GPR30 in spinal cholecystokinin-positive neurons modulates neuropathic pain via mediating descending facilitation

Reviewer #1 (Public review):

In this manuscript, Chen et al. investigate the role of the membrane estrogen receptor GPR30 in spinal mechanisms of neuropathic pain. Using a wide variety of techniques, they first provide convincing evidence that GPR30 expression is restricted to neurons within the spinal cord, and that GPR30 neurons are well-positioned to receive descending input from the primary sensory cortex (S1). In addition, the authors put their findings in the context of the previous knowledge in the field, presenting evidence demonstrating that GRP30 is expressed in the majority of CCK-expressing spinal neurons. Overall, this manuscript furthers our understanding of neural circuity that underlies neuropathic pain and will be of broad interest to neuroscientists, especially those interested in somatosensation. Nevertheless, the manuscript would be strengthened by additional analyses and clarification of data that is currently presented.

Strengths:

The authors present convincing evidence for the expression of GPR30 in the spinal cord that is specific to spinal neurons. Similarly, complementary approaches including pharmacological inhibition and knockdown of GPR30 are used to demonstrate the role of the receptor in driving nerve injury-induced pain in rodent models.

Weaknesses:

Although steps were taken to put their data into the broader context of what is already known about the spinal circuitry of pain, more considerations and analyses would help the authors better achieve their goal. For instance, to determine whether GPR30 is expressed in excitatory or inhibitory neurons, more selective markers for these subtypes should be used over CamK2. Moreover, quantitative analysis of the extent of overlap between GRP30+ and CCK+ spinal neurons is needed to understand the potential heterogeneity of the GRP30 spinal neuron population, and to interpret experiments characterizing descending SI inputs onto GRP30 and CCK spinal neurons. Filling these gaps in knowledge would make their findings more solid.

Reviewer #2 (Public review):

Using a variety of experimental manipulations, the authors show that the membrane estrogen receptor G protein-coupled estrogen receptor (GPER/GPR30) expressed in CCK+ excitatory spinal interneurons plays a major role in the pain symptoms observed in the chronic constriction injury (CCI) model of neuropathic pain. Intrathecal application of selective GPR30 agonist G 1induced mechanical allodynia and thermal hyperalgesia in male and female mice. Downregulation of GPR30 in CCK+ interneurons prevented the development of mechanical and thermal hypersensitivity during CCI. They also show the up modulation of AMPA receptor expression by GPR30.

Generally, the conclusions are supported by the experimental results. I also would like to see significant improvements in the writing and the description of results.

Methodological details for some of the techniques are rather sparse. For example, when examining the co-localization of various markers, the authors do not indicate the number of animals/sections examined. Similarly, when examining the effect of shGper1, it is unclear how many cells/sections/animals were counted and analyzed.

In other sections, there is no description of the concentration of drugs used (for example, Figure 4H). In Figures 4C-E, there is no indication of the duration of the recordings, the ionic conditions, the effect of glutamate receptor blockers, etc

Some results appear anecdotal in the way they are described. For example, in Figure 5, it is unclear how many times this experiment was repeated.

Reviewer #3 (Public review):

Summary:

The authors convincingly demonstrate that a population of CCK+ spinal neurons in the deep dorsal horn express the G protein-coupled estrogen receptor GPR30 to modulate pain sensitivity in the chronic constriction injury (CCI) model of neuropathic pain in mice. Using complementary pharmacological and genetic knockdown experiments they convincingly show that GPR30 inhibition or knockdown reverses mechanical, tactile, and thermal hypersensitivity, conditioned place aversion, and c-fos staining in the spinal dorsal horn after CCI. They propose that GPR30 mediates an increase in postsynaptic AMPA receptors after CCI using slice electrophysiology which may underlie the increased behavioral sensitivity. They then use anterograde tracing approaches to show that CCK and GPR30 positive neurons in the deep dorsal horn may receive direct connections from the primary somatosensory cortex. Chemogenetic activation of these dorsal horn neurons proposed to be connected to S1 increased nociceptive sensitivity in a GPR30-dependent manner. Overall, the data are very convincing and the experiments are well conducted and adequately controlled. However, the proposed model of descending corticospinal facilitation of nociceptive sensitivity through GPR30 in a population of CCK+ neurons in the dorsal horn is not fully supported.

Strengths:

The experiments are very well executed and adequately controlled throughout the manuscript. The data are nicely presented and supportive of a role for GPR30 signaling in the spinal dorsal horn influencing nociceptive sensitivity following CCI. The authors also did an excellent job of using complementary approaches to rigorously test their hypothesis.

Weaknesses:

The primary weakness in this manuscript involves overextending the interpretations of the data to propose a direct link between corticospinal projections signaling through GPR30 on this CCK+ population of spinal dorsal horn neurons. For example, even in the cropped images presented, GPR30 is present in many other CCK-negative neurons. Only about a quarter of the cells labeled by the anterograde viral tracing experiment from S1 are CCK+. Since no direct evidence is provided for S1 signaling through GPR30, this conclusion should be revised.