Tumor necrosis factor receptor 1 inhibition is therapeutic for neuropathic pain in males but not in females

Pain. 2019 Apr;160(4):922-931. doi: 10.1097/j.pain.0000000000001470.


Tumor necrosis factor (TNF) is a proinflammatory cytokine, which is involved in physiological and pathological processes and has been found to be crucial for pain development. In the current study, we were interested in the effects of blocking Tumor necrosis factor receptor 1 (TNFR1) signaling on neuropathic pain after peripheral nerve injury with the use of transgenic mice and pharmacological inhibition. We have previously shown that TNFR1 mice failed to develop neuropathic pain and depressive symptoms after chronic constriction injury (CCI). To investigate the therapeutic effects of inhibiting TNFR1 signaling after injury, we delivered a drug that inactivates soluble TNF (XPro1595). Inhibition of solTNF signaling resulted in an accelerated recovery from neuropathic pain in males, but not in females. To begin exploring a mechanism, we investigated changes in N-methyl-D-aspartate (NMDA) receptors because neuropathic pain has been shown to invoke an increase in glutamatergic signaling. In male mice, XPro1595 treatment reduces elevated NMDA receptor levels in the brain after injury, whereas in female mice, NMDA receptor levels decrease after CCI. We further show that estrogen inhibits the therapeutic response of XPro1595 in females. Our results suggest that TNFR1 signaling plays an essential role in pain induction after CCI in males but not in females.

MeSH terms

  • Animals
  • Estrogens / therapeutic use
  • Female
  • Hyperalgesia / drug therapy
  • Hyperalgesia / physiopathology
  • Male
  • Mice
  • Mice, Transgenic
  • Neuralgia / drug therapy*
  • Ovariectomy
  • Pain Measurement
  • Receptors, N-Methyl-D-Aspartate / metabolism
  • Receptors, Tumor Necrosis Factor, Type I / genetics
  • Receptors, Tumor Necrosis Factor, Type I / metabolism*
  • Sex Characteristics*
  • Signal Transduction / drug effects
  • Spinal Cord / metabolism
  • Tumor Necrosis Factor-alpha / metabolism*
  • Tumor Necrosis Factor-alpha / therapeutic use


  • Estrogens
  • Receptors, N-Methyl-D-Aspartate
  • Receptors, Tumor Necrosis Factor, Type I
  • Tumor Necrosis Factor-alpha
  • XENP 1595