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Angiotensin (Ang) II, the main bioactive component of the renin-angiotensin system, is reported to participate in either the inhibition or the facilitation of pain transmission depending on brain area. Although Ang II is known to exist in the superficial dorsal horn of the spinal cord, the role of Ang II in spinal pain transmission remains unclear. In order to elucidate that role, we examined the effect of intrathecal administration of Ang II to mice. We found that Ang II produced pain-related behavior accompanied by the phosphorylation of p38 mitogen-activated protein kinase (MAPK) via Ang II type 1 (AT1) receptors, which are highly expressed in the superficial dorsal horn (laminae I and II). In addition, pain-related behavior was caused by acting on spinal neurons and astrocytes that express AT1 receptors. We next examined whether the spinal Ang II system is responsible for diabetic neuropathic pain. In streptozotocin-induced diabetic mice, neuronal Ang-converting enzyme was upregulated in the superficial dorsal horn, which led to an increase in spinal Ang II levels. Furthermore, this increase in Ang II caused mechanical hypersensitivity accompanied by the activation of p38 MAPK via AT1 receptors. In conclusion, our findings suggest that Ang II may act as a neurotransmitter and/or neuromodulator in spinal pain transmission. This review describes our recent efforts regarding the role of spinal Ang II in spinal pain transmission.

Behavioral and Molecular Pharmacological Study of the Role of Angiotensin II in Spinal Pain Transmission