Extracellular high mobility group box 1 (
HMGB1) activates the
receptor for advanced glycation end products (RAGE) or
Toll-like receptor 4 (TLR4) and forms a heterocomplex with CXCL12 that strongly activates CXCR4, promoting inflammatory and
pain signals. In the present study, we investigated the role of
HMGB1 in pancreatic
pain accompanying
cerulein-induced
acute pancreatitis in mice. Abdominal referred
hyperalgesia accompanying
acute pancreatitis occurred within 1 h after 6 hourly
injections of
cerulein. The anti-HMGB1
neutralizing antibody or recombinant human soluble
thrombomodulin (rhsTM), known to inactivate
HMGB1, abolished the
cerulein-induced referred
hyperalgesia, but not
pancreatitis itself. Plasma or pancreatic
HMGB1 levels did not change, but macrophage infiltration into the pancreas occurred 1 h after
cerulein treatment.
Minocycline, a macrophage/microglia inhibitor,
ethyl pyruvate that inhibits
HMGB1 release from macrophages, or liposomal
clodronate that depletes macrophages prevented the referred
hyperalgesia, but not
pancreatitis. Antagonists of RAGE or CXCR4, but not TLR4, strongly suppressed the
cerulein-induced referred
hyperalgesia, but not
pancreatitis. Upregulation of RAGE, CXCR4 and CXCL12, but not TLR4, were detected in the pancreas 1 h after
cerulein treatment. Our data suggest that
HMGB1 regionally secreted by macrophages mediates pancreatic
pain by targeting RAGE and CXCL12/CXCR4 axis in the early stage of
acute pancreatitis.