<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article article-type="research-article" dtd-version="2.3" xml:lang="EN" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title>Frontiers in Pharmacology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Pharmacol.</abbrev-journal-title>
<issn pub-type="epub">1663-9812</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">734091</article-id>
<article-id pub-id-type="doi">10.3389/fphar.2021.734091</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Pharmacology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Intense Acute Swimming Induces Delayed-Onset Muscle Soreness Dependent on Spinal Cord Neuroinflammation</article-title>
<alt-title alt-title-type="left-running-head">Borghi et&#x20;al.</alt-title>
<alt-title alt-title-type="right-running-head">Swimming-Induced DOMS and Spinal Neuroinflammation</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Borghi</surname>
<given-names>Sergio M.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/590970/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bussulo</surname>
<given-names>Sylvia K. D.</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1605059/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>Felipe A.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/617572/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Fattori</surname>
<given-names>Victor</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/194780/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Carvalho</surname>
<given-names>Thacyana T.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/607112/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rasquel-Oliveira</surname>
<given-names>Fernanda S.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1604598/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zaninelli</surname>
<given-names>Tiago H.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/576320/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ferraz</surname>
<given-names>Camila R.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1375502/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Casella</surname>
<given-names>Ant&#xf4;nio M. B.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1563155/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cunha</surname>
<given-names>Fernando Q.</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/321443/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cunha</surname>
<given-names>Thiago M.</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/32351/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Casagrande</surname>
<given-names>Rubia</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/555003/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Verri</surname>
<given-names>Waldiceu A.</given-names>
<suffix>Jr</suffix>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/32357/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Departamento de Ci&#xea;ncias Patol&#xf3;gicas</institution>, <institution>Centro de Ci&#xea;ncias Biol&#xf3;gicas</institution>, <institution>Universidade Estadual de Londrina</institution>, <addr-line>Londrina</addr-line>, <country>Brazil</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Centro de Pesquisa Em Ci&#xea;ncias da Sa&#xfa;de</institution>, <institution>Universidade Norte do Paran&#xe1;</institution>, <addr-line>Londrina</addr-line>, <country>Brazil</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Departamento de Cl&#x00ED;nica M&#x00E9;dica, Centro de Ci&#x00EA;ncias da Sa&#xfa;de, Universidade Estadual de Londrina</institution>, <addr-line>Londrina</addr-line>, <country>Brazil</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Departamento de Farmacologia</institution>, <institution>Faculdade de Medicina de Ribeir&#xe3;o Preto</institution>, <institution>Universidade de S&#xe3;o Paulo</institution>, <addr-line>S&#xe3;o Paulo</addr-line>, <country>Brazil</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>Departamento de Ci&#xea;ncias Farmac&#xea;uticas</institution>, <institution>Centro de Ci&#xea;ncias de Sa&#xfa;de</institution>, <institution>Hospital Universit&#xe1;rio</institution>, <institution>Universidade Estadual de Londrina</institution>, <addr-line>Londrina</addr-line>, <country>Brazil</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/682405/overview">Galina Sud&#x2019;ina</ext-link>, Lomonosov Moscow State University, Russia</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/502839/overview">Xuehong Liu</ext-link>, Shaoxing University, China</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1112833/overview">Tingjun Chen</ext-link>, Mayo Clinic, United&#x20;States</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/811815/overview">Jose Antonio Adams</ext-link>, Mount Sinai Medical Center, United&#x20;States</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Sergio M. Borghi, <email>sergio_borghi@yahoo.com.br</email>, <email>sergio.borghi@kroton.com.br</email>; Waldiceu A. Verri Jr, <email>waldiceujr@yahoo.com.br</email>, <email>waverri@uel.br</email>
</corresp>
<fn fn-type="other">
<p>This article was submitted to Inflammation Pharmacology, a section of the journal Frontiers in Pharmacology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>07</day>
<month>01</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>12</volume>
<elocation-id>734091</elocation-id>
<history>
<date date-type="received">
<day>30</day>
<month>06</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>25</day>
<month>11</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2022 Borghi, Bussulo, Pinho-Ribeiro, Fattori, Carvalho, Rasquel-Oliveira, Zaninelli, Ferraz, Casella, Cunha, Cunha, Casagrande and Verri.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Borghi, Bussulo, Pinho-Ribeiro, Fattori, Carvalho, Rasquel-Oliveira, Zaninelli, Ferraz, Casella, Cunha, Cunha, Casagrande and Verri</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these&#x20;terms.</p>
</license>
</permissions>
<abstract>
<p>Unaccustomed exercise involving eccentric contractions, high intensity, or long duration are recognized to induce delayed-onset muscle soreness (DOMS). Myocyte damage and inflammation in affected peripheral tissues contribute to sensitize muscle nociceptors leading to muscle pain. However, despite the essential role of the spinal cord in the regulation of pain, spinal cord neuroinflammatory mechanisms in intense swimming-induced DOMS remain to be investigated. We hypothesized that spinal cord neuroinflammation contributes to DOMS. C57BL/6 mice swam for 2&#x20;h to induce DOMS, and nociceptive spinal cord mechanisms were evaluated. DOMS triggered the activation of astrocytes and microglia in the spinal cord 24&#x20;h after exercise compared to the sham group. DOMS and DOMS-induced spinal cord nuclear factor &#x3ba;B (NF&#x3ba;B) activation were reduced by intrathecal treatments with glial inhibitors (fluorocitrate, &#x3b1;-aminoadipate, and minocycline) and NF&#x3ba;B inhibitor [pyrrolidine dithiocarbamate (PDTC)]. Moreover, DOMS was also reduced by intrathecal treatments targeting C-X<sub>3</sub>-C motif chemokine ligand 1 (CX<sub>3</sub>CL1), tumor necrosis factor (TNF)-&#x3b1;, and interleukin (IL)-1&#x3b2; or with recombinant IL-10. In agreement, DOMS induced the mRNA and protein expressions of CX<sub>3</sub>CR1, TNF-&#x3b1;, IL-1&#x3b2;, IL-10, c-Fos, and oxidative stress in the spinal cord. All these immune and cellular alterations triggered by DOMS were amenable by intrathecal treatments with glial and NF&#x3ba;B inhibitors. These results support a role for spinal cord glial cells, <italic>via</italic> NF&#x3ba;B, cytokines/chemokines, and oxidative stress, in DOMS. Thus, unveiling neuroinflammatory mechanisms by which unaccustomed exercise induces central sensitization and consequently&#x20;DOMS.</p>
</abstract>
<kwd-group>
<kwd>acute exercise</kwd>
<kwd>delayed-onset muscle soreness</kwd>
<kwd>spinal cord</kwd>
<kwd>glial cells</kwd>
<kwd>neuroinflammation</kwd>
</kwd-group>
<contract-sponsor id="cn001">Conselho Nacional de Desenvolvimento Cient&#xed;fico e Tecnol&#xf3;gico<named-content content-type="fundref-id">10.13039/501100003593</named-content>
</contract-sponsor>
<contract-sponsor id="cn002">Funda&#xe7;&#xe3;o Nacional de Desenvolvimento Do Ensino Superior Particular<named-content content-type="fundref-id">10.13039/501100018908</named-content>
</contract-sponsor>
<contract-sponsor id="cn003">Coordena&#xe7;&#xe3;o de Aperfei&#xe7;oamento de Pessoal de N&#xed;vel Superior<named-content content-type="fundref-id">10.13039/501100002322</named-content>
</contract-sponsor>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>The perception of muscle pain occurs because of sensitization and/or activation of group III (A&#x3b4;-fiber) and group IV (C-fiber) polymodal muscle afferents (nociceptors) in peripheral sites after overload and injuries in skeletal myocytes. Nociceptor neuron sensitization reduces its mechanical threshold to weak non-nociceptive stimuli or enhances neuronal activation to nociceptive stimuli leading to allodynia or hyperalgesia, respectively (<xref ref-type="bibr" rid="B14">Connolly et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B19">Graven-Nielsen and Arendt-Nielsen, 2003</xref>; <xref ref-type="bibr" rid="B26">Kubo et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B34">Matsubara et&#x20;al., 2019</xref>). Signs of exercise-induced muscle pain become apparent between 24 and 48&#x20;h after the practice [delayed-onset muscle soreness (DOMS)] in response to unaccustomed exercise, especially those related to muscle fatigue, or of high intensity and long duration (<xref ref-type="bibr" rid="B32">MacIntyre et&#x20;al., 1995</xref>; <xref ref-type="bibr" rid="B49">Taylor et&#x20;al., 2000</xref>; <xref ref-type="bibr" rid="B13">Cheung et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B19">Graven-Nielsen and Arendt-Nielsen, 2003</xref>; <xref ref-type="bibr" rid="B16">Dannecker and Koltyn, 2014</xref>).</p>
<p>Mechanical and/or chemical stimuli detected by peripheral terminals of afferent muscle fibers are then transmitted to spinal cord sites and, subsequently, to higher nervous centers, such as brainstem, thalamus, and somatosensory cortex, where they will be processed (<xref ref-type="bibr" rid="B3">Basbaum et&#x20;al., 2009</xref>). The cell body of primary sensory neurons is localized in the dorsal root ganglia (DRG) and has both peripheral and central axonal branches that innervate skeletal muscle at one extremity and reach the spinal cord at the other (<xref ref-type="bibr" rid="B3">Basbaum et&#x20;al., 2009</xref>). The central axonal branch of muscle nociceptors projects to the spinal cord through the dorsal horn, performing synapses with neurons in laminas I, II and lamina V (<xref ref-type="bibr" rid="B20">Hoheisel et&#x20;al., 1994</xref>; <xref ref-type="bibr" rid="B40">Panneton et&#x20;al., 2005</xref>). In these foci, neuronal&#x2013;glial interactions account for the central sensitization in several muscle pain conditions. In line with this, it was demonstrated that the depolarization of peripheral nociceptors induces the secretion of the chemokine C-X<sub>3</sub>-C motif chemokine ligand 1 (CX<sub>3</sub>CL1; also known as fractalkine) by DRG neurons, which binds to C-X<sub>3</sub>-C motif receptor 1 (CX<sub>3</sub>CR1) in spinal microglia at these sites, stimulating these cells to produce cytokines [such as interleukin-1&#x3b2; (IL-1&#x3b2;)], prostaglandin E2 (PGE<sub>2</sub>), and brain-derived neurotrophic factor (BDNF), promoting increasing excitability and enhanced pain in response to noxious stimuli in neuropathic and inflammatory pain conditions (<xref ref-type="bibr" rid="B35">Milligan et&#x20;al., 2004</xref>; <xref ref-type="bibr" rid="B3">Basbaum et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B18">Gao and Ji, 2010</xref>; <xref ref-type="bibr" rid="B46">Souza et&#x20;al., 2013</xref>). As a major pro-inflammatory transcription factor, nuclear factor &#x3ba;B (NF&#x3ba;B) also plays a critical role during central sensitization after peripheral damage (<xref ref-type="bibr" rid="B28">Lee et&#x20;al., 2004</xref>; <xref ref-type="bibr" rid="B47">Souza et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B31">Liu et&#x20;al., 2018</xref>). All these data raise the assumption that increased nociceptive activity projected from overloaded skeletal muscle induces central effects in muscle pain-like conditions, including those induced by intense exercise.</p>
<p>Studies focusing on peripheral events in DOMS protocols are largely found in the literature (<xref ref-type="bibr" rid="B13">Cheung et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B37">Murase et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B38">Murase et&#x20;al., 2013</xref>; <xref ref-type="bibr" rid="B4">Borghi et&#x20;al., 2014a</xref>; <xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>); however, the mechanisms related to spinal cord sensitization in this condition still remain poorly investigated. Evidence applying exercise models of eccentric (8-week training of downhill running) (<xref ref-type="bibr" rid="B41">Pereira et&#x20;al., 2015</xref>) and aerobic (treadmill running; 40&#x20;min) (<xref ref-type="bibr" rid="B17">Dos Santos et&#x20;al., 2020</xref>) characteristics to induce DOMS observed spinal cord dorsal horn glial reactivity from 24 to 36&#x20;h in post-exercise recovery period. Data regarding the mechanisms in DOMS may vary a lot depending on the exercise protocol applied, thus supporting the need of evaluating varied exercise protocols for a better general interpretation of central responses to acute intense exercise. Therefore, in the present study, we addressed the role of spinal glial cells (astrocytes and microglia) and the mechanisms by which these cells modulate exercise-induced neuroinflammation and pain using a model of intense acute swimming-induced muscle mechanical hyperalgesia in mice as we previously described (<xref ref-type="bibr" rid="B4">Borghi et&#x20;al., 2014a</xref>; <xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>; <xref ref-type="bibr" rid="B6">Borghi et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>). Models using classical eccentric exercise protocols are common to study DOMS pathophysiological mechanisms; however, the investigation of models characterized by exercise protocols with high intensity and long duration is less frequent. We developed an intense acute swimming protocol to fill this gap (<xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>). We hypothesized that spinal cord glial cells, such as astrocytes and microglia, have a role in DOMS-induced neuroinflammation, whereas they trigger inflammatory mechanisms in response to peripheral stimuli. Our hypothesis differs from previous data in the sense that we searched for a causal relationship between gliosis and pain (<xref ref-type="bibr" rid="B41">Pereira et&#x20;al., 2015</xref>) and questioned whether the activation of peripheral nociceptor neurons could also be a contributing mechanism to spinal cord gliosis and pain and not solely an inflammatory molecule produced during exercise such as heat shock protein (Hsp)70 (<xref ref-type="bibr" rid="B17">Dos Santos et&#x20;al., 2020</xref>).</p>
</sec>
<sec sec-type="materials|methods" id="s2">
<title>Materials and Methods</title>
<sec id="s2-1">
<title>Animals</title>
<p>The experiments were performed on male pathogen-free C57BL/6 and heterozygous CX<sub>3</sub>CR1-eGFP<sup>&#x2b;/-</sup> C57BL/6 mice [replacement of CX<sub>3</sub>CR1 gene expression by green fluorescent protein (GFP) marker], 12 weeks, weighing between 20 and 25&#x20;g from the State University of Londrina (UEL), Paran&#xe1;, Brazil, and Ribeirao Preto Medical School, University of Sao Paulo (USP), S&#xe3;o Paulo, Brazil, respectively. Only male mice were used because of the well-known sex dimorphism in pain regulation in this species (<xref ref-type="bibr" rid="B45">Sorge et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B11">Chen et&#x20;al., 2018</xref>). Mice were placed in standard clear plastic cages of ventilated rack (Alesco Ind&#xfa;stria e Com&#xe9;rcio LTDA, Monte Mor, S&#xe3;o Paulo, Brazil) and fed <italic>ad libitum</italic>, light/dark cycle of 12/12 h, and temperature-controlled room. Mice were maintained in the vivarium of the Department of Pathology of UEL for at least 2&#x20;days before the experiments. Mice were used only once and were acclimatized to the testing room by at least 1&#x20;h before the behavioral experiments, which were conducted exclusively during the light cycle. At the end of the experiments, mice were anesthetized with isoflurane 5% only once by inhalation overdose and terminally killed by cervical dislocation followed by decapitation. Animals&#x2019; care and handling procedures were in accordance with the International Association for Study of Pain (IASP) guidelines and with the approval of the Institutional Ethics Committee for Animal Research of UEL (CEUA-UEL), process number 4010.2015.27. All efforts were made to minimize the number of animals used and their suffering. No unexpected deaths occurred during the study. Animals were identified and subsequently randomized using a true random number service.</p>
</sec>
<sec id="s2-2">
<title>Chemicals</title>
<p>The pharmacological compounds used in this study are presented in <xref ref-type="sec" rid="s11">Supplementary Table S1</xref> that also shows the intended use and range of doses administered.</p>
</sec>
<sec id="s2-3">
<title>Methods for Intrathecal Injections</title>
<p>The administration of drugs by intrathecal (i.t.) route was performed in unconscious animals (targeting lumbar segment, L<sub>4</sub>&#x2013;L<sub>6</sub> zone) under anesthesia with isoflurane 3% inhalation (Abbott Park, IL, USA), randomly divided in treatment groups described in <xref ref-type="fig" rid="F1">Figure&#x20;1</xref>. Fluorocitrate (0.05&#x2013;0.45 &#xb5;g), &#x3b1;-aminoadipate (10&#x2013;100 nmol), minocycline (15&#x2013;150 &#xb5;g), and pyrrolidine dithiocarbamate (PDTC; 30&#x2013;300 &#xb5;g) were diluted in dimethyl sulfoxide (DMSO; D8418; Sigma-Aldrich, St. Louis, MO, USA), Tween 20% (P1379; Sigma-Aldrich, St. Louis, MO, USA), and saline. Antibody anti-CX<sub>3</sub>CL1 (0.25&#x2013;2.5 g), etanercept (10&#x2013;100 ng), IL-1ra (10&#x2013;100 ng), and mouse recombinant (mr) IL-10 (1&#x2013;3 ng) were diluted only in saline. The dilutions were made immediately before i.t. administration of the drugs. After performing the dose&#x2013;response experiment (<xref ref-type="sec" rid="s11">Supplementary Table S1</xref>), the doses of 0.15 &#xb5;g of fluorocitrate, 100 nmol of &#x3b1;-aminoadipate, 150&#x20;&#xb5;g of minocycline, and 300&#x20;&#xb5;g of PDTC were chosen for the next sets of experiments. I.t. injections were performed to achieve a local effect on spinal sites. Mice received i.t. treatments always 30&#x20;min before intense acute swimming (IAS). I.t. treatments were performed only once to avoid excessively injuring local tissues, which would cause inflammation and enhanced nociceptive responses (<xref ref-type="bibr" rid="B1">Almeida et&#x20;al., 2000</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Schematic representation of experimental design used in the study. Mice were randomly divided in different experimental groups receiving i.t. treatments according to targets 30&#x20;min (&#x2212;0.5&#x20;h in diagram) before IAS. Mice experienced IAS session for two consecutive hours (0&#x2013;2&#x20;h in diagram). Swimming behavior and immobility behavior were evaluated during the session. Motor performance analysis was conducted between 30&#x20;min and 48&#x20;h after the session. The measurements of mechanical hyperalgesia and the determination of spinal cord <italic>Gfap</italic>, <italic>Iba1</italic>, and <italic>cfos</italic> mRNA expression were carried out from 6 to 48&#x20;h after the IAS session. In the peak of DOMS (24&#x20;h in diagram), spinal cord samples were collected for the following approaches: GFAP, Iba-1, pNF&#x3ba;B, CX<sub>3</sub>CR1, and c-Fos for IF analysis; ELISA tests for NF&#x3ba;B activation and TNF-&#x3b1;, IL-1&#x3b2;, and IL-10 protein levels; <italic>Cx3cr1</italic>, <italic>Tnf&#x3b1;</italic>, <italic>Il1&#x3b2;</italic>, and <italic>Il10</italic> mRNA expression determination by RT-qPCR; and oxidative stress (superoxide anion production and lipid peroxidation levels) evaluation. IAS, intense acute swimming; IF, immunofluorescence. The total number of mice per analysis is shown within parentheses.</p>
</caption>
<graphic xlink:href="fphar-12-734091-g001.tif"/>
</fig>
</sec>
<sec id="s2-4">
<title>General Experimental Procedures</title>
<p>Mice were divided into 22 experimental groups during the study, as follows: sham; IAS; IAS &#x2b; vehicle (saline); IAS &#x2b; fluorocitrate 0.05, 0.15, and 0.45 &#xb5;g; IAS &#x2b; &#x3b1;-aminoadipate 10, 30, and 100 nmol; IAS &#x2b; minocycline 15, 50, and 100&#x20;&#x3bc;g; IAS &#x2b; PDTC 30 and 300&#x20;&#x3bc;g; IAS &#x2b; Ab CX<sub>3</sub>CL1 0.25 and 2.5 &#x3bc;g; IAS &#x2b; etanercept 10 and 100 ng; IAS &#x2b;10 and 100 ng; and IAS &#x2b; mrIL-10 1 and 3 ng. We used 6 mice per group in each experiment per analysis apart from immunofluorescence, motor performance and time spent in swimming behavior and immobility time in which 4 mice were used per group per experiment. Every experiment was performed twice. Prior studies with the IAS model and similar experimental parameters were used to define the <italic>n</italic> for each group (<xref ref-type="bibr" rid="B8">Borghi et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B9">Borghi et&#x20;al., 2021</xref>). Sham animals (exposed to water during 30&#x20;s only) were used as control group of IAS. <xref ref-type="fig" rid="F1">Figure&#x20;1</xref> summarizes the experimental design and total number of animals used in each experiment. Total number of animals used in the present study was 1,148. Mice were treated by i.t. route always 30&#x20;min before the IAS session. The following time points were used for the indicated evaluation parameters: time&#x2013;response of mRNA expression of glial fibrillary acidic protein (GFAP) and ionized calcium-binding adaptor molecule 1 (Iba-1) (biomarkers for astrocytic and microglial activity, respectively) in spinal cord samples (6&#x2013;48&#x20;h after IAS); spinal cord immunofluorescence assay for GFAP and Iba-1 at the peak of its mRNA expression (24&#x20;h after IAS); muscle mechanical hyperalgesia (6&#x2013;48&#x20;h after IAS); spinal cord CX<sub>3</sub>CR1-eGFP fluorescence and spinal cord NF&#x3ba;B activation (ELISA and immunofluorescence, 24&#x20;h after IAS); spinal cord mRNA expression of <italic>Cx3cr1</italic>, <italic>Tnf&#x3b1;</italic>, <italic>Il1&#x3b2;</italic>, and <italic>Il-10</italic> (RT-qPCR, 24&#x20;h after IAS); spinal cord protein levels of tumor necrosis factor (TNF)-&#x3b1;, IL-1&#x3b2;, and IL-10 (ELISA, 24&#x20;h after IAS); spinal cord oxidative stress (superoxide anion production and lipid peroxidation levels) (colorimetric tests, 24&#x20;h after IAS); and spinal cord <italic>cfos</italic> mRNA expression (RT-qPCR, 6&#x2013;48&#x20;h after IAS) and protein staining (immunofluorescence, 24&#x20;h after IAS) (<xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>). All these analyses were performed with samples of the spinal cord lumbar segment (L<sub>4</sub>&#x2013;L<sub>6</sub>). Motor function of animals was analyzed using the rotarod performance test, which did not identify impairment of motor capacity (0.5&#x2013;48&#x20;h after IAS; <xref ref-type="sec" rid="s11">Supplementary Figure S1A</xref>). Time spent in swimming behavior and immobility time behavior during unaccustomed IAS session were evaluated (in minutes; <xref ref-type="sec" rid="s11">Supplementary Figures S1B, C</xref>, respectively) in vehicle, &#x3b1;-aminoadipate, minocycline, fluorocitrate, PDTC, antibody anti-CX<sub>3</sub>CL1, etanercept, IL-1ra- and IL-10-treated groups to determine whether the doses used in the study interfered in the swimming behavior, and consequently, in the nociceptive, biochemical, and molecular analyses. None of the treatments altered the time spent swimming or the immobility time of the mice (<xref ref-type="sec" rid="s11">Supplementary Figures S1B, C</xref>), thus confirming that behavior and immune-biochemical changes observed were due to the involvement of such mechanisms in IAS and not by altered time of swimming. The ARRIVE guideline checklist can be found in supplementary information (<xref ref-type="bibr" rid="B23">Kilkenny et&#x20;al., 2010</xref>).</p>
</sec>
<sec id="s2-5">
<title>Unaccustomed Intense Acute Swimming Protocol</title>
<p>Mice were placed in a glass box (45&#x20;cm &#xd7; 28&#x20;cm &#xd7; 25 cm, divided into six compartments) with approximately 20&#x20;L of temperature-controlled water at 31&#xb0;C&#x20;&#xb1; 1&#xb0;C. Each mouse was placed alone in individual compartments at the same time as for all mice. Sham animals were allowed to swim for just 30&#x20;s and were immediately removed from the water after this period. Mice in the swimming group were exposed to water for one acute session with a duration of 2 h. The muscle mechanical hyperalgesia was evaluated 6&#x2013;48&#x20;h after the IAS session. The present study used a model of swimming exercise, avoiding stress or hypoalgesia, and focusing on exercise-induced hyperalgesia as previously demonstrated and standardized (<xref ref-type="bibr" rid="B27">Kuphal et&#x20;al., 2007</xref>; <xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>).</p>
</sec>
<sec id="s2-6">
<title>Motor Performance Assessment</title>
<p>To evaluate whether IAS session affects motor function of mice, motor performance was evaluated using the rotarod performance test. The test is used to quantitate the effects of varied conditions and procedures upon motor planning with very high reliability (<xref ref-type="bibr" rid="B44">Rustay et&#x20;al., 2003</xref>). The apparatus consists of a bar with a diameter of 2.5 cm, subdivided into four compartments by disks of 25&#x20;cm in diameter (Ugo Basile, model 7600). During the measurements, the bar rotates at a constant speed of 22 rotations per minute. Mice were selected 24&#x20;h before the IAS session (during the familiarization phase) by eliminating those that did not remain on the bar for two consecutive periods of 180 s. Selected mice were then evaluated 0.5, 2, 6, 12, 24, 36, and 48&#x20;h after the IAS session (<xref ref-type="sec" rid="s11">Supplementary Figure S1A</xref>). The cutoff time used was 180 s. No alteration in the motor function of mice that underwent IAS was observed in comparison with sham animals (<xref ref-type="sec" rid="s11">Supplementary Figure&#x20;S1A</xref>).</p>
</sec>
<sec id="s2-7">
<title>Spinal Cord Immunofluorescence Analysis Using Confocal Microscopy</title>
<p>Spinal cord immunofluorescence assay was performed 24&#x20;h after the swimming session. For this purpose, mice were perfused through the ascending aorta with phosphate buffered saline (PBS) followed by 4% paraformaldehyde (PFA), and L<sub>4</sub>&#x2013;L<sub>6</sub> segments of the spinal cord were accurately dissected out and post fixed in 4% PFA for 24 h. After this period, PFA was replaced by a solution of 30% saccharose and incubated for 3 additional days. The spinal cord segments were then properly washed with PBS and embedded in optimum cutting temperature (O.C.T.) using Tissue-Tek<sup>&#xae;</sup> reagent (Sakura<sup>&#xae;</sup> Finetek United&#x20;States, Torrance, CA, USA). Sections of 10&#x20;&#x3bc;m were cut in a cryostat (CM1520, Leica Biosystems, Richmond, IL, USA) and processed for immunofluorescence (four samples per mouse per slide/four animals per group). All the sections were initially blocked with a buffer solution [500 &#x3bc;l per slide containing PBS plus 0.1% Tween 20 plus 5% bovine serum albumin (BSA)] for 2&#x20;h at room temperature and subsequently incubated overnight at &#x2212;4&#xb0;C with a solution containing primary antibodies against target proteins. Next, a new incubation with secondary antibodies was performed for 1&#x20;h at room temperature. For GFAP and Iba-1 primary antibodies, Alexa Fluor 488 secondary antibody was used. For pNF&#x3ba;B primary antibody, immunoglobulin G (IgG)-horseradish peroxidase (HRP) secondary antibody was used. For CX<sub>3</sub>CR1 detection, heterozygous CX<sub>3</sub>CR1-eGPF<sup>&#x2b;/-</sup> C57BL/6 mice were used. For c-Fos and NeuN, Alexa Fluor 488 and Alexa Fluor 647 secondary antibodies were used, respectively. The description of product codes, dilutions used, and manufacturers are presented in <xref ref-type="sec" rid="s11">Supplementary Table S2</xref>. To count NeuN/c-Fos double-positive cells, five random fields were counted in each slice, and the average of these five fields per animal was plotted to subsequently conduct the analysis of the mean of the means of the n of 4 mice per group. The analyses were always performed in fields encompassing regions of laminae 1, 2, and 5 of the dorsal horn of the spinal cord. The assembly of the slides was conducted using ProLong<sup>TM</sup> Gold Antifade Mountant with DAPI melting media (&#x23;P36931, Thermo Fisher Scientific, Waltham, MA, USA) or Fluoromount<sup>TM</sup> Aqueous Mounting Medium (&#x23;F4680, Sigma-Aldrich, St. Louis, MO, USA). Analysis using slides with secondary antibodies alone was conducted in parallel as controls to ensure that unspecified staining did not occur. Immunofluorescence analyses were performed in the dorsal horn of the spinal cord in the magnification of &#xd7;10 or &#xd7;20 as indicated in the figure legends. The images and analyses were performed using a confocal microscope (TSC SP8, Leica Microsystems, Mannheim, Germany).</p>
</sec>
<sec id="s2-8">
<title>Evaluation of Muscle Mechanical Hyperalgesia</title>
<p>Muscle mechanical hyperalgesia was tested in mice 6&#x2013;48&#x20;h after the swimming session as previously reported (<xref ref-type="bibr" rid="B15">Cunha et&#x20;al., 2004</xref>). The test consisted of evoking a hind paw flexion reflex with a handheld force transducer (electronic von Frey aesthesiometer; Insight, Ribeir&#xe3;o Preto, SP, Brazil) adapted with a 0.5-mm<sup>2</sup> contact area polypropylene tip (<xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>). During the experiments, only the right limb of animals was evaluated. The applied pressure to hind paw surface induces an articular movement on the ankle joint (dorsiflexion), leading to stretch of the Achilles tendon, which in turn promotes an exaggerated muscle movement response (movement-induced hyperalgesia) when there is sensitization of nociceptors of calf muscle. The end point was characterized by the removal of the paw followed by clear flinching movements. Muscle distension is sufficient to trigger muscle nociceptive responses (<xref ref-type="bibr" rid="B4">Borghi et&#x20;al., 2014a</xref>; <xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>). After the paw withdrawal, the intensity of the pressure was recorded automatically by the von Frey apparatus. The value of the response was an average of three measurements performed by the experimenter. The results are expressed by delta (&#x394;) withdrawal threshold (in g) calculated by subtracting the mean measurements (indicated time points) after swimming from the baseline measurements (obtained at rest). The basal mechanical withdrawal threshold was 8.5&#x20;&#xb1; 0.2&#x20;g (mean&#x20;&#xb1; SEM between the groups, 6 mice per group) before IAS session. There was no difference of basal mechanical withdrawal thresholds between groups in the same experiment. Behavioral experiments were conducted always by the same experimenter who was blinded to the experimental groups in an intention to avoid the risk of&#x20;bias.</p>
</sec>
<sec id="s2-9">
<title>Nuclear Factor &#x3ba;B Activation Assessment by ELISA</title>
<p>Spinal cord samples were collected 24&#x20;h after the swimming session and homogenized in ice-cold lysis buffer (Cell Signaling Technology, Beverly, MA, USA). The homogenates were centrifuged (16,000&#x20;g &#xd7; 10&#x20;min &#xd7; 4&#xb0;C), and the resultant supernatants were used to assess the levels of total and phosphorylated NF-&#x3ba;B p65 subunit by enzyme-linked immunosorbent assay (ELISA) using PathScan kits (Cell Signaling Technology, Beverly, MA, USA) according to the manufacturer&#x2019;s instructions. The test indicates the proportion between total NF&#x3ba;B and phosphorylated (p)NF&#x3ba;B in analyzed samples. When the ratio is high, a high amount of total NF&#x3ba;B is detected relative to pNF&#x3ba;B, indicating its activation is lessened in samples under analysis. On the other hand, when the total NF&#x3ba;B/pNF&#x3ba;B ratio is low, a greater amount of phosphorylated protein is detected relative to total NF&#x3ba;B, indicating high phosphorylation of NF&#x3ba;B relative to total NF&#x3ba;B in the sample. The results are presented as the sample ratio of NF&#x3ba;B activation (total p65/phospho-p65) per milligram of spinal cord tissue measured at 450 nm (<xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>).</p>
</sec>
<sec id="s2-10">
<title>Reverse Transcription and Quantitative Polymerase Chain Reaction Assay</title>
<p>RT-qPCR was performed as previously described (<xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>). After euthanasia process, mouse spinal cord samples were collected (6&#x2013;48&#x20;h after the IAS session, depending on the experiment) for homogenization in TRIzol&#x2122; Reagent (Thermo Fisher Scientific). Subsequently, total RNA was isolated according to the manufacturer&#x2019;s guideline. The purity of total RNA was measured spectrophotometrically, and the wavelength absorption ratio (260/280) was between 1.8 and 2.0 for all preparations. Reverse transcription of total RNA to cDNA and qPCR were carried out using GoTaq<sup>&#xae;</sup> 2-Step RT-qPCR System (Promega) and target primers. qPCR reaction was performed in Step One Plus TM Real-Time PCR System (Applied Biosystems<sup>&#xae;</sup>). The relative gene expression was measured using the comparative 2<sup>-(&#x2206;&#x2206;Cq)</sup> method. The primers used in this study are shown in <xref ref-type="sec" rid="s11">Supplementary Table S3</xref>. The expression of <italic>&#x3b2;-actin</italic> mRNA was used as a control for tissue integrity in all samples.</p>
</sec>
<sec id="s2-11">
<title>Quantitation of Tumor Necrosis Factor-&#x3b1;, Interleukin-1&#x3b2;, and Interleukin-10 by ELISA</title>
<p>Spinal cord samples were collected 24&#x20;h after the IAS in PBS buffer containing protease inhibitors (500 &#x3bc;l), homogenized, and centrifuged to obtain the supernatant. TNF-&#x3b1; (&#x23;DY410), IL-1&#x3b2; (&#x23;DY401), and IL-10 (&#x23;DY417) production was determined by ELISA using R&#x26;D Systems, Inc., kits (Minneapolis, MN, USA). During the assay, plates were coated overnight at 4&#xb0;C with an immunoaffinity-purified polyclonal antibody specifically for each cytokine. Recombinant murine TNF-&#x3b1;, IL-1&#x3b2;, and IL-10 standards at various dilutions and the samples were added in duplicate and incubated by an additional period (2 h) at room temperature. Rabbit biotinylated immunoaffinity-purified antibodies anti-TNF-&#x3b1;, anti-IL-1&#x3b2;, and anti-IL-10 were added, followed by another incubation at room temperature for 1 h. Finally, avidin-HRP was added to each well, and after 30&#x20;min, the plates were washed and the color reagent o-phenylenediamine was added. After blocking reactions, measurements were performed spectrophotometrically at 450 nm (Multiskan GO Microplate Spectrophotometer, Thermo Fisher Scientific, Vantaa, Finland). The results were expressed as picograms (pg) of cytokine per milligram of spinal cord tissue.</p>
</sec>
<sec id="s2-12">
<title>Nitroblue Tetrazolium Reduction Test for Determining the Production of Superoxide Anion</title>
<p>Spinal cord samples were collected 24&#x20;h after the swimming session and homogenized with 500&#x20;&#x3bc;l of saline solution, and 50&#x20;&#x3bc;l of the resultant homogenate was placed in a sterilized 96-well plate, followed by the addition of 100&#x20;&#x3bc;l of NBT solution (1&#x20;mg/ml) and incubation for 1&#x20;h at 37&#xb0;C. The supernatant was carefully removed from the plates, and the precipitated formazan remaining in the wells was then solubilized by adding 120&#x20;&#x3bc;l of 2&#x20;M KOH and 140&#x20;&#x3bc;l of DMSO. Superoxide anion production was determined spectrophotometrically by the reduction of the redox dye NBT. Readings were performed at 600 nm (Multiskan GO Microplate Spectrophotometer, Thermo Fisher Scientific, Vantaa, Finland). The results were presented as NBT reduction through optical density measurements of tissue samples (OD/mg of spinal cord) (<xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>).</p>
</sec>
<sec id="s2-13">
<title>Lipid Peroxidation Assay</title>
<p>Lipid peroxidation levels induced by IAS session in the spinal cord samples were assessed by determining thiobarbituric acid reactive substances (TBARS) levels using an adapted method previously described (<xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>). Mice were euthanized 24&#x20;h after the swimming session, and samples of spinal cord were collected for lipid peroxidation assessment. Malondialdehyde (MDA), an intermediate product of lipid peroxidation, was determined by the difference between two absorbances performed at 535 and 572 nm using a microplate spectrophotometer reader (Multiskan GO Microplate Spectrophotometer, Thermo Fisher Scientific, Vantaa, Finland). The results were presented as lipid peroxidation (nmol of MDA/mg of tissue).</p>
</sec>
<sec id="s2-14">
<title>Statistical Analysis</title>
<p>Results are presented as means&#x20;&#xb1; SEM of measurements made on 4&#x2013;6 mice in each group per experiment, depending on the experiment, and are representative of two separate experiments. Two-way analysis of variance (ANOVA) was used to compare the groups and doses at all time points (curves). The analyzed factors were treatments, time, and time vs. treatment interaction. When there was a significant time vs. treatment interaction, one-way ANOVA followed by Tukey&#x2019;s t-test was performed for each time. Statistical differences were significant at p &#x3c;&#x20;0.05.</p>
</sec>
</sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<sec id="s3-1">
<title>Intense Acute Swimming Induced the Activation of Spinal Cord Astrocytes and Microglia After 24&#x20;h</title>
<p>In the first set of experiments, we evaluate the time-course response of spinal cord <italic>Gfap</italic> and <italic>Iba1</italic> mRNA expression as indicative of astrocyte and microglial activation, respectively. The time points were between 6 and 48&#x20;h after the mice experienced unaccustomed IAS session (<xref ref-type="fig" rid="F2">Figure&#x20;2</xref>). No increase in the mRNA expression of <italic>Gfap</italic> and <italic>Iba1</italic> was detected in comparison to that in the sham mice at 6 and 12&#x20;h post-exercise session. On the other hand, the IAS group presented a significant increase of <italic>Gfap</italic> and <italic>Iba1</italic> mRNA expression compared to that in the sham group at the 24th hour (<xref ref-type="fig" rid="F2">Figures 2A, B</xref>). To validate the mRNA expression data at the protein level, immunofluorescence assay was conducted 24&#x20;h after the IAS session. The activation of spinal cord astrocytes and microglia was confirmed bilaterally in IAS but not in sham mice (<xref ref-type="fig" rid="F2">Figures 2C&#x2013;H</xref>). Based on previous studies of our laboratory (<xref ref-type="bibr" rid="B4">Borghi et&#x20;al., 2014a</xref>; <xref ref-type="bibr" rid="B5">Borghi et&#x20;al., 2014b</xref>; <xref ref-type="bibr" rid="B6">Borghi et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>), mechanical hyperalgesia starts to increase 6&#x20;h after the unaccustomed IAS session and reaches its peak at 24&#x20;h after the exercise, which according to the present data coincides with the activation of astrocytes and microglia in the spinal&#x20;cord.</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Unaccustomed IAS session induces spinal cord astrocyte and microglial activation in the spinal cord dorsal horn. <bold>(A)</bold> <italic>Gfap</italic> and (<bold>B)</bold> <italic>Iba1</italic> mRNA expression was determined in sham and exercised mice 6&#x2013;48&#x20;h after the intense acute swimming session by RT-qPCR. At time 24&#x20;h after the exercise session (peak of <italic>Gfap</italic> and <italic>Iba1</italic> mRNA expression), immunofluorescence analysis of the spinal cord samples was performed to confirm <bold>(C)</bold> GFAP and <bold>(D)</bold> Iba-1 expression (the percentage of GFAP and Iba-1 fluorescence intensity in each experimental group). Spinal cord samples were stained with antibodies for astrocytes <bold>(E, G)</bold> and microglia <bold>(F, H)</bold> (GFAP and Iba-1, respectively; green) and nucleus (DAPI, blue) detection. Representative immunostainings of the spinal cord of sham and exercised mice are shown in panels <bold>E&#x2013;H</bold> (&#xd7;20 magnification, scale bar 250&#x20;&#x3bc;m). Results are presented as spinal cord <italic>gfap and Iba1</italic> mRNA expression fold change (normalized to &#x3b2;-actin) (<italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment, representative of two independent experiments) and as spinal cord GFAP and Iba-1 fluorescence intensity (<italic>n</italic>&#x20;&#x3d; 4 mice per group per experiment, representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to sham mice (one-way ANOVA followed by Tukey&#x2019;s posttest).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g002.tif"/>
</fig>
</sec>
<sec id="s3-2">
<title>Treatments With Glial Inhibitors by Intrathecal Route Diminished Intense Acute Swimming-Induced Mechanical Hyperalgesia</title>
<p>To evaluate the role of spinal cord astrocytes and microglia in unaccustomed IAS-induced muscle pain, animals received a single local (i.t.) treatment with vehicle or well-known glial inhibitors fluorocitrate (0.05&#x2013;0.45 &#xb5;g; astrocyte inhibitor), &#x3b1;-aminoadipate (10&#x2013;100 nmol; astrocyte inhibitor), and minocycline (15&#x2013;150 &#x3bc;g; microglial inhibitor) 30&#x20;min before the exercise session. Mechanical hyperalgesia was evaluated from 6 to 48&#x20;h after the swimming (<xref ref-type="fig" rid="F3">Figure&#x20;3</xref>). Fluorocitrate, &#x3b1;-aminoadipate, and minocycline i.t. treatments dose-dependently reduced muscle mechanical hyperalgesia induced by IAS session from the 12th hour onward, with the highest doses of each compound being the most effective in inhibiting unaccustomed IAS-induced pain, except for the intermediate dose of fluorocitrate that achieved a similar effect as the higher dose (<xref ref-type="fig" rid="F3">Figures 3A&#x2013;C</xref>). In the case of &#x3b1;-aminoadipate and minocycline, they abolished IAS-induced mechanical hyperalgesia at 48&#x20;h after the exercise session (<xref ref-type="fig" rid="F3">Figures 3B, C</xref>). Thus, the intermediate dose of fluorocitrate and the higher doses of &#x3b1;-aminoadipate and minocycline were selected for the next set of experiments. These results corroborate the notion that spinal cord astrocyte and microglia activation is necessary to induce DOMS, especially between 24 and 48&#x20;h post-exercise (time of hyperalgesia peak).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>
<bold>(A)</bold> Fluorocitrate, <bold>(B)</bold> &#x3b1;-aminoadipate, and <bold>(C)</bold> minocycline reduce, in a dose-dependent manner, IAS-induced muscle mechanical hyperalgesia. Mice received vehicle (saline, i.t.), fluorocitrate (0.05&#x2013;0.45 &#xb5;g, i.t.), &#x3b1;-aminoadipate (10&#x2013;1,000 nmol, i.t.), or minocycline (15&#x2013;150 &#x3bc;g, i.t.) 30&#x20;min before experiencing unaccustomed intense acute swimming session. The intensity of muscle mechanical hyperalgesia was evaluated 6&#x2013;48&#x20;h after the exercise session. Results are presented as intensity of hyperalgesia (&#x394; reaction, in grams; <italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment and is representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared with sham group, &#x23;p &#x3c; 0.05 compared with vehicle group, &#x2a;&#x2a;p &#x3c; 0.05 compared with vehicle and with the lowest dose tested of the compound (two-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g003.tif"/>
</fig>
</sec>
<sec id="s3-3">
<title>Spinal Cord Astrocytes and Microglia Mediate Intense Acute Swimming-Induced Mechanical Hyperalgesia in a Nuclear Factor &#x3ba;B-Dependent Manner</title>
<p>Our next goal was to evaluate whether spinal cord NF&#x3ba;B has a role in mediating IAS-induced DOMS (<xref ref-type="fig" rid="F4">Figure&#x20;4</xref>). In our first approach, mice received a single i.t. treatment with vehicle or the selective NF&#x3ba;B inhibitor PDTC (30&#x2013;300 &#xb5;g) 30&#x20;min before the exercise session, and mechanical hyperalgesia was evaluated from 6 to 48&#x20;h after IAS (<xref ref-type="fig" rid="F4">Figure&#x20;4A</xref>). PDTC dose-dependently reduced IAS-induced muscle mechanical hyperalgesia, with significant inhibition from 6 to 48&#x20;h with the dose of 300&#x20;&#xb5;g (<xref ref-type="fig" rid="F4">Figure&#x20;4A</xref>). Subsequently, the efforts were focused on verifying the relationship between spinal cord glial cells and NF&#x3ba;B in the peak of IAS-induced DOMS (24&#x20;h after the exercise session) (<xref ref-type="fig" rid="F4">Figures 4B&#x2013;I</xref>). For this purpose, spinal cord NF&#x3ba;B activation was evaluated in mice treated by i.t. route with fluorocitrate, &#x3b1;-aminoadipate, minocycline, and PDTC (control drug) using ELISA (<xref ref-type="fig" rid="F4">Figure&#x20;4B</xref>) and immunofluorescence (<xref ref-type="fig" rid="F4">Figures 4C&#x2013;I</xref>) approaches. Spinal cord NF&#x3ba;B activation was triggered by IAS [decreased the ratio of total NF&#x3ba;B/pNF&#x3ba;B (the activated form is the phosphorylated one)], which was reversed by the treatments with all tested glial inhibitors (<xref ref-type="fig" rid="F4">Figure&#x20;4B</xref>). PDTC i.t. treatment also reverted NF&#x3ba;B activation in the spinal cord of IAS animals, further corroborating that its effect on hyperalgesia was due to the inhibition of spinal cord NF&#x3ba;B activation (<xref ref-type="fig" rid="F4">Figure&#x20;4B</xref>). Using immunofluorescence analysis, we demonstrate that pNF&#x3ba;B staining in spinal cord dorsal horn is elevated at 24&#x20;h in IAS animals compared to sham animals (<xref ref-type="fig" rid="F4">Figures 4C&#x2013;E</xref>). In agreement with ELISA data (<xref ref-type="fig" rid="F4">Figure&#x20;4B</xref>), spinal cord pNF&#x3ba;B staining was reduced upon i.t. treatment with glial and NF&#x3ba;B inhibitors (<xref ref-type="fig" rid="F4">Figures 4F&#x2013;I</xref>). These results suggest the participation of spinal cord NF&#x3ba;B and spinal cord glial cell in NF&#x3ba;B activation during&#x20;DOMS.</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>
<bold>(A)</bold> PDTC reduces in a dose-dependent manner IAS-induced muscle mechanical hyperalgesia. Mice received vehicle (saline, i.t.) and PDTC (30&#x2013;300 &#x3bc;g, i.t.) 30&#x20;min before experiencing unaccustomed intense acute swimming session. The intensity of muscle mechanical hyperalgesia was evaluated 6&#x2013;48&#x20;h after the exercise session. Results are presented as intensity of hyperalgesia (&#x394; reaction, in grams; <italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment and is representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to the sham group, &#x23;p &#x3c; 0.05 compared to the vehicle-treated group (two-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>). Fluorocitrate (0.15 &#xb5;g, i.t.), &#x3b1;-aminoadipate (1,000 nmol, i.t.), minocycline (150 &#x3bc;g, i.t.), and PDTC (300 &#x3bc;g, i.t.) inhibit <bold>(B)</bold> spinal cord NF&#x3ba;B activation (total NF&#x3ba;B/phosphorylated NF&#x3ba;B ratio) and <bold>(C&#x2013;I)</bold> pNF&#x3ba;B immunoreactivity (the percentage of pNF&#x3ba;B fluorescence intensity in each experimental group) 24&#x20;h after the exercise session. Control mice received saline i.t. as vehicle. Representative immunostainings of the spinal cord of sham and exercised-treated mice are shown in panels <bold>D&#x2013;I</bold> (&#xd7;10 magnification, scale bar 250&#x20;&#x3bc;m). Results are presented as NF&#x3ba;B activation (total-p65/phosphotrilated-p65 ratio)/mg of spinal cord (<italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment, representative of two independent experiments) and as spinal cord pNF&#x3ba;B fluorescence intensity, respectively (<italic>n</italic>&#x20;&#x3d; 4 mice per group per experiment, representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to the sham group, &#x23;p &#x3c; 0.05 compared to the vehicle-treated group (one-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g004.tif"/>
</fig>
</sec>
<sec id="s3-4">
<title>Spinal Cord CX<sub>3</sub>CL1/CX<sub>3</sub>CR1 Signaling Contribution to Intense Acute Swimming-Induced Mechanical Hyperalgesia</title>
<p>CX<sub>3</sub>CL1 is released by primary afferent neurons in the spinal cord and activates its receptor CX<sub>3</sub>CR1, expressed mainly by microglia. This intercellular event represents a potential spinal cord mechanism during central sensitization, evidencing how peripheral neurons activate microglia in the spinal cord (<xref ref-type="bibr" rid="B42">Pinho-Ribeiro et&#x20;al., 2017</xref>). The participation of CX<sub>3</sub>CL1/CX<sub>3</sub>CR1 signaling would sum up to corroborate the participation of spinal cord glial cells in DOMS (<xref ref-type="fig" rid="F5">Figure&#x20;5</xref>). Mice received a single i.t. treatment of isotype control IgG antibody or neutralizing antibody anti-CX<sub>3</sub>CL1 (Ab CX<sub>3</sub>CL1; 0.25&#x2013;2.5 &#xb5;g) 30&#x20;min before the exercise session, and mechanical hyperalgesia was evaluated from 6 to 48&#x20;h after swimming (<xref ref-type="fig" rid="F5">Figure&#x20;5A</xref>). The lowest dose of the Ab CX<sub>3</sub>CL1 had no effect on mechanical hyperalgesia; however, 2.5 &#xb5;g dose efficiently inhibited mechanical hyperalgesia from 12&#x20;h onward (<xref ref-type="fig" rid="F5">Figure&#x20;5A</xref>). Further extending on this topic, we next evaluated the mRNA expression of spinal cord <italic>Cx3cr1</italic> 24&#x20;h after IAS (peak of DOMS) and if inhibiting glial cells and NF&#x3ba;B at this time point influences its mRNA expression (<xref ref-type="fig" rid="F5">Figure&#x20;5B</xref>). Unaccustomed IAS significantly enhanced <italic>Cx3cr1</italic> mRNA expression in comparison to sham group, while i.t. treatments with fluorocitrate, &#x3b1;-aminoadipate, minocycline, and PDTC inhibited its expression (<xref ref-type="fig" rid="F5">Figure&#x20;5B</xref>). Corroborating the mRNA expression data, IAS CX<sub>3</sub>CR1-eGFP<sup>&#x2b;/-</sup> mice (24 h) presented higher fluorescence intensity than sham CX<sub>3</sub>CR1-eGFP<sup>&#x2b;/-</sup> mice, indicating higher CX<sub>3</sub>CR1 protein levels in IAS animals than in sham animals. The i.t. treatment with glial and NF&#x3ba;B inhibitors reduced CX<sub>3</sub>CR1 fluorescence in IAS animals (<xref ref-type="fig" rid="F5">Figures 5C&#x2013;I</xref>). These data show that spinal cord CX<sub>3</sub>CL1/CX<sub>3</sub>CR1 signaling plays a role in DOMS and that the expression of this chemokine receptor is regulated by glial cells and NF&#x3ba;B in the spinal cord during&#x20;DOMS.</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>
<bold>(A)</bold> Antibody anti-CX<sub>3</sub>CL1 reduces IAS-induced muscle mechanical hyperalgesia. Mice received vehicle (IgG, i.t.) and Ab CX<sub>3</sub>CL1 (0.25&#x2013;2.5 &#xb5;g, i.t.) 30&#x20;min before experiencing unaccustomed intense acute swimming session. The intensity of muscle mechanical hyperalgesia was evaluated 6&#x2013;48&#x20;h after the exercise session. Results are presented as intensity of hyperalgesia (&#x394; reaction, in grams; <italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment and is representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to the sham group, &#x23;p &#x3c; 0.05 compared to the vehicle-treated group (two-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>). Fluorocitrate (0.15 &#xb5;g, i.t.), &#x3b1;-aminoadipate (1,000 nmol, i.t.), minocycline (150 &#x3bc;g, i.t.), and PDTC (300 &#x3bc;g, i.t.) inhibit <bold>(B)</bold> spinal cord <italic>Cx3cr1</italic> expression and <bold>(C&#x2013;I)</bold> CX<sub>3</sub>CR1 reporter fluorescence (the percentage of CX<sub>3</sub>CR1 fluorescence intensity in each experimental group) 24&#x20;h after the exercise session. Control mice received saline i.t. as vehicle. Representative immunostainings of the spinal cord of sham and exercised-treated mice are shown in panels <bold>D&#x2013;I</bold> (&#xd7;10 magnification, scale bar 250&#x20;&#x3bc;m). Results are presented as spinal cord <italic>Cx3cr1</italic> mRNA expression fold change (normalized to &#x3b2;-actin) (<italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment, representative of two independent experiments) and as spinal cord CX<sub>3</sub>CR1 reporter fluorescence intensity, respectively (<italic>n</italic>&#x20;&#x3d; 4 mice per group per experiment, representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to the sham group, &#x23;p &#x3c; 0.05 compared to the vehicle-treated group (one-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g005.tif"/>
</fig>
</sec>
<sec id="s3-5">
<title>Targeting Spinal Cord Tumor Necrosis Factor-&#x3b1; and Interleukin-1&#x3b2; and Exogenous Interleukin-10 Intrathecal Administration Inhibit Intense Acute Swimming-Induced Mechanical Hyperalgesia</title>
<p>After determining the role of spinal cord astrocytes, microglia, NF&#x3ba;B, and CX<sub>3</sub>CL1/CX<sub>3</sub>CR1 signaling in unaccustomed IAS-induced DOMS, the participation of spinal cord cytokines TNF-&#x3b1;, IL-1&#x3b2;, and IL-10 was evaluated using immune-pharmacological tools. For this purpose, mice received a single i.t. treatment of vehicle or TNF-&#x3b1; blocker etanercept (10&#x2013;100 ng), IL-1 receptor antagonist (IL-1ra), or mouse recombinant IL-10 (1&#x2013;3 ng) (<xref ref-type="fig" rid="F6">Figure&#x20;6</xref>). The dose of 10&#x20;ng of etanercept only inhibited mechanical hyperalgesia at 24 h; however, the dose of 100&#x20;ng was effective in inhibiting mechanical hyperalgesia between 6 and 48&#x20;h (<xref ref-type="fig" rid="F6">Figure&#x20;6A</xref>). Regarding IL-1ra, the dose of 10&#x20;ng was ineffective, whereas the dose of 100&#x20;ng inhibited mechanical hyperalgesia between 6 and 48&#x20;h (<xref ref-type="fig" rid="F6">Figure&#x20;6B</xref>). Finally, i.t. treatment with 1&#x20;ng of IL-10 inhibited mechanical hyperalgesia in the 12th and 24th hour after the exercise session, whereas the dose of 3&#x20;ng abolished mechanical hyperalgesia at all evaluated times (<xref ref-type="fig" rid="F6">Figure&#x20;6C</xref>). These results point to the participation of spinal cord TNF-&#x3b1; and IL-1&#x3b2; in mediating IAS-induced DOMS, while IL-10 is important to counteract&#x20;it.</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>
<bold>(A)</bold> Etanercept, <bold>(B)</bold> IL-1ra, and <bold>(C)</bold> mRIL-10 reduce IAS-induced muscle mechanical hyperalgesia. Mice received vehicle (saline, i.t.), etanercept (10&#x2013;100 ng, i.t.), IL-1ra (10&#x2013;100 ng, i.t.), and mRIL-10 (1&#x2013;3 ng, i.t.) 30&#x20;min before experiencing unaccustomed intense acute swimming session. The intensity of muscle mechanical hyperalgesia was evaluated 6&#x2013;48&#x20;h after the exercise session. Results are presented as intensity of hyperalgesia (&#x394; reaction, in grams; <italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment and is representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared with sham group, &#x23;p &#x3c; 0.05 compared with vehicle group (two-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g006.tif"/>
</fig>
</sec>
<sec id="s3-6">
<title>Targeting Spinal Cord Astrocytes, Microglia, and Nuclear Factor &#x3ba;B Inhibits Intense Acute Swimming-Induced <italic>Tnf&#x3b1;</italic>, <italic>Il1&#x3b2;</italic>, and <italic>Il10</italic> mRNA Expression and Protein Levels</title>
<p>Considering that cytokines (<xref ref-type="fig" rid="F6">Figure&#x20;6</xref>) participate in unaccustomed IAS-induced DOMS, we next quantitated the mRNA expression and protein levels of TNF-&#x3b1;, IL-1&#x3b2;, and IL-10 in the spinal cord after inhibition of glial cells and NF&#x3ba;B (<xref ref-type="fig" rid="F7">Figure&#x20;7</xref>). For this investigation, in the first set of experiments, mice received a single i.t. treatment of vehicle, fluorocitrate, &#x3b1;-aminoadipate, minocycline, or PDTC 30&#x20;min before IAS session. The mRNA expression of cytokines was evaluated at the peak DOMS (24 h). The increased mRNA expression of <italic>Tnf&#x3b1;</italic>, <italic>Il1&#x3b2;</italic>, and <italic>Il10</italic> induced by IAS was successfully inhibited by i.t. treatments with glial and NF&#x3ba;B inhibitors (<xref ref-type="fig" rid="F7">Figures 7A&#x2013;C</xref>). Spinal cord TNF-&#x3b1;, IL-1&#x3b2;, and IL-10 protein levels were also increased after IAS compared to sham animals in the peak of DOMS (24 h), while i.t. treatment with glial and NF&#x3ba;B inhibitors significantly reduced IAS-induced cytokine production (<xref ref-type="fig" rid="F7">Figures 7D, E</xref>). These data demonstrate that spinal cord astrocytes, microglia, and NF&#x3ba;B activation mediates neuroinflammation in DOMS, as well as their inhibition counteracts the expression of classical cytokines that have pro-hyperalgesic or anti-hyperalgesic&#x20;roles.</p>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption>
<p>Fluorocitrate (0.15 &#xb5;g, i.t.), &#x3b1;-aminoadipate (1,000 nmol, i.t.), minocycline (150 &#x3bc;g, i.t.), and PDTC (300 &#x3bc;g, i.t.) inhibit spinal cord <bold>(A)</bold> <italic>Tnf&#x3b1;</italic>, <bold>(B)</bold> <italic>Il1&#x3b2;</italic>, and <bold>(C)</bold> <italic>Il10</italic> mRNA expression and <bold>(D)</bold> TNF-&#x3b1;, <bold>(E)</bold> IL-1&#x3b2;, and <bold>(F)</bold> IL-10 protein levels 24&#x20;h after IAS session. Control mice received saline i.t. as vehicle. Results are presented as spinal cord <italic>Tnf&#x3b1;</italic>, <italic>Il1&#x3b2;</italic>, and <italic>Il10</italic> mRNA expression fold change (normalized to &#x3b2;-actin) and as spinal cord TNF-&#x3b1;, IL-1&#x3b2;, and IL-10 in pg/ml, respectively (<italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment and is representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to the sham group, &#x23;p &#x3c; 0.05 compared to the vehicle-treated group (one-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g007.tif"/>
</fig>
</sec>
<sec id="s3-7">
<title>Targeting Spinal Cord Astrocytes, Microglia, and Nuclear Factor &#x3ba;B Inhibits Intense Acute Swimming-Induced Oxidative Stress</title>
<p>Evidence supports that IAS induces oxidative stress in the spinal cord and that this redox imbalance also accounts for IAS-induced hyperalgesia and NF&#x3ba;B activation (<xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>). Mice were treated with a single i.t. administration of vehicle, fluorocitrate, &#x3b1;-aminoadipate, minocycline, or PDTC 30&#x20;min before the swimming session, and the levels of spinal cord superoxide anion (NBT reduction assay) and lipid peroxidation (MDA concentration assay) were assessed at the peak of DOMS (24 h) (<xref ref-type="fig" rid="F8">Figure&#x20;8</xref>). Unaccustomed IAS session significantly elevated the levels of spinal cord superoxide anion and lipid peroxidation compared to sham mice. I.t. treatments with glial and NF&#x3ba;B inhibitors reduced the production of superoxide anion and lipid peroxidation (<xref ref-type="fig" rid="F8">Figures 8A, B</xref>). This evidence demonstrates that inhibition of spinal cord astrocytes, microglia, and NF&#x3ba;B also as a consequence diminishes oxidative stress.</p>
<fig id="F8" position="float">
<label>FIGURE 8</label>
<caption>
<p>Fluorocitrate (0.15 &#xb5;g, i.t.), &#x3b1;-aminoadipate (1,000 nmol, i.t.), minocycline (150 &#x3bc;g, i.t.), and PDTC (300 &#x3bc;g, i.t.) inhibit spinal cord <bold>(A)</bold> superoxide anion production and <bold>(B)</bold> lipid peroxidation levels 24&#x20;h after IAS session. Control mice received saline i.t. as vehicle. Results are presented as spinal cord NBT reduction (OD/mg of spinal cord) and lipid peroxidation (nmol of MDA/mg of spinal cord), respectively (<italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment and is representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to the sham group, &#x23;p &#x3c; 0.05 compared to the vehicle-treated group (one-way ANOVA followed by Tukey&#x2019;s <italic>post-hoc</italic>).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g008.tif"/>
</fig>
</sec>
<sec id="s3-8">
<title>Intense Acute Swimming Induces Neuronal Activation in the Spinal Cord, Which Is Amenable by Glial and Nuclear Factor &#x3ba;B Inhibitors</title>
<p>To further explore the mechanisms underlying neuroinflammation in DOMS, we next investigated spinal cord neuronal activation in IAS through c-Fos evaluation and whether the activity of glial cells and NF&#x3ba;B would influence the neuronal activation in the spinal cord (<xref ref-type="fig" rid="F9">Figure&#x20;9</xref>). In the first round of experiments, the time-course response of spinal cord <italic>cfos</italic> mRNA expression from 6 to 48&#x20;h after IAS session was evaluated (<xref ref-type="fig" rid="F9">Figure&#x20;9A</xref>). In the first 12 h, no increase in the expression of <italic>cfos</italic> was detected; however, a sharp and significant increase in its expression was observed at 24&#x20;h after IAS (<xref ref-type="fig" rid="F9">Figure&#x20;9A</xref>). Thus, 24&#x20;h was selected as the time point of analyses in the following experiments. The next investigation was to determine whether inhibiting glia and NF&#x3ba;B would alter the increase of <italic>cfos</italic> mRNA expression. Mice were treated once by i.t. route with vehicle, fluorocitrate, &#x3b1;-aminoadipate, minocycline, or PDTC 30&#x20;min before IAS session, and after 24 h, the mRNA expression of <italic>cfos</italic> was evaluated. The IAS-induced <italic>cfos</italic> mRNA expression was inhibited by i.t. treatments with glial and NF&#x3ba;B inhibitors (<xref ref-type="fig" rid="F9">Figure&#x20;9B</xref>). In the next step, mice were treated with vehicle, fluorocitrate, &#x3b1;-aminoadipate, minocycline, or PDTC 30&#x20;min before IAS session, and c-Fos staining was analyzed in spinal cord samples collected at 24&#x20;h (<xref ref-type="fig" rid="F9">Figures 9C&#x2013;J</xref>). The immunodetection of c-Fos was increased in IAS animals compared to sham group, while i.t. treatments with glial and NF&#x3ba;B inhibitors significantly reduced c-Fos detection (<xref ref-type="fig" rid="F9">Figures 9C&#x2013;J</xref>). We also used NeuN as a neuronal marker to identify neurons in the spinal cord dorsal horn that were positive for c-Fos. The number of c-Fos/NeuN double-positive cells was significantly higher in IAS animals than in sham animals (<xref ref-type="fig" rid="F9">Figures 9D&#x2013;J</xref>). Inset panels in the right side (<xref ref-type="fig" rid="F9">Figures 9E&#x2013;J</xref>) and quantitation of c-Fos/NeuN double-positive cells (<xref ref-type="fig" rid="F9">Figure&#x20;9D</xref>) showed that i.t. treatments with glial and NF&#x3ba;B inhibitors reduced the presence of these double-positive cells in the spinal cord dorsal horn. These results suggest the participation of spinal cord astrocytes, microglia, and NF&#x3ba;B in the modulation of spinal cord neuronal activation during&#x20;DOMS.</p>
<fig id="F9" position="float">
<label>FIGURE 9</label>
<caption>
<p>Unaccustomed IAS session induces spinal cord dorsal horn c-Fos activation. <bold>(A)</bold> The <italic>cfos</italic> mRNA expression was determined in sham and exercised mice 6&#x2013;48&#x20;h after the intense acute swimming session by RT-qPCR. At time 24&#x20;h after the exercise session (peak of <italic>cfos</italic> mRNA expression), RT-qPCR and immunofluorescence analysis of the spinal cord samples were performed under vehicle (5 &#x3bc;l, i.t.), fluorocitrate (0.15 &#xb5;g, i.t.), &#x3b1;-aminoadipate (1,000 nmol, i.t.), minocycline (150 &#x3bc;g, i.t.), and PDTC (300 &#x3bc;g, i.t.) treatments to evaluate <bold>(B)</bold> <italic>cfos</italic> mRNA expression and <bold>(C&#x2013;J)</bold> c-Fos protein immunodetection. Panel <bold>C</bold> presents the percentage of c-Fos fluorescence intensity in each experimental group. <bold>(D)</bold> Mean of quantification of double-positive cells per experimental group. <bold>(E&#x2013;J)</bold> Spinal cord samples were double-stained with antibodies for c-Fos (neuronal activation; red) and NeuN (neuron nuclear marker; green) detection. Representative immunostainings of the spinal cord of sham and exercise-treated mice are shown in panels <bold>D&#x2013;I</bold> (&#xd7;10 magnification, scale bar 250&#x20;&#x3bc;m); zoom in inset panels on right; white arrows denote c-Fos/NeuN double-positive cells. Results are presented as spinal cord <italic>cfos</italic> mRNA expression fold change (normalized to &#x3b2;-actin) (<italic>n</italic>&#x20;&#x3d; 6 mice per group per experiment, representative of two independent experiments), as spinal cord c-Fos fluorescence intensity, and as c-Fos/NeuN double-positive cells per field, respectively (<italic>n</italic>&#x20;&#x3d; 4 mice per group per experiment, representative of two independent experiments). &#x2a;p &#x3c; 0.05 compared to sham mice, &#x23;p &#x3c; 0.05 compared to the vehicle-treated group (one-way ANOVA followed by Tukey&#x2019;s posttest).</p>
</caption>
<graphic xlink:href="fphar-12-734091-g009.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="s4">
<title>Discussion</title>
<p>The present study demonstrates that DOMS caused by unaccustomed intense acute aerobic swimming exercise (IAS) involves neuroinflammatory events in the spinal cord. The primary afferent neurons contribute to this neuroinflammatory process by releasing CX<sub>3</sub>CL1 in the spinal cord and activating microglia, thus initiating a neuroimmune communication that produces cytokines and oxidative stress and activates NF&#x3ba;B, causing the sensitization of nociceptor sensory neurons in the spinal cord, which is observed as&#x20;DOMS.</p>
<p>DOMS may emerge after both acute high-intensity and prolonged exercise sessions (<xref ref-type="bibr" rid="B32">MacIntyre et&#x20;al., 1995</xref>; <xref ref-type="bibr" rid="B13">Cheung et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B16">Dannecker and Koltyn, 2014</xref>; <xref ref-type="bibr" rid="B17">Dos Santos et&#x20;al., 2020</xref>). In humans, evidence demonstrates that eccentric exercise modulates spinal sites in DOMS, accounting for central sensitization (<xref ref-type="bibr" rid="B21">Hosseinzadeh et&#x20;al., 2013</xref>). The study applied nociceptive withdrawal reflex test to measure sensitivity in the spinal cord system and found a reduction of approximately 30% of nociceptive withdrawal reflex threshold on the first day after the eccentric exercise bout (<xref ref-type="bibr" rid="B21">Hosseinzadeh et&#x20;al., 2013</xref>). Preclinically, few articles demonstrated spinal cord glial reactivity and the role of cytokines using DOMS models (<xref ref-type="bibr" rid="B41">Pereira et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B17">Dos Santos et&#x20;al., 2020</xref>). In trained (8 weeks, 5&#x20;days per week) mice exposed to a protocol of downhill running, spinal cord dorsal horn astrocytic and microglial activation markers were increased 36&#x20;h after the end of the last exercise session in week 8 (<xref ref-type="bibr" rid="B41">Pereira et&#x20;al., 2015</xref>). In a different protocol, mice that performed only one session of running exercise (40&#x20;min with progressive speed over the period) presented increased spinal cord dorsal horn microglial activation associated with elevated TNF-&#x3b1; and IL-6 levels in spinal cord 24&#x2013;48&#x20;h after the exercise session. Furthermore, 70&#x20;kDa Hsp70, which is a molecule produced upon exercise, activates Toll-like receptor 4 (TLR4) expressed by spinal cord microglia, accounting to explain DOMS (<xref ref-type="bibr" rid="B17">Dos Santos et&#x20;al., 2020</xref>). Our study demonstrates for the first time the involvement of spinal cord dorsal horn glial cells in increased neuronal activity after acute prolonged swimming exercise (120 min) that presents different environmental and physiological aspects in comparison to other aerobic modalities. For example, swimming exercise is characterized by reduced mechanical impact and gravity interference compared to exercise performed out of water. We demonstrate herein that DOMS is a notorious outcome also in this condition and is related to glial activation and function in the spinal&#x20;cord.</p>
<p>Importantly, our study evaluated the temporal expression of classical markers of astrocytes and microglial activation in the spinal cord after IAS-induced DOMS. Astrocytic (GFAP) and microglial (Iba-1) activation became statistically detectable 24&#x20;h after the swimming session at the mRNA and protein levels. To establish a causal relationship between spinal cord gliosis and pain in DOMS, we performed pharmacological approaches using fluorocitrate and &#x3b1;-aminoadipate (inhibitors of astrocyte metabolism) (<xref ref-type="bibr" rid="B51">Voss et&#x20;al., 2016</xref>) and minocycline (selective inhibitor of M1 microglia) (<xref ref-type="bibr" rid="B24">Kobayashi et&#x20;al., 2013</xref>) i.t. treatments. All treatments efficiently inhibited IAS-induced mechanical hyperalgesia in post-recovery exercise period from 12 to 48 h. The absence of mechanical hyperalgesia inhibition by i.t. treatments at early periods (6 h) after exercise is reasonable, since there was no massive activation of glia at least until 24&#x20;h.</p>
<p>Next, we demonstrated that glial inhibitors target spinal cord p65 NF&#x3ba;B activation (as demonstrated by ELISA and immunofluorescence analyses) and, additionally, glial and NF&#x3ba;B inhibitors target spinal cord CX<sub>3</sub>CR1 (mRNA expression and CX<sub>3</sub>CR1 reporter mouse), both 24&#x20;h after IAS session. A functional experiment using the i.t. treatment of neutralizing antibody anti-CX<sub>3</sub>CL1 demonstrated that inhibiting this chemokine reduces IAS-induced DOMS. NF&#x3ba;B activation is responsible for neuroinflammatory and nociceptive pathologic events in the spinal cord (<xref ref-type="bibr" rid="B54">Zarpelon et&#x20;al., 2016</xref>; <xref ref-type="bibr" rid="B42">Pinho-Ribeiro et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B29">Li et&#x20;al., 2020</xref>). Here, i.t. treatment with the NF&#x3ba;B inhibitor PDTC reduced DOMS from 6 to 48&#x20;h after the swimming exercise, and i.t. treatment with glial inhibitors reduced NF&#x3ba;B activation, thus suggesting a crucial role of spinal cord glial cells and NF&#x3ba;B activity for DOMS development. Peripheral nociceptor neurons contribute to neuroinflammation and neuronal sensitization by releasing CX<sub>3</sub>CL1 in the spinal cord, which activates CX<sub>3</sub>CR1 in microglia (<xref ref-type="bibr" rid="B35">Milligan et&#x20;al., 2004</xref>; <xref ref-type="bibr" rid="B18">Gao and Ji, 2010</xref>). In the periphery, CX<sub>3</sub>CL1 (from muscle-related endothelium) levels are enhanced at mRNA and protein levels in skeletal muscle after one bout of 1&#x20;h of aerobic exercise in humans, accounting to macrophage recruitment and inflammatory products (<xref ref-type="bibr" rid="B48">Stromberg et&#x20;al., 2016</xref>). However, to our knowledge, this is the first demonstration of the contribution of spinal cord CX<sub>3</sub>CL1/CX<sub>3</sub>CR1 signaling to IAS-induced&#x20;DOMS.</p>
<p>IAS-induced DOMS was inhibited 6&#x2013;48&#x20;h after the session when endogenous TNF-&#x3b1; and IL-1&#x3b2; were targeted, just like when exogenous IL-10 was administered. Further extending on this topic, we next evaluate whether IAS modifies the expression of these cytokines in the spinal cord at the peak of DOMS (24 h). IAS enhanced the mRNA expression of <italic>Tnf-&#x3b1;</italic>, <italic>Il-1&#x3b2;</italic>, and <italic>Il-10</italic> as well as their respective protein levels, which were diminished by glial and NF&#x3ba;B inhibitors. NF&#x3ba;B activation enhances TNF-&#x3b1; and IL-1&#x3b2; production (<xref ref-type="bibr" rid="B39">Pahl, 1999</xref>); thus, its inhibition reduces the transcription of these genes. The crosstalk between non-neuronal cells using cytokines as mediators has been demonstrated to be essential for central nervous system (CNS) pathology (<xref ref-type="bibr" rid="B30">Liu et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B33">Matejuk and Ransohoff, 2020</xref>). Spinal cord microglia mediate the activation of resident astrocytes and oligodendrocytes. Microglia release TNF-&#x3b1; and IL-1&#x3b2;, and in turn, TNF-&#x3b1; activates astrocytes (<xref ref-type="bibr" rid="B42">Pinho-Ribeiro et&#x20;al., 2017</xref>). Activated astrocytic networks may as well facilitate microglial activation <italic>via</italic> calcium wave-related adenosine triphosphate (ATP) release, which interacts with its purinergic receptor in microglia and activates these cells (<xref ref-type="bibr" rid="B30">Liu et&#x20;al., 2011</xref>). These concomitant glial-to-glial mechanisms converge to promote spinal cord neuronal sensitization. These mechanisms may explain, for example, the inhibition of IAS-induced spinal cord <italic>Cx3cr1</italic> mRNA expression and its protein levels by fluorocitrate and &#x3b1;-aminoadipate.</p>
<p>IL-10 has been proposed as a crucial cytokine for the control of central sensitization (<xref ref-type="bibr" rid="B36">Milligan et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B50">Vanderwall and Milligan, 2019</xref>). Here, we observed that i.t. treatment with mrIL-10 abolished DOMS (3&#x20;ng dose) 6&#x2013;48&#x20;h after the exercise session. Moreover, the increased <italic>Il10</italic> mRNA expression and protein levels after DOMS (24 h) was reversed by i.t. treatments with glial and NF&#x3ba;B inhibitors. This reduction in IL-10 production instead of an increase during treatments might be a result of diminished pro-hyperalgesic cytokine production, waiving the need of endogenous IL-10 production to limit hyperalgesia. This is supported by evidence demonstrating that endogenous IL-10 limits hyperalgesia by reducing pro-hyperalgesic cytokine production in models of inflammatory pain, neuropathic pain, and IAS-induced DOMS (<xref ref-type="bibr" rid="B43">Poole et&#x20;al., 1995</xref>; <xref ref-type="bibr" rid="B6">Borghi et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B25">Krukowski et&#x20;al., 2016</xref>; <xref ref-type="bibr" rid="B50">Vanderwall and Milligan, 2019</xref>).</p>
<p>Our study also demonstrated that IAS enhanced the levels of&#x20;oxidative stress in the spinal cord at the peak of DOMS, as&#x20;reflected by increased superoxide anion production and lipid peroxidation levels. Astrocytes and microglia can produce large quantities of reactive oxygen species (ROS) in pathological conditions (<xref ref-type="bibr" rid="B53">Wolf et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B12">Chen et&#x20;al., 2020</xref>). NF&#x3ba;B activation by ROS also regulates the expression of gp91<sup>phox</sup> in nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex, thus contributing to oxidative metabolism (<xref ref-type="bibr" rid="B2">Anrather et&#x20;al., 2006</xref>). Additionally, oxidative stress at the level of spinal cord contributes to inflammatory pain (<xref ref-type="bibr" rid="B52">Wang et&#x20;al., 2004</xref>). In accordance with the abovementioned, we showed that treating mice by i.t. route with glial and NF&#x3ba;B inhibitors reduced IAS-induced oxidative stress and pain, evidencing a role for astrocytes, microglia, and NF&#x3ba;B in DOMS. Further corroborating the contribution of oxidative stress to DOMS, evidence supports that antioxidant treatment reduces IAS-induced DOMS (<xref ref-type="bibr" rid="B7">Borghi et&#x20;al., 2016</xref>).</p>
<p>Finally, an upregulation of the proto-oncogene <italic>cfos</italic> and its nuclear protein c-Fos in the spinal cord dorsal horn neurons (NeuN-positive cells) of IAS animals was observed at the peak of mechanical hyperalgesia (24 h). c-Fos has been broadly used as a marker of nociceptive neuron activity in the superficial laminae of spinal cord dorsal horn following peripheral stimulatory events (<xref ref-type="bibr" rid="B22">Hunt et&#x20;al., 1987</xref>; <xref ref-type="bibr" rid="B10">Bullitt, 1990</xref>). In IAS animals, there was increased immunodetection of c-Fos in the region of superficial laminae where the axons of primary afferent neurons enter the spinal cord. Thus, further confirming that peripheral inflammatory events triggered by IAS cause neuronal activation in the spinal cord. As mentioned earlier, stimulation of primary afferent neurons increases the secretion of CX<sub>3</sub>CL1 into the DRG and spinal cord microenvironment, leading to the activation of microglia that through communication with astrocytes and neurons support an effective neuroimmune communication accounting for neuroinflammation and neuronal activation in the spinal cord. Our data support that this is occurring in&#x20;DOMS.</p>
<p>In conclusion, this study shows that DOMS caused by IAS depends on spinal cord neuroinflammation. The present data uncover that spinal cord astrocytes and microglia are activated at the peak of DOMS and, through neuron-to-glia as well as glia-to-glia communications, may contribute to increased spinal cord dorsal horn neuronal activity and consequently pain in the post-exercise recovery period. Besides, IAS-induced DOMS depends on NF&#x3ba;B activation, modulation of cytokines (including TNF-&#x3b1;, IL-1&#x3b2;, and IL-10), and oxidative stress in the spinal cord. Thus, this study advances in the understanding of neuroimmune interactions in DOMS pathophysiology at the spinal cord, which may have clinical relevance contributing to the therapy and prophylaxis of&#x20;DOMS.</p>
</sec>
</body>
<back>
<sec id="s5">
<title>Data Availability Statement</title>
<p>The raw data supporting the conclusions of this article will&#x20;be&#x20;made available by the authors, without undue reservation.</p>
</sec>
<sec id="s6">
<title>Ethics Statement</title>
<p>The animal study was reviewed and approved by the Institutional Ethics Committee on Animal Use (CEUA) of the State University of Londrina (UEL).</p>
</sec>
<sec id="s7">
<title>Author Contributions</title>
<p>SMB designed the study and conducted most of the experiments, analyzed the data, and wrote the article. SB, FP-R, VF, TTC, FR-O, TZ, and CF designed and performed experiments. AC, FC, TMC, and RC contributed reagents, analytical tools, and expert intellectual support for the study. WV conceived and designed the study and supervised the project. SMB and WV analyzed the data and wrote the paper. All authors read and revised the paper and approved the final version of the article.</p>
</sec>
<sec id="s8">
<title>Funding</title>
<p>This work was supported by grants from Coordenadoria de Aperfei&#xe7;oamento de Pessoal de N&#xed;vel Superior (CAPES, finance code 001), Conselho Nacional de Desenvolvimento Cient&#xed;fico e Tecnol&#xf3;gico (CNPq), S&#xe3;o Paulo Research Foundation (grant number 2013/08216-2; Center for Research in Inflammatory Disease&#x2013;CRID), Programa de Apoio a Grupos de Excel&#xea;ncia (PRONEX) grant supported by SETI (Secretaria da Ci&#xea;ncia, Tecnologia e Ensino Superior)/Arauc&#xe1;ria Foundation and MCTI (Minist&#xe9;rio da Ci&#xea;ncia, Tecnologia e Inova&#xe7;&#xe3;o)/CNPq, and Paran&#xe1; State Government (agreement 014/2017, protocol 46.843) (Brazil). SMB acknowledges Funda&#xe7;&#xe3;o Nacional de Desenvolvimento do Ensino Superior Particular (FUNADESP; grant number 5301159) research fellowship. FC, TMC, RC, and WV acknowledge the CNPq productivity research fellowship. The confocal microscope was acquired by a project supported by Financiadora de Estudo e Projetos (FINEP)-Apoio &#xe0; Infraestrutura (CT-INFRA 01/2011; process 01.13.0049.00). During the conduction of the study, SMB received postdoctoral fellowships from CAPES and&#x20;CNPq.</p>
</sec>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s10">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations or those of the publisher, the editors, and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s11">
<title>Supplementary Material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fphar.2021.734091/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fphar.2021.734091/full&#x23;supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="DataSheet1.PDF" id="SM1" mimetype="application/PDF" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Almeida</surname>
<given-names>F. R.</given-names>
</name>
<name>
<surname>Schivo</surname>
<given-names>I. R.</given-names>
</name>
<name>
<surname>Lorenzetti</surname>
<given-names>B. B.</given-names>
</name>
<name>
<surname>Ferreira</surname>
<given-names>S. H.</given-names>
</name>
</person-group> (<year>2000</year>). <article-title>Chronic Intrathecal Cannulation Enhances Nociceptive Responses in Rats</article-title>. <source>Braz. J.&#x20;Med. Biol. Res.</source> <volume>33</volume>, <fpage>949</fpage>&#x2013;<lpage>956</lpage>. <pub-id pub-id-type="doi">10.1590/s0100-879x2000000800011</pub-id> </citation>
</ref>
<ref id="B2">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Anrather</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Racchumi</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Iadecola</surname>
<given-names>C.</given-names>
</name>
</person-group> (<year>2006</year>). <article-title>NF-kappaB Regulates Phagocytic NADPH Oxidase by Inducing the Expression of Gp91phox</article-title>. <source>J.&#x20;Biol. Chem.</source> <volume>281</volume>, <fpage>5657</fpage>&#x2013;<lpage>5667</lpage>. <pub-id pub-id-type="doi">10.1074/jbc.M506172200</pub-id> </citation>
</ref>
<ref id="B3">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Basbaum</surname>
<given-names>A. I.</given-names>
</name>
<name>
<surname>Bautista</surname>
<given-names>D. M.</given-names>
</name>
<name>
<surname>Scherrer</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Julius</surname>
<given-names>D.</given-names>
</name>
</person-group> (<year>2009</year>). <article-title>Cellular and Molecular Mechanisms of Pain</article-title>. <source>Cell</source> <volume>139</volume>, <fpage>267</fpage>&#x2013;<lpage>284</lpage>. <pub-id pub-id-type="doi">10.1016/j.cell.2009.09.028</pub-id> </citation>
</ref>
<ref id="B4">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Borghi</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Zarpelon</surname>
<given-names>A. C.</given-names>
</name>
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>F. A.</given-names>
</name>
<name>
<surname>Cardoso</surname>
<given-names>R. D.</given-names>
</name>
<name>
<surname>Cunha</surname>
<given-names>T. M.</given-names>
</name>
<name>
<surname>Alves-Filho</surname>
<given-names>J.&#x20;C.</given-names>
</name>
<etal/>
</person-group> (<year>2014a</year>). <article-title>Targeting Interleukin-1&#x3b2; Reduces Intense Acute Swimming-Induced Muscle Mechanical Hyperalgesia in Mice</article-title>. <source>J.&#x20;Pharm. Pharmacol.</source> <volume>66</volume>, <fpage>1009</fpage>&#x2013;<lpage>1020</lpage>. <pub-id pub-id-type="doi">10.1111/jphp.12226</pub-id> </citation>
</ref>
<ref id="B5">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Borghi</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Zarpelon</surname>
<given-names>A. C.</given-names>
</name>
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>F. A.</given-names>
</name>
<name>
<surname>Cardoso</surname>
<given-names>R. D.</given-names>
</name>
<name>
<surname>Martins-Pinge</surname>
<given-names>M. C.</given-names>
</name>
<name>
<surname>Tatakihara</surname>
<given-names>R. I.</given-names>
</name>
<etal/>
</person-group> (<year>2014b</year>). <article-title>Role of TNF-&#x3b1;/TNFR1 in Intense Acute Swimming-Induced Delayed Onset Muscle Soreness in Mice</article-title>. <source>Physiol. Behav.</source> <volume>128</volume>, <fpage>277</fpage>&#x2013;<lpage>287</lpage>. <pub-id pub-id-type="doi">10.1016/j.physbeh.2014.01.023</pub-id> </citation>
</ref>
<ref id="B6">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Borghi</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>F. A.</given-names>
</name>
<name>
<surname>Zarpelon</surname>
<given-names>A. C.</given-names>
</name>
<name>
<surname>Cunha</surname>
<given-names>T. M.</given-names>
</name>
<name>
<surname>Alves-Filho</surname>
<given-names>J.&#x20;C.</given-names>
</name>
<name>
<surname>Ferreira</surname>
<given-names>S. H.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Interleukin-10 Limits Intense Acute Swimming-Induced Muscle Mechanical Hyperalgesia in Mice</article-title>. <source>Exp. Physiol.</source> <volume>100</volume>, <fpage>531</fpage>&#x2013;<lpage>544</lpage>. <pub-id pub-id-type="doi">10.1113/ep085026</pub-id> </citation>
</ref>
<ref id="B7">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Borghi</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>F. A.</given-names>
</name>
<name>
<surname>Fattori</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Bussmann</surname>
<given-names>A. J.</given-names>
</name>
<name>
<surname>Vignoli</surname>
<given-names>J.&#x20;A.</given-names>
</name>
<name>
<surname>Camilios-Neto</surname>
<given-names>D.</given-names>
</name>
<etal/>
</person-group> (<year>2016</year>). <article-title>Quercetin Inhibits Peripheral and Spinal Cord Nociceptive Mechanisms to Reduce Intense Acute Swimming-Induced Muscle Pain in Mice</article-title>. <source>PLoS One</source> <volume>11</volume>, <fpage>e0162267</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pone.0162267</pub-id> </citation>
</ref>
<ref id="B8">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Borghi</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Fattori</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>F. A.</given-names>
</name>
<name>
<surname>Domiciano</surname>
<given-names>T. P.</given-names>
</name>
<name>
<surname>Miranda-Sapla</surname>
<given-names>M. M.</given-names>
</name>
<name>
<surname>Zaninelli</surname>
<given-names>T. H.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>Contribution of Spinal Cord Glial Cells to L. Amazonensis Experimental Infection-Induced Pain in BALB/c Mice</article-title>. <source>J.&#x20;Neuroinflamm.</source> <volume>16</volume>, <fpage>113</fpage>. <pub-id pub-id-type="doi">10.1186/s12974-019-1496-2</pub-id> </citation>
</ref>
<ref id="B9">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Borghi</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Fattori</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Carvalho</surname>
<given-names>T. T.</given-names>
</name>
<name>
<surname>Tatakihara</surname>
<given-names>V. L. H.</given-names>
</name>
<name>
<surname>Zaninelli</surname>
<given-names>T. H.</given-names>
</name>
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>F. A.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>Experimental Trypanosoma Cruzi Infection Induces Pain in Mice Dependent on Early Spinal Cord Glial Cells and NF&#x3ba;B Activation and Cytokine Production</article-title>. <source>Front. Immunol.</source> <volume>11</volume>, <fpage>539086</fpage>. <pub-id pub-id-type="doi">10.3389/fimmu.2020.539086</pub-id> </citation>
</ref>
<ref id="B10">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bullitt</surname>
<given-names>E.</given-names>
</name>
</person-group> (<year>1990</year>). <article-title>Expression of C-fos-like Protein as a Marker for Neuronal Activity Following Noxious Stimulation in the Rat</article-title>. <source>J.&#x20;Comp. Neurol.</source> <volume>296</volume>, <fpage>517</fpage>&#x2013;<lpage>530</lpage>. <pub-id pub-id-type="doi">10.1002/cne.902960402</pub-id> </citation>
</ref>
<ref id="B11">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Luo</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Qadri</surname>
<given-names>M. Y.</given-names>
</name>
<name>
<surname>Berta</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Ji</surname>
<given-names>R. R.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Sex-Dependent Glial Signaling in Pathological Pain: Distinct Roles of Spinal Microglia and Astrocytes</article-title>. <source>Neurosci. Bull.</source> <volume>34</volume>, <fpage>98</fpage>&#x2013;<lpage>108</lpage>. <pub-id pub-id-type="doi">10.1007/s12264-017-0145-y</pub-id> </citation>
</ref>
<ref id="B12">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Qin</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Tang</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>K.</given-names>
</name>
<etal/>
</person-group> (<year>2020</year>). <article-title>The Role of Astrocytes in Oxidative Stress of central Nervous System: A Mixed Blessing</article-title>. <source>Cell Prolif.</source> <volume>53</volume>, <fpage>e12781</fpage>. <pub-id pub-id-type="doi">10.1111/cpr.12781</pub-id> </citation>
</ref>
<ref id="B13">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cheung</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Hume</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Maxwell</surname>
<given-names>L.</given-names>
</name>
</person-group> (<year>2003</year>). <article-title>Delayed Onset Muscle Soreness : Treatment Strategies and Performance Factors</article-title>. <source>Sports Med.</source> <volume>33</volume>, <fpage>145</fpage>&#x2013;<lpage>164</lpage>. <pub-id pub-id-type="doi">10.2165/00007256-200333020-00005</pub-id> </citation>
</ref>
<ref id="B14">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Connolly</surname>
<given-names>D. A.</given-names>
</name>
<name>
<surname>Sayers</surname>
<given-names>S. P.</given-names>
</name>
<name>
<surname>Mchugh</surname>
<given-names>M. P.</given-names>
</name>
</person-group> (<year>2003</year>). <article-title>Treatment and Prevention of Delayed Onset Muscle Soreness</article-title>. <source>J.&#x20;Strength Cond Res.</source> <volume>17</volume>, <fpage>197</fpage>&#x2013;<lpage>208</lpage>. <pub-id pub-id-type="doi">10.1519/1533-4287(2003)017&#x3c;0197:tapodo&#x3e;2.0.co;2</pub-id> </citation>
</ref>
<ref id="B15">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cunha</surname>
<given-names>T. M.</given-names>
</name>
<name>
<surname>Verri</surname>
<given-names>W. A.</given-names>
<suffix>Jr.</suffix>
</name>
<name>
<surname>Vivancos</surname>
<given-names>G. G.</given-names>
</name>
<name>
<surname>Moreira</surname>
<given-names>I. F.</given-names>
</name>
<name>
<surname>Reis</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Parada</surname>
<given-names>C. A.</given-names>
</name>
<etal/>
</person-group> (<year>2004</year>). <article-title>An Electronic Pressure-Meter Nociception Paw Test for Mice</article-title>. <source>Braz. J.&#x20;Med. Biol. Res.</source> <volume>37</volume>, <fpage>401</fpage>&#x2013;<lpage>407</lpage>. <pub-id pub-id-type="doi">10.1590/s0100-879x2004000300018</pub-id> </citation>
</ref>
<ref id="B16">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Dannecker</surname>
<given-names>E. A.</given-names>
</name>
<name>
<surname>Koltyn</surname>
<given-names>K. F.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Pain During and within Hours after Exercise in Healthy Adults</article-title>. <source>Sports Med.</source> <volume>44</volume>, <fpage>921</fpage>&#x2013;<lpage>942</lpage>. <pub-id pub-id-type="doi">10.1007/s40279-014-0172-z</pub-id> </citation>
</ref>
<ref id="B17">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Dos Santos</surname>
<given-names>R. S.</given-names>
</name>
<name>
<surname>Veras</surname>
<given-names>F. P.</given-names>
</name>
<name>
<surname>Ferreira</surname>
<given-names>D. W.</given-names>
</name>
<name>
<surname>Sant&#x27;anna</surname>
<given-names>M. B.</given-names>
</name>
<name>
<surname>Lollo</surname>
<given-names>P. C. B.</given-names>
</name>
<name>
<surname>Cunha</surname>
<given-names>T. M.</given-names>
</name>
<etal/>
</person-group> (<year>2020</year>). <article-title>Involvement of the Hsp70/TLR4/IL-6 and TNF-&#x3b1; Pathways in Delayed-Onset Muscle Soreness</article-title>. <source>J.&#x20;Neurochem.</source> <volume>155</volume>, <fpage>29</fpage>&#x2013;<lpage>44</lpage>. <pub-id pub-id-type="doi">10.1111/jnc.15006</pub-id> </citation>
</ref>
<ref id="B18">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gao</surname>
<given-names>Y. J.</given-names>
</name>
<name>
<surname>Ji</surname>
<given-names>R. R.</given-names>
</name>
</person-group> (<year>2010</year>). <article-title>Chemokines, Neuronal-Glial Interactions, and central Processing of Neuropathic Pain</article-title>. <source>Pharmacol. Ther.</source> <volume>126</volume>, <fpage>56</fpage>&#x2013;<lpage>68</lpage>. <pub-id pub-id-type="doi">10.1016/j.pharmthera.2010.01.002</pub-id> </citation>
</ref>
<ref id="B19">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Graven-Nielsen</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Arendt-Nielsen</surname>
<given-names>L.</given-names>
</name>
</person-group> (<year>2003</year>). <article-title>Induction and Assessment of Muscle Pain, Referred Pain, and Muscular Hyperalgesia</article-title>. <source>Curr. Pain Headache Rep.</source> <volume>7</volume>, <fpage>443</fpage>&#x2013;<lpage>451</lpage>. <pub-id pub-id-type="doi">10.1007/s11916-003-0060-y</pub-id> </citation>
</ref>
<ref id="B20">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hoheisel</surname>
<given-names>U.</given-names>
</name>
<name>
<surname>Koch</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Mense</surname>
<given-names>S.</given-names>
</name>
</person-group> (<year>1994</year>). <article-title>Functional Reorganization in the Rat Dorsal Horn during an Experimental Myositis</article-title>. <source>Pain</source> <volume>59</volume>, <fpage>111</fpage>&#x2013;<lpage>118</lpage>. <pub-id pub-id-type="doi">10.1016/0304-3959(94)90054-x</pub-id> </citation>
</ref>
<ref id="B21">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hosseinzadeh</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Andersen</surname>
<given-names>O. K.</given-names>
</name>
<name>
<surname>Arendt-Nielsen</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Madeleine</surname>
<given-names>P.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Pain Sensitivity Is Normalized after a Repeated Bout of Eccentric Exercise</article-title>. <source>Eur. J.&#x20;Appl. Physiol.</source> <volume>113</volume>, <fpage>2595</fpage>&#x2013;<lpage>2602</lpage>. <pub-id pub-id-type="doi">10.1007/s00421-013-2701-0</pub-id> </citation>
</ref>
<ref id="B22">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hunt</surname>
<given-names>S. P.</given-names>
</name>
<name>
<surname>Pini</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Evan</surname>
<given-names>G.</given-names>
</name>
</person-group> (<year>1987</year>). <article-title>Induction of C-fos-Like Protein in Spinal Cord Neurons Following Sensory Stimulation</article-title>. <source>Nature</source> <volume>328</volume>, <fpage>632</fpage>&#x2013;<lpage>634</lpage>. <pub-id pub-id-type="doi">10.1038/328632a0</pub-id> </citation>
</ref>
<ref id="B23">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kilkenny</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Browne</surname>
<given-names>W. J.</given-names>
</name>
<name>
<surname>Cuthill</surname>
<given-names>I. C.</given-names>
</name>
<name>
<surname>Emerson</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Altman</surname>
<given-names>D. G.</given-names>
</name>
</person-group> (<year>2010</year>). <article-title>Improving Bioscience Research Reporting: the ARRIVE Guidelines for Reporting Animal Research</article-title>. <source>Plos Biol.</source> <volume>8</volume>, <fpage>e1000412</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pbio.1000412</pub-id> </citation>
</ref>
<ref id="B24">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kobayashi</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Imagama</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Ohgomori</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Hirano</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Uchimura</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Sakamoto</surname>
<given-names>K.</given-names>
</name>
<etal/>
</person-group> (<year>2013</year>). <article-title>Minocycline Selectively Inhibits M1 Polarization of Microglia</article-title>. <source>Cell Death Dis</source> <volume>4</volume>, <fpage>e525</fpage>. <pub-id pub-id-type="doi">10.1038/cddis.2013.54</pub-id> </citation>
</ref>
<ref id="B25">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Krukowski</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Eijkelkamp</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Laumet</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Hack</surname>
<given-names>C. E.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Dougherty</surname>
<given-names>P. M.</given-names>
</name>
<etal/>
</person-group> (<year>2016</year>). <article-title>CD8&#x2b; T&#x20;Cells and Endogenous IL-10 Are Required for Resolution of Chemotherapy-Induced Neuropathic Pain</article-title>. <source>J.&#x20;Neurosci.</source> <volume>36</volume>, <fpage>11074</fpage>&#x2013;<lpage>11083</lpage>. <pub-id pub-id-type="doi">10.1523/JNEUROSCI.3708-15.2016</pub-id> </citation>
</ref>
<ref id="B26">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kubo</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Koyama</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Tamura</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Takagishi</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Murase</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Mizumura</surname>
<given-names>K.</given-names>
</name>
</person-group> (<year>2012</year>). <article-title>Absence of Mechanical Hyperalgesia after Exercise (Delayed Onset Muscle Soreness) in Neonatally Capsaicin-Treated Rats</article-title>. <source>Neurosci. Res.</source> <volume>73</volume>, <fpage>56</fpage>&#x2013;<lpage>60</lpage>. <pub-id pub-id-type="doi">10.1016/j.neures.2012.02.005</pub-id> </citation>
</ref>
<ref id="B27">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kuphal</surname>
<given-names>K. E.</given-names>
</name>
<name>
<surname>Fibuch</surname>
<given-names>E. E.</given-names>
</name>
<name>
<surname>Taylor</surname>
<given-names>B. K.</given-names>
</name>
</person-group> (<year>2007</year>). <article-title>Extended Swimming Exercise Reduces Inflammatory and Peripheral Neuropathic Pain in Rodents</article-title>. <source>J.&#x20;Pain</source> <volume>8</volume>, <fpage>989</fpage>&#x2013;<lpage>997</lpage>. <pub-id pub-id-type="doi">10.1016/j.jpain.2007.08.001</pub-id> </citation>
</ref>
<ref id="B28">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lee</surname>
<given-names>K. M.</given-names>
</name>
<name>
<surname>Kang</surname>
<given-names>B. S.</given-names>
</name>
<name>
<surname>Lee</surname>
<given-names>H. L.</given-names>
</name>
<name>
<surname>Son</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Hwang</surname>
<given-names>S. H.</given-names>
</name>
<name>
<surname>Kim</surname>
<given-names>D. S.</given-names>
</name>
<etal/>
</person-group> (<year>2004</year>). <article-title>Spinal NF-kB Activation Induces COX-2 Upregulation and Contributes to Inflammatory Pain Hypersensitivity</article-title>. <source>Eur. J.&#x20;Neurosci.</source> <volume>19</volume>, <fpage>3375</fpage>&#x2013;<lpage>3381</lpage>. <pub-id pub-id-type="doi">10.1111/j.0953-816X.2004.03441.x</pub-id> </citation>
</ref>
<ref id="B29">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Li</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Guo</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Guo</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Feng</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>X.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Spinal NF-kB Upregulation Contributes to Hyperalgesia in a Rat Model of Advanced Osteoarthritis</article-title>. <source>Mol. Pain</source> <volume>16</volume>, <fpage>1744806920905691</fpage>. <pub-id pub-id-type="doi">10.1177/1744806920905691</pub-id> </citation>
</ref>
<ref id="B30">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liu</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Tang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Feng</surname>
<given-names>J.</given-names>
</name>
</person-group> (<year>2011</year>). <article-title>Cross Talk between Activation of Microglia and Astrocytes in Pathological Conditions in the central Nervous System</article-title>. <source>Life Sci.</source> <volume>89</volume>, <fpage>141</fpage>&#x2013;<lpage>146</lpage>. <pub-id pub-id-type="doi">10.1016/j.lfs.2011.05.011</pub-id> </citation>
</ref>
<ref id="B31">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liu</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Wei</surname>
<given-names>F.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>NF-kB Mediated CX3CL1 Activation in the Dorsal Root Ganglion Contributes to the Maintenance of Neuropathic Pain Induced in Adult Male Sprague Dawley Rats1</article-title>. <source>Acta Cir Bras.</source> <volume>33</volume>, <fpage>619</fpage>&#x2013;<lpage>628</lpage>. <pub-id pub-id-type="doi">10.1590/s0102-865020180070000007</pub-id> </citation>
</ref>
<ref id="B32">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>MacIntyre</surname>
<given-names>D. L.</given-names>
</name>
<name>
<surname>Reid</surname>
<given-names>W. D.</given-names>
</name>
<name>
<surname>Mckenzie</surname>
<given-names>D. C.</given-names>
</name>
</person-group> (<year>1995</year>). <article-title>Delayed Muscle Soreness. The Inflammatory Response to Muscle Injury and its Clinical Implications</article-title>. <source>Sports Med.</source> <volume>20</volume>, <fpage>24</fpage>&#x2013;<lpage>40</lpage>. <pub-id pub-id-type="doi">10.2165/00007256-199520010-00003</pub-id> </citation>
</ref>
<ref id="B33">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Matejuk</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Ransohoff</surname>
<given-names>R. M.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Crosstalk between Astrocytes and Microglia: An Overview</article-title>. <source>Front. Immunol.</source> <volume>11</volume>, <fpage>1416</fpage>. <pub-id pub-id-type="doi">10.3389/fimmu.2020.01416</pub-id> </citation>
</ref>
<ref id="B34">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Matsubara</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Hayashi</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Wakatsuki</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Abe</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Ozaki</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Yamanaka</surname>
<given-names>A.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>Thin-fibre Receptors Expressing Acid-Sensing Ion Channel 3 Contribute to Muscular Mechanical Hypersensitivity after Exercise</article-title>. <source>Eur. J.&#x20;Pain</source> <volume>23</volume>, <fpage>1801</fpage>&#x2013;<lpage>1813</lpage>. <pub-id pub-id-type="doi">10.1002/ejp.1454</pub-id> </citation>
</ref>
<ref id="B35">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Milligan</surname>
<given-names>E. D.</given-names>
</name>
<name>
<surname>Zapata</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Chacur</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Schoeniger</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Biedenkapp</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>O&#x27;connor</surname>
<given-names>K. A.</given-names>
</name>
<etal/>
</person-group> (<year>2004</year>). <article-title>Evidence that Exogenous and Endogenous Fractalkine Can Induce Spinal Nociceptive Facilitation in Rats</article-title>. <source>Eur. J.&#x20;Neurosci.</source> <volume>20</volume>, <fpage>2294</fpage>&#x2013;<lpage>2302</lpage>. <pub-id pub-id-type="doi">10.1111/j.1460-9568.2004.03709.x</pub-id> </citation>
</ref>
<ref id="B36">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Milligan</surname>
<given-names>E. D.</given-names>
</name>
<name>
<surname>Penzkover</surname>
<given-names>K. R.</given-names>
</name>
<name>
<surname>Soderquist</surname>
<given-names>R. G.</given-names>
</name>
<name>
<surname>Mahoney</surname>
<given-names>M. J.</given-names>
</name>
</person-group> (<year>2012</year>). <article-title>Spinal Interleukin-10 Therapy to Treat Peripheral Neuropathic Pain</article-title>. <source>Neuromodulation</source> <volume>15</volume>, <fpage>520</fpage>&#x2013;<lpage>526</lpage>. <comment>discussion 526</comment>. <pub-id pub-id-type="doi">10.1111/j.1525-1403.2012.00462.x</pub-id> </citation>
</ref>
<ref id="B37">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Murase</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Terazawa</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Queme</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Ota</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Matsuda</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Hirate</surname>
<given-names>K.</given-names>
</name>
<etal/>
</person-group> (<year>2010</year>). <article-title>Bradykinin and Nerve Growth Factor Play Pivotal Roles in Muscular Mechanical Hyperalgesia after Exercise (Delayed-onset Muscle Soreness)</article-title>. <source>J.&#x20;Neurosci.</source> <volume>30</volume>, <fpage>3752</fpage>&#x2013;<lpage>3761</lpage>. <pub-id pub-id-type="doi">10.1523/JNEUROSCI.3803-09.2010</pub-id> </citation>
</ref>
<ref id="B38">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Murase</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Terazawa</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Hirate</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Yamanaka</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Kanda</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Noguchi</surname>
<given-names>K.</given-names>
</name>
<etal/>
</person-group> (<year>2013</year>). <article-title>Upregulated Glial Cell Line-Derived Neurotrophic Factor through Cyclooxygenase-2 Activation in the Muscle Is Required for Mechanical Hyperalgesia after Exercise in Rats</article-title>. <source>J.&#x20;Physiol.</source> <volume>591</volume>, <fpage>3035</fpage>&#x2013;<lpage>3048</lpage>. <pub-id pub-id-type="doi">10.1113/jphysiol.2012.249235</pub-id> </citation>
</ref>
<ref id="B39">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Pahl</surname>
<given-names>H. L.</given-names>
</name>
</person-group> (<year>1999</year>). <article-title>Activators and Target Genes of Rel/NF-kappaB Transcription Factors</article-title>. <source>Oncogene</source> <volume>18</volume>, <fpage>6853</fpage>&#x2013;<lpage>6866</lpage>. <pub-id pub-id-type="doi">10.1038/sj.onc.1203239</pub-id> </citation>
</ref>
<ref id="B40">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Panneton</surname>
<given-names>W. M.</given-names>
</name>
<name>
<surname>Gan</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Juric</surname>
<given-names>R.</given-names>
</name>
</person-group> (<year>2005</year>). <article-title>The central Termination of Sensory Fibers from Nerves to the Gastrocnemius Muscle of the Rat</article-title>. <source>Neuroscience</source> <volume>134</volume>, <fpage>175</fpage>&#x2013;<lpage>187</lpage>. <pub-id pub-id-type="doi">10.1016/j.neuroscience.2005.02.032</pub-id> </citation>
</ref>
<ref id="B41">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Pereira</surname>
<given-names>B. C.</given-names>
</name>
<name>
<surname>Lucas</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Da Rocha</surname>
<given-names>A. L.</given-names>
</name>
<name>
<surname>Pauli</surname>
<given-names>J.&#x20;R.</given-names>
</name>
<name>
<surname>Ropelle</surname>
<given-names>E. R.</given-names>
</name>
<name>
<surname>Cintra</surname>
<given-names>D.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Eccentric Exercise Leads to Glial Activation but Not Apoptosis in Mice Spinal Cords</article-title>. <source>Int. J.&#x20;Sports Med.</source> <volume>36</volume>, <fpage>378</fpage>&#x2013;<lpage>385</lpage>. <pub-id pub-id-type="doi">10.1055/s-0034-1395589</pub-id> </citation>
</ref>
<ref id="B42">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Pinho-Ribeiro</surname>
<given-names>F. A.</given-names>
</name>
<name>
<surname>Verri</surname>
<given-names>W. A.</given-names>
<suffix>Jr.</suffix>
</name>
<name>
<surname>Chiu</surname>
<given-names>I. M.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Nociceptor Sensory Neuron-Immune Interactions in Pain and Inflammation</article-title>. <source>Trends Immunol.</source> <volume>38</volume>, <fpage>5</fpage>&#x2013;<lpage>19</lpage>. <pub-id pub-id-type="doi">10.1016/j.it.2016.10.001</pub-id> </citation>
</ref>
<ref id="B43">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Poole</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Cunha</surname>
<given-names>F. Q.</given-names>
</name>
<name>
<surname>Selkirk</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Lorenzetti</surname>
<given-names>B. B.</given-names>
</name>
<name>
<surname>Ferreira</surname>
<given-names>S. H.</given-names>
</name>
</person-group> (<year>1995</year>). <article-title>Cytokine-mediated Inflammatory Hyperalgesia Limited by Interleukin-10</article-title>. <source>Br. J.&#x20;Pharmacol.</source> <volume>115</volume>, <fpage>684</fpage>&#x2013;<lpage>688</lpage>. <pub-id pub-id-type="doi">10.1111/j.1476-5381.1995.tb14987.x</pub-id> </citation>
</ref>
<ref id="B44">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rustay</surname>
<given-names>N. R.</given-names>
</name>
<name>
<surname>Wahlsten</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Crabbe</surname>
<given-names>J.&#x20;C.</given-names>
</name>
</person-group> (<year>2003</year>). <article-title>Assessment of Genetic Susceptibility to Ethanol Intoxication in Mice</article-title>. <source>Proc. Natl. Acad. Sci. U S A.</source> <volume>100</volume>, <fpage>2917</fpage>&#x2013;<lpage>2922</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.0437273100</pub-id> </citation>
</ref>
<ref id="B45">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sorge</surname>
<given-names>R. E.</given-names>
</name>
<name>
<surname>Mapplebeck</surname>
<given-names>J.&#x20;C.</given-names>
</name>
<name>
<surname>Rosen</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Beggs</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Taves</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Alexander</surname>
<given-names>J.&#x20;K.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Different Immune Cells Mediate Mechanical Pain Hypersensitivity in Male and Female Mice</article-title>. <source>Nat. Neurosci.</source> <volume>18</volume>, <fpage>1081</fpage>&#x2013;<lpage>1083</lpage>. <pub-id pub-id-type="doi">10.1038/nn.4053</pub-id> </citation>
</ref>
<ref id="B46">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Souza</surname>
<given-names>G. R.</given-names>
</name>
<name>
<surname>Talbot</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Lotufo</surname>
<given-names>C. M.</given-names>
</name>
<name>
<surname>Cunha</surname>
<given-names>F. Q.</given-names>
</name>
<name>
<surname>Cunha</surname>
<given-names>T. M.</given-names>
</name>
<name>
<surname>Ferreira</surname>
<given-names>S. H.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Fractalkine Mediates Inflammatory Pain through Activation of Satellite Glial Cells</article-title>. <source>Proc. Natl. Acad. Sci. U S A.</source> <volume>110</volume>, <fpage>11193</fpage>&#x2013;<lpage>11198</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.1307445110</pub-id> </citation>
</ref>
<ref id="B47">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Souza</surname>
<given-names>G. R.</given-names>
</name>
<name>
<surname>Cunha</surname>
<given-names>T. M.</given-names>
</name>
<name>
<surname>Silva</surname>
<given-names>R. L.</given-names>
</name>
<name>
<surname>Lotufo</surname>
<given-names>C. M.</given-names>
</name>
<name>
<surname>Verri</surname>
<given-names>W. A.</given-names>
<suffix>Jr.</suffix>
</name>
<name>
<surname>Funez</surname>
<given-names>M. I.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Involvement of Nuclear Factor Kappa B in the Maintenance of Persistent Inflammatory Hypernociception</article-title>. <source>Pharmacol. Biochem. Behav.</source> <volume>134</volume>, <fpage>49</fpage>&#x2013;<lpage>56</lpage>. <pub-id pub-id-type="doi">10.1016/j.pbb.2015.04.005</pub-id> </citation>
</ref>
<ref id="B48">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Str&#xf6;mberg</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Olsson</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Dijksterhuis</surname>
<given-names>J.&#x20;P.</given-names>
</name>
<name>
<surname>Rullman</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Schulte</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Gustafsson</surname>
<given-names>T.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>CX3CL1--a Macrophage Chemoattractant Induced by a Single Bout of Exercise in Human Skeletal Muscle</article-title>. <source>Am. J.&#x20;Physiol. Regul. Integr. Comp. Physiol.</source> <volume>310</volume>, <fpage>R297</fpage>&#x2013;<lpage>R304</lpage>. <pub-id pub-id-type="doi">10.1152/ajpregu.00236.2015</pub-id> </citation>
</ref>
<ref id="B49">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Taylor</surname>
<given-names>J.&#x20;L.</given-names>
</name>
<name>
<surname>Butler</surname>
<given-names>J.&#x20;E.</given-names>
</name>
<name>
<surname>Gandevia</surname>
<given-names>S. C.</given-names>
</name>
</person-group> (<year>2000</year>). <article-title>Changes in Muscle Afferents, Motoneurons and Motor Drive during Muscle Fatigue</article-title>. <source>Eur. J.&#x20;Appl. Physiol.</source> <volume>83</volume>, <fpage>106</fpage>&#x2013;<lpage>115</lpage>. <pub-id pub-id-type="doi">10.1007/s004210000269</pub-id> </citation>
</ref>
<ref id="B50">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Vanderwall</surname>
<given-names>A. G.</given-names>
</name>
<name>
<surname>Milligan</surname>
<given-names>E. D.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Cytokines in Pain: Harnessing Endogenous Anti-Inflammatory Signaling for Improved Pain Management</article-title>. <source>Front. Immunol.</source> <volume>10</volume>, <fpage>3009</fpage>. <pub-id pub-id-type="doi">10.3389/fimmu.2019.03009</pub-id> </citation>
</ref>
<ref id="B51">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Voss</surname>
<given-names>L. J.</given-names>
</name>
<name>
<surname>Harvey</surname>
<given-names>M. G.</given-names>
</name>
<name>
<surname>Sleigh</surname>
<given-names>J.&#x20;W.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>Inhibition of Astrocyte Metabolism Is Not the Primary Mechanism for Anaesthetic Hypnosis</article-title>. <source>Springerplus</source> <volume>5</volume>, <fpage>1041</fpage>. <pub-id pub-id-type="doi">10.1186/s40064-016-2734-z</pub-id> </citation>
</ref>
<ref id="B52">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wang</surname>
<given-names>Z. Q.</given-names>
</name>
<name>
<surname>Porreca</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Cuzzocrea</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Galen</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Lightfoot</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Masini</surname>
<given-names>E.</given-names>
</name>
<etal/>
</person-group> (<year>2004</year>). <article-title>A Newly Identified Role for Superoxide in Inflammatory Pain</article-title>. <source>J.&#x20;Pharmacol. Exp. Ther.</source> <volume>309</volume>, <fpage>869</fpage>&#x2013;<lpage>878</lpage>. <pub-id pub-id-type="doi">10.1124/jpet.103.064154</pub-id> </citation>
</ref>
<ref id="B53">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wolf</surname>
<given-names>S. A.</given-names>
</name>
<name>
<surname>Boddeke</surname>
<given-names>H. W.</given-names>
</name>
<name>
<surname>Kettenmann</surname>
<given-names>H.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Microglia in Physiology and Disease</article-title>. <source>Annu. Rev. Physiol.</source> <volume>79</volume>, <fpage>619</fpage>&#x2013;<lpage>643</lpage>. <pub-id pub-id-type="doi">10.1146/annurev-physiol-022516-034406</pub-id> </citation>
</ref>
<ref id="B54">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zarpelon</surname>
<given-names>A. C.</given-names>
</name>
<name>
<surname>Rodrigues</surname>
<given-names>F. C.</given-names>
</name>
<name>
<surname>Lopes</surname>
<given-names>A. H.</given-names>
</name>
<name>
<surname>Souza</surname>
<given-names>G. R.</given-names>
</name>
<name>
<surname>Carvalho</surname>
<given-names>T. T.</given-names>
</name>
<name>
<surname>Pinto</surname>
<given-names>L. G.</given-names>
</name>
<etal/>
</person-group> (<year>2016</year>). <article-title>Spinal Cord Oligodendrocyte-Derived Alarmin IL-33 Mediates Neuropathic Pain</article-title>. <source>FASEB J.</source> <volume>30</volume>, <fpage>54</fpage>&#x2013;<lpage>65</lpage>. <pub-id pub-id-type="doi">10.1096/fj.14-267146</pub-id> </citation>
</ref>
</ref-list>
</back>
</article>