Koui, Y. | bioRxiv Science

bioRxiv2026

OBESITY-INDUCED ENDOTHELIAL FENESTRATION AND CAPILLARY LEAKAGE CONTRIBUTE TO INCREASED PAIN SENSATION

Peripheral pain sensation is regulated by interactions between sensory nerves and various tissue cells. In obese patients with painful small fiber neuropathy, skin sensory nerves are often hypersensitive. While obesity is known to cause circulation-related vascular abnormalities, how these changes affect sensory dysfunction is not fully understood. In this study, we found that in a diet-induced obesity mouse model, skin capillaries become fenestrated, allowing insulin to diffuse into the avascular epidermis. This exposure triggers the production and secretion of nerve growth factor (NGF) from epidermal keratinocytes via insulin signaling with the forkhead box O1 (FOXO1) transcription factor. Elevated NGF leads to heightened sensory hypersensitivity by enhancing transient receptor potential vanilloid subtype 1 (TRPV1) in sensory nerves. Controlling capillary permeability reduces abnormal NGF expression and attenuates pain hypersensitivity. These findings nominate peripheral nerve-associated capillary permeability as a novel therapeutic target in obesity-associated sensory dysfunction.

neuroscience↗

bioRxiv2024

Local keratinocyte-nociceptor interactions enhance obesity-mediated small fiber neuropathy via NGF-TrkA-PI3K signaling axis

The pathology of diabetic small fiber neuropathy, characterized by neuropathic pain and axon degeneration, develops locally within the skin during the stages of obesity and pre-diabetes. However, the initiation and progression of morphological and functional abnormalities in skin sensory nerves remains elusive. To address this, we utilized ear skin from mice with diet-induced obesity (DIO), the mouse models for obesity and pre-type 2 diabetes. We evaluated pain-associated wiping behavior and conducted ex vivo live Ca2+ imaging of the DIO ear skin to detect sensory hypersensitivity. Our findings reveal sensory hypersensitivity in skin nociceptive axons followed by axon degeneration. Further mechanistic analysis identified keratinocytes as a major source of nerve growth factor (NGF) in DIO skin, which locally sensitizes nociceptors through NGF-mediated signaling. Indeed, the local inactivation of NGF and its receptor TrkA-mediated downstream signaling, including the phosphoinositide 3-kinases (PI3K) pathway, suppresses sensory hypersensitivity in DIO skin. Thus, targeting these local interactions between keratinocytes and nociceptors offers a therapeutic strategy for managing neuropathic pain, avoiding the adverse effects associated with systemic interventions.

neuroscience↗