Neurogenic pain and steroid synthesis in the spinal cord

The spinal cord (SC) is a biosynthetic center for neurosteroids, including pregnenolone (PREG), progesterone (PROG), and 3α/5α- tetrahydroprogesterone (3α/5α-THP). In particular, an active form of cytochrome P450 side-chain cleavage (P450scc) has been localized in sensory networks of the rat SC dorsal horn (DH). P450scc is the key enzyme catalyzing the conversion of cholesterol (CHOL) into PREG, the rate-limiting step in the biosynthesis of all classes of steroids. To determine whether neurosteroidogenesis might be involved in the pivotal role played by the DH in nociception, effects of neurogenic pain provoked by sciatic nerve ligature were investigated on P450scc expression, cellular distribution, and activity in the SC. P450scc mRNA concentration was threefold higher in the DH of neuropathic rats than in controls. The nerve ligature also increased the density of P450scc-positive neuronal perykarya and fibers in the ipsilateral DH. Incubation of spinal tissue homogenates with [³H]CHOL revealed that the amount of newly synthesized [³H]PREG from [³H]CHOL was 80% higher in the DH of neuropathic rats. Radioimmunoassays showed an increase of PREG and 3α/5α-THP concentrations in neuropathic rat DH. The upregulation of PREG and 3α/5α-THP biosynthesis might be involved in endogenous mechanisms triggered by neuropathic rats to cope with the chronic pain state. 3α/5α-THP formation from PREG can also generate PROG, which decreases sensitivity to pain and protects nerve cells against degeneration. Because apoptotic cell death has been demonstrated in the DH during neuropathic pain, activation of neurosteroidogenesis in spinal tissues might also be correlated to the neuroprotective role of steroids in the SC.