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Review:
Ian Gilron, C. Peter N. Watson, Catherine M. Cahill, and Dwight E. Moulin
Neuropathic pain: a practical guide for the clinician
CMAJ 2006; 175: 265-275 [Abstract] [Full text] [PDF]
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[Read eLetter] Metabolic considerations.
Richard G Fiddian-Green   (8 August 2006)

Metabolic considerations. 8 August 2006
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Richard G Fiddian-Green,
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Re: Metabolic considerations.

richardfg{at}hoptmail.com Richard G Fiddian-Green

Why does "nerve injury..elicit.. hypertrophy and activation of glial cells, including microglia within the grey matter of the spinal cord"(1)? Because there is an increased demand for nutrient to meet the metabolic needs for anaerobic glycolysis in the glial cells and microglia?

"Microglia express P2X4 purinergic receptors, allowing them to be activated by ..ATP" (1). From my understanding of the review in the last issue of Nature it is an increase in extracellular [ATP] that expresses the P2X4 receptors. If so what increases extracellular [ATP]? Healthy cells that donate their ATP to meet an increased demand for ATP resynthesis in the injured nerves along the lines proposed in the myocyte buddy hypothesis (2)? Unreversed ATP hydrolysis in injured nerves might then be responsible for the activation of the microglia and release the IL -1, TNF- and neurotrophins, including brain-derived neurotrophic factor.

1. Ian Gilron, C. Peter N. Watson, Catherine M. Cahill, and Dwight E. Moulin Neuropathic pain: a practical guide for the clinician CMAJ 2006; 175: 265-275

2. Richard G Fiddian-Green A myocyte buddy system in stressed myocardium? http://www.heartjnl.com/cgi/eletters/90/4/425#393, 2 Aug 2004

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