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Article
Nature Medicine  9, 1055 - 1061 (2003)
Published online: 29 June 2003; | doi:10.1038/nm885

Endothelin-B receptor activation triggers an endogenous analgesic cascade at sites of peripheral injury

Alla Khodorova1, 8, Betsy Navarro2, 8, Laurence Sophie Jouaville1, 3, 8, Jo-Ellen Murphy4, Frank L Rice5, Joseph E Mazurkiewicz5, Denise Long-Woodward4, Markus Stoffel6, Gary R Strichartz3, Rus Yukhananov7 & Gudarz Davar1

1  Molecular Neurobiology of Pain Laboratory, Pain Research Center, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, 02115 USA.

2  Department of Cardiology, Children's Hospital, Harvard Medical School, Boston, Massachusetts, 02115 USA.

3  Sensory Neurophysiology Laboratory, Pain Research Center, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts, 02115 USA.

4  Harvard Skin Disease Research Center, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, 02115 USA.

5  Center for Neuropharmacology and Neuroscience, Albany Medical College, Albany, New York, 12208 USA.

6  Laboratory of Metabolic Diseases, Rockefeller University, New York, New York, 10021 USA.

7  Neurogenomic Laboratory, Pain Research Center, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, 02115 USA.

8  These authors contributed equally to this work.

Correspondence should be addressed to Gudarz Davar gdavar@zeus.bwh.harvard.edu
Endothelin-1 (ET-1) is a newly described pain mediator that is involved in the pathogenesis of pain states ranging from trauma to cancer. ET-1 is synthesized by keratinocytes in normal skin and is locally released after cutaneous injury. While it is able to trigger pain through its actions on endothelin-A (ETA) receptors of local nociceptors, it can coincidentally produce analgesia through endothelin-B (ETB) receptors. Here we map a new endogenous analgesic circuit, in which ETB receptor activation induces the release of beta-endorphin from keratinocytes and the activation of G-protein-coupled inwardly rectifying potassium channels (GIRKs, also named Kir-3) linked to opioid receptors on nociceptors. These results indicate the existence of an intrinsic feedback mechanism to control peripheral pain in skin, and establish keratinocytes as an ETB receptor−operated opioid pool.

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Nature Medicine
ISSN: 1078-8956
EISSN: 1546-170X
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