Nociceptors: the sensors of the pain pathway

Abstract

Specialized peripheral sensory neurons known as nociceptors alert us to potentially damaging stimuli at the skin by detecting extremes in temperature and pressure and injury-related chemicals, and transducing these stimuli into long-ranging electrical signals that are relayed to higher brain centers. The activation of functionally distinct cutaneous nociceptor populations and the processing of information they convey provide a rich diversity of pain qualities. Current work in this field is providing researchers with a more thorough understanding of nociceptor cell biology at molecular and systems levels and insight that will allow the targeted design of novel pain therapeutics.

Figure 1. Anatomy of nociceptors.

(A) Somatosensory neurons are located in peripheral ganglia (trigeminal and dorsal root ganglia) located alongside the spinal column and medulla. Afferent neurons project centrally to the brainstem (Vc) and dorsal horn of the spinal cord and peripherally to the skin and other organs. Vc, trigeminal brainstem sensory subnucleus caudalis. (B) Most nociceptors are unmyelinated with small diameter axons (C-fibers, red). Their peripheral afferent innervates the skin (dermis and/or epidermis) and central process projects to superficial laminae I and II of the dorsal horn. (C) A-fiber nociceptors are myelinated and usually have conduction velocities in the Aδ range (red). A-fiber nociceptors project to superficial laminae I and V.

Figure 2. Known or proposed transduction mechanisms in uninjured mammalian nociceptor peripheral terminals.

Ion channels that transduce heat (A), cold (B), and mechanical stimuli (C) are depicted. Stimuli are presented to the skin, which is depicted as containing representative nonneuronal cells (such as keratinocytes) (brown cells) and the free nerve endings of nociceptor axons (blue). Arrows next to channels indicate whether their activity is increased or decreased upon stimulation. Note that these nocisensors are not necessarily coexpressed in the same terminal. The curved arrow in C refers to the transducer(s) and other channels and molecules that contribute to the firing pattern (e.g., rapidly adapting vs. slowly adapting) in these fibers. Molecularly unidentified channels with indicated ion permeabilities inside drawing of channel are referred to as “putative RA MA channel” and “putative IA/SA MA channel.” MA, mechanically activated; RA, rapidly adapting; IA, intermediate adapting; SA, slowly adapting.