RESUMO
Neuropathic pain (NP) following a spinal cord injury (SCI) is often hard to control and therapies should be focused on the physical, psychological, behavioral, social, and environmental factors that may contribute to chronic sensory symptoms. Novel therapeutic treatments for NP management should be based on the combination of pharmacological and nonpharmacological options. Some of them are addressed in this review with a focus on mechanisms and novel treatments. Several reports demonstrated an aberrant expression of non-coding RNAs (ncRNAs) that may represent key regulatory factors with a crucial role in the pathophysiology of NP and as potential diagnostic biomarkers. This review analyses the latest evidence for cellular and molecular mechanisms associated with the role of circular RNAs (circRNAs) in the management of pain after SCI. Advantages in the use of circRNA are their stability (up to 48 h), and specificity as sponges of different miRNAs related to SCI and nerve injury. The present review discusses novel data about deregulated circRNAs (up or downregulated) that sponge miRNAs, and promote cellular and molecular interactions with mRNAs and proteins. This data support the concept that circRNAs could be considered as novel potential therapeutic targets for NP management especially after spinal cord injuries.
Assuntos
MicroRNAs , Neuralgia , Traumatismos da Medula Espinal , Humanos , RNA Circular/genética , Manejo da Dor , Traumatismos da Medula Espinal/metabolismo , MicroRNAs/genética , Neuralgia/genéticaRESUMO
Spinal Cord Injury (SCI) can elicit a progressive loss of nerve cells promoting disability, morbidity, and even mortality. Despite different triggering mechanisms, a cascade of molecular events involving complex gene alterations and activation of the neuroimmune system influence either cell damage or repair. Effective therapies to avoid secondary mechanisms underlying SCI are still lacking. The recent progression in circular RNAs (circRNAs) research has drawn increasing attention and opened a new insight on SCI pathology. circRNAs differ from traditional linear RNAs and have emerged as the active elements to regulate gene expression as well as to facilitate the immune response involved in pathophysiology-related conditions. In this review, we focus on the impact and possible close relationship of circRNAs with pathophysiological mechanisms following SCI, where circRNAs could be the key transcriptional regulatory molecules to define neuronal death or survival. Advances in circRNAs research provide new insight on potential biomarkers and effective therapeutic targets for SCI patients.
RESUMO
A medula espinhal dos mamíferos adultos não permite a regeneração de axônios. Por razões ainda desconhecidas, as fibras neurais falham em cruzar o sítio da lesão, como se não houvesse crescimento, desde a primeira tentativa. Quais mecanismos poderiam explicar a perda da capacidade de regeneração? As cicatrizes formadas pelas células da glia seriam uma consequência da falha na regeneração ou a causa? Diversas linhas de evidência sugerem que a regeneração da medula espinhal seria impedida no sistema nervoso central pela ação de fatores locais no sítio da lesão, e que o sistema nervoso central não-lesado é um meio permissivo para o crescimento axonal, na direção de alvos específicos. Uma vez que os axônios são induzidos adequadamente a cruzar a lesão com o auxílio de implantes, fármacos ou células indiferenciadas, as fibras em regeneração podem encontrar a via específica e estabelecer conexões corretas. O que ainda não se sabe é que combinação de moléculas induz/inibe o potencial de regeneração do tecido e que mecanismos permitem aos neurônios formarem conexões específicas com os alvos com os quais são programados a fazer.
The adult mammal spinal cord does not allow axons regeneration. For unknown reasons, the neural fibers fail in coming across the site of the lesion, as if there were no growing from the first try. What mechanisms may explain the lost of regeneration capability? Are scars formed by glial cells a consequence of regeneration fail or the cause? Several evidence lines suggest that spinal cord regeneration would be blocked in the central nervous system by actions of local factors in the site of the wound, and no injured central nervous system is a permissive way for the axonal growing into specific targets. If axons are correctly induced to cross the injury, supported by implants, drugs and undifferentiated cells, the fibers in regeneration may find a specific way to establish the right connections. The combination of molecules which induce/inhibit the regeneration potential of the tissue remains unknown, as well as the mechanisms that enable the neuron to make specific connections with targets it is programmed to connect with.
La medula espinal de los mamíferos adultos no permite la regeneración de los axones. Por razones aun no conocidas, las fibras neurales fallan en la tarea de cruzar por el sitio de la lesión, como si no hubiese crecimiento, desde el primer intento. ¿Cuáles mecanismos podrían explicar la pérdida de la capacidad de la regeneración? ¿Las cicatrices formadas por las células de la glía son una consecuencia del fallo en la regeneración o serían la causa? Diversas líneas de evidencia sugieren que la regeneración de la medula espinal sería impedida en el sistema nervioso central por la acción de factores locales en el sitio de la lesión, y que el sistema nervioso central no lesionado es un medio permisivo para el crecimiento axonal, en la dirección de dianas específicas. Una vez que los axones sean inducidos adecuadamente a cruzar la lesión, con auxilio de implantes, fármacos o células indiferenciadas, las fibras en regeneración podrían encontrar la vía específica y establecer conexiones correctas. Lo que aun es desconocido es que combinación de moléculas induce/inhibe el potencial de regeneración del tejido y cuáles mecanismos permiten a las neuronas formar conexiones específicas, con las dianas que son programadas a hacer.