Neuropeptide Y-expressing dorsal horn inhibitory interneurons gate spinal pain and itch signalling

Reviewer #1 (Public Review):

The first synapses of the pain pathway are concentrated in the superficial spinal cord dorsal horn. Here peripheral inputs are processed by local interneuron circuitry before ascending to the brain. The spinal dorsal horn is organized into lamina with the resident interneurons differentiated by their anatomy, physiological and molecular properties. Over the past decade, the restricted expression of select genes has been used to assign potential function to dorsal horn neuron "cell types". This type of work has relied on the genesis of Cre-reporter mouse strains and intersectional tools to generate mice where select sets of neurons can be activated, inhibited, or ablated. The picture that has emerged from these types of experiments is murky but favors the model where there exist genetically defined cell-types play distinct roles in the detection of painful, itchy, thermal, and mechanical stimuli under normal and pathological situations. The current work by Boyle and colleagues concerns itself with the dorsal horn neurons expressing the neuropeptide NPY. This study is directly related to previously published work that demonstrated that ablating spinal cord neurons that express Npy, including those who express this gene transiently during development, resulted in mice that had heightened touch-evoked itch that seemed different from the canonical chemical itch pathways previously identified. A major conclusion from this previous work was that other modalities were unaffected. Subsequent work built on these findings to identify the potential touch inputs and spinal neuron expressing the Npy receptor as part of a mechanical itch circuit.

This current work by Boyle and colleagues challenge challenges this view by providing evidence that in adult mice, the dorsal horn neurons expressing Npy function to broadly inhibit pain and itch. The authors use direct injection of viral vectors, chemogenetics and synaptic silencing to probe the behavioral effects of stimulating or silencing Npy-expressing dorsal horn neurons in a variety of assays under normal and pathological conditions known to produce allodynia and hyperalgesia. Overall, this is a rather carefully conducted study with the appropriate controls. The data are clear, the effect sizes robust and the presentation easy to follow. These findings challenge the conclusion that these neurons are involved selectively in mechanical itch and instead reveal a potentially clinical important group of neurons for pain.

Reviewer #2 (Public Review):

Whether and how molecularly defined neuronal groups in the spinal cord process distinct modalities are of great interest. In this study, Boyle et al. characterized roles of inhibitory neurons expressing NPY in adult mice. By using chemogenetic, electrophysiological tools and behavioral measurements, the authors discovered that activating NPY+ interneurons strongly reduced pruritogen-evoked itch and reflexive behaviors (acute nociception or under inflammation / neuropathic pain states). Silencing NPY+ spinal interneurons enhanced spontaneous and chemical itch in a GRPR+ neurons dependent manner. The authors concluded that, unlike previous findings suggesting that these neurons are selective for mechanical itch, adult NPY+ interneurons play dual roles in gating various types of itch and pain.

Strengths:

The authors performed careful characterization and comparisons between development lineage and adult spinal neurons expressing NPY. This lays the foundation of the current study. The behavioral measurements were also well designed with proper controls.

Weaknesses:

There is inadequate discussion about previous studies of NPY interneurons. Specifically, the authors should address why a more restricted subset of these neurons (this study) have broader effects than seen previously.

I cannot see the reason for including results from manipulation of Dyn+ interneurons in this paper. First, the title does not reflect roles of spinal Dyn+ population. In addition, without further experiments characterizing relationships between NPY and Dyn interneurons in modulating itch and/or nociception, Dyn datasets seem to deviate from the main theme.

While the authors provided convincing evidence that GRPR+ neurons serve as a downstream effector of NPY+ neuron evoked itch, the relationship between GRPR and NPY neurons in modulating pain is not examined. Therefore, Fig. 7B is pure speculation and should be removed.

Reviewer #3 (Public Review):

In the present study by Boyle et al., the function of NPY expressing spinal neurons in pain and itch perception is studied. While the function of these neurons has been addressed previously, the difference to previous studies is the combinatorial use of AAV encoded effectors and cre transgenic mice whereas previous studies relied on cre transgenic mice and reporter mice encoding the effector or only viruses. Boyle at al. demonstrate that their strategy enabled them to restrict the analysis to only those neurons expressing NPY in the adult mouse compared to a more heterogenous population that had been studied before. By using a combination of morphology, electrophysiology and behavioral paradigms they convincingly show that NPY neurons impact pruritoception via inhibiting GRPR neurons. Furthermore, they indicate a role of NPY neurons also in nociception as activation attenuates not only responses to acute nociceptive stimuli but also blocks inflammation or nerve injury induced mechanical and heat hypersensitivity. Selectively activating NPY neurons in vivo may therefore be a promising strategy to treat neuropathic pain.

The result of this study extends and partially contrasts previous studies. The authors argue that contrasting results may be due to the different experimental strategies (e.g. only neurons expressing NPY adult in the present study versus a more heterogeneous population before).

Overall, the experiments are convincing, and the quality of the data/figures is exceptionally high.