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1 Laboratoire de Physiopathologie Respiratoire (Unité Propre de Recherche de l'Enseignement Supérieur, Equipe d'Accueil 2201), Institut Jean Roche, Faculté de Médecine, Université de la Méditerranée, Marseille, France
Although pain and dyspnoea are common symptoms in pleural diseases, there are few studies on the sensory innervation of the pleura. Using rabbits, after removal of all muscles in the intercostal space to be studied, we investigated the afferents of the internal intercostal nerve by applying to the internal thoracic wall pieces of gauze soaked in warmed (37°C), buffered saline (mechanical stimulation) or solutions containing lactic acid, inflammatory mediators or capsaicin (chemical stimulation). The afferent conduction velocity ranged from 0.5 to 14 m s–1. Most units (97%) were activated by mechanical stimulation of the pleura (local positive pressure range = 4.5–8.5 cmH2O) and we found a linear relationship between the discharge rate of afferents and the force applied to the thoracic wall. The majority of mechanosensitive units (70%) also responded to one or several chemical agents. Thus, the afferents were activated by lactic acid (49%) and/or a mixture of inflammatory mediators (50%). Local application of capsaicin elicited an initial increased or decreased background afferent activity in 57% of the afferents, a delayed decrease in firing rate being noted in some units initially activated by capsaicin. Capsaicin blocked the afferent response to a further application of inflammatory mediators but did not affect the mechanosensitive units. Thus, sensory endings connected with thin myelinated and unmyelinated fibres in the internal intercostal nerve detect the mechanical and chemical events of pleural diseases.
(Received 26 April 2005;
accepted after revision 17 June 2005;
first published online 23 June 2005)
Corresponding author Y. Jammes: Laboratoire de Physiopathologie Respiratoire (UPRES EA 2201), Faculté de Médecine, Boulevard Pierre Dramard, 13916 cedex 20, Marseille, France. Email: jammes.y{at}jean-roche.university-mrs.fr
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