构: Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, Spain Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, SpainGonzalez-Ramirez, Mar论文数: 0 引用数: 0 h-index: 0机构: Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, Spain Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, SpainAlcaine-Colet, Anna论文数: 0 引用数: 0 h-index: 0机构: Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, Spain Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, SpainAranda, Sergi论文数: 0 引用数: 0 h-index: 0机构: Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, Spain Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, SpainDi Croce, Luciano论文数: 0 引用数: 0 h-index: 0机构: Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, Spain UPF, Placa Merce 10, Barcelona 08002, Spain ICREA, Passeig Lluis Companys 23, Barcelona 08010, Spain Barcelona Inst Sci & Technol, Ctr Genom Regulat CRG, Carrer Doctor Aiguader 88, Barcelona 08003, Spain
- [5] Peripheral inflammation selectively increases TRPV1 function in IB4-positive sensory neurons from adult mouse[J]. PAIN, 2005, 115 (1-2) : 37 - 49Breese, NM论文数: 0 引用数: 0 h-index: 0机构: Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USA Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USAGeorge, AC论文数: 0 引用数: 0 h-index: 0机构: Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USA Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USAPauers, LE论文数: 0 引用数: 0 h-index: 0机构: Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USA Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USAStucky, CL论文数: 0 引用数: 0 h-index: 0机构: Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USA Med Coll Wisconsin, Dept Cell Biol & Anat, Milwaukee, WI 53226 USA
- [6] Impaired nociception and pain sensation in mice lacking the capsaicin receptor[J]. SCIENCE, 2000, 288 (5464) : 306 - 313Caterina, MJ论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USALeffler, A论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USAMalmberg, AB论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USAMartin, WJ论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USATrafton, J论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USAPetersen-Zeitz, KR论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USAKoltzenburg, M论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USABasbaum, AI论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USAJulius, D论文数: 0 引用数: 0 h-index: 0机构: Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USA Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USA
- [7] QUANTITATIVE ASSESSMENT OF TACTILE ALLODYNIA IN THE RAT PAW[J]. JOURNAL OF NEUROSCIENCE METHODS, 1994, 53 (01) : 55 - 63CHAPLAN, SR论文数: 0 引用数: 0 h-index: 0机构: UNIV TEXAS,MED BRANCH,INST MARINE BIOMED,GALVESTON,TX 77555BACH, FW论文数: 0 引用数: 0 h-index: 0机构: UNIV TEXAS,MED BRANCH,INST MARINE BIOMED,GALVESTON,TX 77555POGREL, JW论文数: 0 引用数: 0 h-index: 0机构: UNIV TEXAS,MED BRANCH,INST MARINE BIOMED,GALVESTON,TX 77555CHUNG, JM论文数: 0 引用数: 0 h-index: 0机构: UNIV TEXAS,MED BRANCH,INST MARINE BIOMED,GALVESTON,TX 77555YAKSH, TL论文数: 0 引用数: 0 h-index: 0机构: UNIV TEXAS,MED BRANCH,INST MARINE BIOMED,GALVESTON,TX 77555
- [8] Maintenance of gene silencing by the coordinate action of the H3K9 methyltransferase G9a/KMT1C and the H3K4 demethylase Jarid1a/KDM5A[J]. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2012, 109 (46) : 18845 - 18850Chaturvedi, Chandra-Prakash论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaSomasundaram, Brinda论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON K1H 8L6, Canada Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaSingh, Kulwant论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaCarpenedo, Richard L.论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaStanford, William L.论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON K1H 8L6, Canada Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaDilworth, F. Jeffrey论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON K1H 8L6, Canada Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaBrand, Marjorie论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON K1H 8L6, Canada Ottawa Hosp Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada
- [9] Dual role for the methyltransferase G9a in the maintenance of β-globin gene transcription in adult erythroid cells[J]. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2009, 106 (43) : 18303 - 18308Chaturvedi, Chandra-Prakash论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaHosey, Alison M.论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaPalii, Carmen论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaPerez-Iratxeta, Carolina论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaNakatani, Yoshihiro论文数: 0 引用数: 0 h-index: 0机构: Dana Farber Canc Inst, Boston, MA 02115 USA Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaRanish, Jeffrey A.论文数: 0 引用数: 0 h-index: 0机构: Inst Syst Biol, Seattle, WA 98103 USA Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaDilworth, F. Jeffrey论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON K1H 8L6, Canada Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, CanadaBrand, Marjorie论文数: 0 引用数: 0 h-index: 0机构: Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON K1H 8L6, Canada Ottawa Hosp, Res Inst, Regenerat Med Program, Sprott Ctr Stem Cell Res, Ottawa, ON K1H 8L6, Canada
- [10] Loss of TRPV1-expressing sensory neurons reduces spinal μ opioid receptors but paradoxically potentiates opioid analgesia[J]. JOURNAL OF NEUROPHYSIOLOGY, 2006, 95 (05) : 3086 - 3096Chen, SR论文数: 0 引用数: 0 h-index: 0机构: Penn State Univ, Coll Med, Dept Anesthesiol, Hershey, PA USAPan, HL论文数: 0 引用数: 0 h-index: 0机构: Penn State Univ, Coll Med, Dept Anesthesiol, Hershey, PA USA