Trevor Smith

Dr Trevor Smith


Research Associate

Academic and research departments

Surrey Sleep Research Centre.

Publications

Eduard Masvidal-Codina, Trevor M. Smith, Daman Rathore, Yunan Gao, Xavi Illa, Elisabet Prats-Alfonso, Elena Del Corro, Andrea Bonaccini Calia, Gemma Rius, Inigo Martin-Fernandez, Christoph Guger, Patrick Reitner, Rosa Villa, Jose A. Garrido, Anton Guimera-Brunet, Rob C. Wykes (2021)Characterization of optogenetically-induced cortical spreading depression in awake mice using graphene micro-transistor arrays, In: Journal of neural engineering18(5)055002 IOP Publishing Ltd

Objective. The development of experimental methodology utilizing graphene micro-transistor arrays to facilitate and advance translational research into cortical spreading depression (CSD) in the awake brain. Approach. CSDs were reliably induced in awake nontransgenic mice using optogenetic methods. High-fidelity DC-coupled electrophysiological mapping of propagating CSDs was obtained using flexible arrays of graphene soultion-gated field-effect transistors (gSGFETs). Main results. Viral vectors targetted channelrhopsin expression in neurons of the motor cortex resulting in a transduction volume 1 mm(3). 5-10 s of continous blue light stimulation induced CSD that propagated across the cortex at a velocity of 3.0 +/- 0.1 mm min(-1). Graphene micro-transistor arrays enabled high-density mapping of infraslow activity correlated with neuronal activity suppression across multiple frequency bands during both CSD initiation and propagation. Localized differences in the CSD waveform could be detected and categorized into distinct clusters demonstrating the spatial resolution advantages of DC-coupled recordings. We exploited the reliable and repeatable induction of CSDs using this preparation to perform proof-of-principle pharmacological interrogation studies using NMDA antagonists. MK801 (3 mg kg(-1)) suppressed CSD induction and propagation, an effect mirrored, albeit transiently, by ketamine (15 mg kg(-1)), thus demonstrating this models' applicability as a preclinical drug screening platform. Finally, we report that CSDs could be detected through the skull using graphene micro-transistors, highlighting additional advantages and future applications of this technology. Significance. CSD is thought to contribute to the pathophysiology of several neurological diseases. CSD research will benefit from technological advances that permit high density electrophysiological mapping of the CSD waveform and propagation across the cortex. We report an in vivo assay that permits minimally invasive optogenetic induction, combined with multichannel DC-coupled recordings enabled by gSGFETs in the awake brain. Adoption of this technological approach could facilitate and transform preclinical investigations of CSD in disease relevant models.

The underlying cellular and molecular mechanisms of peripheral neuropathic pain are not fully understood. However, preclinical studies using animal models suggest that this debilitating condition is driven partly by aberrant spontaneous activity (SA) in injured and uninjured dorsal root ganglion (DRG) neurons, and that SA in injured DRG neurons is triggered by subthreshold membrane potential oscillations (SMPOs). Here, using in vivo intracellular recording from control L4-DRG neurons, and ipsilateral L4-DRG neurons in female Wistar rats that had previously undergone L5 spinal nerve axotomy (SNA), we examined whether conducting 'uninjured' L4-DRG neurons in SNA rats exhibit SMPOs, and if so, whether such SMPOs are associated with SA in those L4 neurons, and whether they are mediated by hyperpolarization-activated cyclic nucleotide gated (HCN) channels. We found that 7 days after SNA: (a) none of the control A- or C-fibre DRG neurons showed SMPOs or SA, but 50%, 43% and 0% of spontaneously active cutaneous L4 A beta-low threshold mechanoreceptors, A beta-nociceptors and C-nociceptors exhibited SMPOs, respectively, in SNA rats with established neuropathic pain behaviors; (b) neither SMPOs nor SA in L4 A beta-neurons was suppressed by blocking HCN channels with ZD7288 (10 mg kg(-1), I. V.); and (c) there is a tendency for female rats to show greater pain hypersensitivity than male rats. These results suggest that SMPOs are linked to SA only in some of the conducting L4 A beta-neurons, that such oscillations are not a prerequisite for SA generation in those L4 A-or C-fibre neurons, and that HCN channels are not involved in their electrogenesis.

Andrea Bonaccini Calia, Eduard Masvidal-Codina, Trevor M Smith, Nathan Schäfer, Daman Rathore, Elisa Rodríguez-Lucas, Xavi Illa, Jose M De la Cruz, Elena Del Corro, Elisabet Prats-Alfonso, Damià Viana, Jessica Bousquet, Clement Hébert, Javier Martínez-Aguilar, Justin R Sperling, Matthew Drummond, Arnab Halder, Abbie Dodd, Katharine Barr, Sinead Savage, Jordina Fornell, Jordi Sort, Christoph Guger, Rosa Villa, Kostas Kostarelos, Rob C Wykes, Anton Guimerà-Brunet, Jose A Garrido (2022)Full-bandwidth electrophysiology of seizures and epileptiform activity enabled by flexible graphene microtransistor depth neural probes, In: Nature nanotechnology17(3)pp. 301-309

Mapping the entire frequency bandwidth of brain electrophysiological signals is of paramount importance for understanding physiological and pathological states. The ability to record simultaneously DC-shifts, infraslow oscillations (

Christopher A.R. Chapman, Trevor M. Smith, Max Kelly, James Avery, Theo Rouanet, Kirill Aristovich, Daniel J. Chew, David S. Holder (2019)Optimisation of bioimpedance measurements of neuronal activity with an ex vivo preparation of Cancer pagurus peripheral nerves, In: Journal of neuroscience methods327108322pp. 108322-108322 Elsevier B.V

[Display omitted] •Physiological parameters for the crab walking leg nerve model of an unmyelinated fibre were optimised resulting in improved nerve health.•Developed protocol to combine improved bioimpedance measurement methods with previously reported unmyelinated fibre recording methods.•New, optimised method produced recorded data with single trace SNR ratios of ≥3:1, which resulted in a 10-trace average of an SNR of ≥9:1.•Demonstrated two methods in which to ascertain if the measured bioimpedance change is a genuine CAP dependent signal. In mammals, fast neural Electrical Impedance Tomography (EIT) can image the myelinated component of the compound action potentials (CAP) using a nerve cuff. If applied to unmyelinated fibres this has great potential to improve selective neuromodulation (“electroceuticals”) to avoid off-target effects. Previously, bioimpedance recordings were averaged from unmyelinated crab leg nerve fibres, but the signal to noise ratio (SNR) needs improving. Currently, functional non-invasive neuronal imaging is accomplished through surface electrodes or genetically expressed indicators that provide good spatial, but poor temporal, resolution. Here is an improved method for bioimpedance measurements from a model of unmyelinated fibres to enable optimisation through improvement of the 1) signal processing measurement paradigm, 2) neurophysiology, and 3) electrode-nerve interface. For bioimpedance recordings, the recruitment and necessity of the CAP was quantified and saline significantly improved the SNR. An improved protocol resulted in averaging not being required, as sequentially recorded traces produced bioimpedance changes of −0.232 ± 0.064% that did not show phase or timing related artefacts. Here, two bioimpedance traces displayed an SNR of ≥3:1, while previously over >100 averages were required with greater inter-experimental variability. 10 paired traces were averaged for an SNR of ≥9:1, or near real-time measurement. This method facilitates further studies aiming to enable non-invasive localization of fascicular activity in unmyelinated fibres within peripheral nerves. This technique could ultimately produce the first 3-D tomographic images to help guide selective neuromodulation using bioelectric devices.

Laiche Djouhri, Mohammed Imad Malki, Asad Zeidan, Karim Nagi, Trevor Smith (2019)Activation of K(v)7 channels with the anticonvulsant retigabine alleviates neuropathic pain behaviour in the streptozotocin rat model of diabetic neuropathy, In: Journal of drug targeting27(10)pp. 1118-1126 Taylor & Francis

Diabetic peripheral neuropathy (DPN) is the most incapacitating complication of diabetes mellitus. Up to 50% of patients with DPN develop peripheral neuropathic pain (PNP). The underlying ionic and molecular mechanisms of diabetic PNP (DPNP) are poorly understood. However, voltage gated potassium (K(v)7) channels which have been implicated in the pathogenesis of other types of PNP are likely to be involved. Here we examined, in the streptozotocin (STZ) rat model of DPNP, whether activating the Kv7 channels with a potent activator retigabine (ezogabine) would reverse/attenuate behavioural signs of DPNP. STZ rats exhibited behavioural indices of mechanical and heat hypersensitivity, but not cold hypersensitivity or spontaneous pain, 35 days after STZ injection. Retigabine given at a dose of 15 mg/kg (but not at 7.5 mg/kg, i.p.) significantly attenuated mechanical, but not heat hypersensitivity in DPNP rats, and was as effective as the positive control gabapentin. This analgesic effect of retigabine was completely reversed by the K(v)7/M channel blocker XE991 (3 mg/kg, i.p.) indicating that the anti-allodynic effects of retigabine were mediated by K(v)7 channels. In conclusion, the findings suggest that Kv7 channels are involved in DPNP pathogenesis, and that strategies that target their activation may prove to be effective in treating DPNP.

Junnat Hamdam, Swaminathan Sethu, Trevor Smith, Ana Alfirevic, Mohammad Alhaidari, Jeffrey Atkinson, Mimieveshiofuo Ayala, Helen Box, Michael Cross, Annie Delaunois, Ailsa Dermody, Karthik Govindappa, Jean-Michel Guillon, Rosalind Jenkins, Gerry Kenna, Björn Lemmer, Ken Meecham, Adedamola Olayanju, Sabine Pestel, Andreas Rothfuss, James Sidaway, Rowena Sison-Young, Emma Smith, Richard Stebbings, Yulia Tingle, Jean-Pierre Valentin, Awel Williams, Dominic Williams, Kevin Park, Christopher Goldring (2013)Safety pharmacology — Current and emerging concepts, In: Toxicology and applied pharmacology273(2)pp. 229-241 Elsevier Inc

Safety pharmacology (SP) is an essential part of the drug development process that aims to identify and predict adverse effects prior to clinical trials. SP studies are described in the International Conference on Harmonisation (ICH) S7A and S7B guidelines. The core battery and supplemental SP studies evaluate effects of a new chemical entity (NCE) at both anticipated therapeutic and supra-therapeutic exposures on major organ systems, including cardiovascular, central nervous, respiratory, renal and gastrointestinal. This review outlines the current practices and emerging concepts in SP studies including frontloading, parallel assessment of core battery studies, use of non-standard species, biomarkers, and combining toxicology and SP assessments. Integration of the newer approaches to routine SP studies may significantly enhance the scope of SP by refining and providing mechanistic insight to potential adverse effects associated with test compounds. •SP — mandatory non-clinical risk assessments performed during drug development.•SP organ system studies ensure the safety of clinical participants in FiH trials.•Frontloading in SP facilitates lead candidate drug selection.•Emerging trends: integrating SP-Toxicological endpoints; combined core battery tests.

Laiche Djouhri, Trevor Smith, Ahmad Ahmeda, Mohammad Alotaibi, Xiechuan Weng (2018)Hyperpolarization-activated cyclic nucleotide-gated channels contribute to spontaneous activity in L4 C-fiber nociceptors, but not A beta-non-nociceptors, after axotomy of L5-spinal nerve in the rat in vivo, In: Pain (Amsterdam)159(7)1392pp. 1392-1402 Lippincott Williams & Wilkins

Peripheral neuropathic pain associated with partial nerve injury is believed to be driven partly by aberrant spontaneous activity (SA) in both injured and uninjured dorsal root ganglion (DRG) neurons. The underlying ionic mechanisms are not fully understood, but hyperpolarization-activated cyclic nucleotide-gated (HCN) channels which underlie the excitatory I-h current have been implicated in SA generation in axotomized A-fiber neurons after L5-spinal nerve ligation/axotomy (SNL/SNA). Here, using a modified model of SNA (mSNA) which involves, in addition to L5-SNA, loose ligation of the L4-spinal nerve with neuroinflammation-inducing chromic gut, we examined whether HCN channels also contribute to SA in the adjacent L4-neurons. Intracellular recordings from L4-DRG neurons in control rats, and L4-DRG neurons in mSNA rats were made using in vivo voltage-and current-clamp techniques. Compared with control, L4 C-nociceptors and A beta-low-threshold mechanoreceptors (LTMs) exhibited SA 7 days after mSNA. This was accompanied, in C-nociceptors, by a significant increase in Ih amplitude, the percentage of I-h-expressing neurons, and I-h activation rate. Hyperpolarization-activated cyclic nucleotide-gated channel blockade with ZD7288 (10 mg/kg, intravenously) suppressed SA in C-nociceptors, but not A beta-LTMs, and caused in C-nociceptors, membrane hyperpolarization and a decrease in Ih activation rate. Furthermore, intraplantar injection of ZD7288 (100 mu M) was found to be as effective as gabapentin (positive control) in attenuating cold hypersensitivity in mSNA rats. These findings suggest that HCN channels contribute to nerve injury-induced SA in L4 C-nociceptors, but not A beta-LTMs, and that ZD7288 exerts its analgesic effects by altering I-h activation properties and/or causing membrane hyperpolarization in L4 C-nociceptors.

Laiche Djouhri, Asad Zeidan, Seham A. Abd El-Aleem, Trevor Smith (2020)Cutaneous Aβ-Non-nociceptive, but Not C-Nociceptive, Dorsal Root Ganglion Neurons Exhibit Spontaneous Activity in the Streptozotocin Rat Model of Painful Diabetic Neuropathy in vivo, In: Frontiers in neuroscience14530pp. 530-530 Frontiers Media S.A

Diabetic peripheral neuropathic pain (DPNP) is the most devastating complication of diabetes mellitus. Unfortunately, successful therapy for DPNP remains a challenge because its pathogenesis is still elusive. However, DPNP is believed to be due partly to abnormal hyperexcitability of dorsal root ganglion (DRG) neurons, but the relative contributions of specific functional subtypes remain largely unknown. Here, using the strepotozotocin (STZ) rat model of DPNP induced by a STZ injection (60 mg/kg, i.p), and intracellular recordings of action potentials (APs) from DRG neurons in anesthetized rats, we examined electrophysiological changes in C-and Aβ-nociceptive and Aβ-low threshold mechanoreceptive (LTM) neurons that may contribute to DPNP. Compared with control, we found in STZ-rats with established pain hypersensitivity (5 weeks post-STZ) several significant changes including: (a) A 23% increase in the incidence of spontaneous activity (SA) in Aβ-LTMs (but not C-mechanosensitive nociceptors) that may cause dysesthesias/paresthesia suffered by DPNP patients, (b) membrane hyperpolarization and a ∼85% reduction in SA rate in Aβ-LTMs by K v 7 channel activation with retigabine (6 mg/kg, i.v.) suggesting that K v 7/M channels may be involved in mechanisms of SA generation in Aβ-LTMs, (c) decreases in AP duration and in duration and amplitude of afterhyperpolarization (AHP) in C-and/or Aβ-nociceptors. These faster AP and AHP kinetics may lead to repetitive firing and an increase in afferent input to the CNS and thereby contribute to DPNP development, and (d) a decrease in the electrical thresholds of Aβ-nociceptors that may contribute to their sensitization, and thus to the resulting hypersensitivity associated with DPNP.

Trevor M. Smith, Dongchul Lee, Kerry Bradley, Stephen B. McMahon (2020)Methodology for quantifying excitability of identified projection neurons in the dorsal horn of the spinal cord, specifically to study spinal cord stimulation paradigms, In: Journal of neuroscience methods330108479pp. 108479-108479 Elsevier

Background: Using in and ex vivo preparations, electrophysiological methods help understand the excitability of biological tissue, particularly neurons, by providing microsecond temporal resolution. However, for in vivo recordings, in the context of extracellular recordings, it is often unclear precisely which type of neuron the tip of the electrode is recording from. This is particularly true in the densely-populated central nervous system, such as the spinal cord dorsal horn at both superficial and deep levels. New Method: Here, we present a detailed protocol for the identification of superficial dorsal horn spinal cord neurons that receive peripheral input and project to the brain, using multiple surgical laminectomies and the careful placement of electrodes. Once a superficial projection unit was found, quantification to electrical peripheral stimulation was performed using a Matlab algorithm to form a template of projection neuron response to controlled C2 stimulation and accurately match this to the responses from peripheral stimulation. Results: These superficial spinal projection neurons are normally activated by noxious peripheral stimuli, so we adopted a well-characterised wind-up protocol to obtain a neuronal excitability profile. Once achieved, this protocol allows for testing specific interventions, either pharmacological or neuromodulatory (e.g., spinal cord stimulation) to see how these affect the neuron's excitability. This preparation is robust and allows the accurate tracking of a projection neuron for over 3-h. Comparison with existing method(s): Currently, most existing methods record from dorsal horn neurons that are often profiled based on their excitability to different peripherally-applied sensory modalities. While this is wellestablished, it fails to discriminate between interneurons and projection neurons, which is important as these two populations signal via distinctly different neuronal networks. Using the approach detailed here will result in studies with improved mechanistic understanding of the signal integration and processing that occurs in the superficial dorsal horn. Conclusions: The refinements detailed in this protocol allow for more comprehensive studies to be carried out that will help understand spinal plasticity, in addition to many considerations for isolating the relevant neuronal population when performing in vivo electrophysiology.

•Expression of HCN2 is increased in L4 DRG neurons adjacent to axotomized L5 neurons.•Blockade of HCN channels with ZD7288 attenuates chronic spontaneous pain behavior.•Mechanical, but not heat hypersensitivity, is also attenuated by HCN channel blockade.•These differential effects may be mediated by different nociceptor subpopulations.•The findings implicate HCN channels in mechanisms of peripheral neuropathic pain. A hallmark of peripheral neuropathic pain (PNP) is chronic spontaneous pain and/or hypersensitivity to normally painful stimuli (hyperalgesia) or normally nonpainful stimuli (allodynia).This pain results partly from abnormal hyperexcitability of dorsal root ganglion (DRG) neurons. We have previously shown, using a modified version of the lumbar 5 (L5)-spinal nerve ligation model of PNP (mSNA model involving L5-spinal nerve axotomy plus loose ligation of the lumbar 4 (L4)-spinal nerve with neuroinflammation-inducing chromic-gut), that L4 DRG neurons exhibit increased spontaneous activity, the key characteristic of neuronal hyperexcitability. The underlying ionic and molecular mechanisms of the hyperexcitability of L4 DRG neurons are incompletely understood, but could result from changes in expression and/or function of ion channels including hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, which are active near the neuron’s resting membrane potential, and which produce an excitatory inward current that depolarizes the membrane potential toward the threshold of action potential generation. Therefore, in the present study we used the mSNA model to investigate whether: (a) expression of HCN1–HCN3 channels is altered in L4 DRG neurons which, in the mSNA model, are essential for transmission of the evoked pain, and which contribute to chronic spontaneous pain, and (b) local (intraplantar) blockade of these HCN channels, with a specific blocker, ZD7288, attenuates chronic spontaneous pain and/or evoked pain in mSNA rats. We found 7days after mSNA: (1) a significant increase in HCN2-immunoreactivity in small (

Geoffroy Laumet, Judit Garriga, Shao-Rui Chen, Yuhao Zhang, De-Pei Li, Trevor M. Smith, Yingchun Dong, Jaroslav Jelinek, Matteo Cesaroni, Jean-Pierre Issa, Hui-Lin Pan (2015)G9a is essential for epigenetic silencing of K+ channel genes in acute-to-chronic pain transition, In: Nature neuroscience18(12)pp. 1746-1755 Springer Nature

Neuropathic pain is a debilitating clinical problem and difficult to treat. Nerve injury causes a long-lasting reduction in K+ channel expression in the dorsal root ganglion (DRG), but little is known about the epigenetic mechanisms involved. We found that nerve injury increased dimethylation of Lys9 on histone H3 (H3K9me2) at Kcna4, Kcnd2, Kcnca and Kcnmal promoters but did not affect levels of DNA methylation on these genes in DRGs. Nerve injury increased activity of euchromatic histone-lysine N-methyltransferase-2 (G9a), histone deacetylases and enhancer of zeste homolog-2 (EZH2), but only G9a inhibition consistently restored K+ channel expression. Selective knockout of the gene encoding G9a in DRG neurons completely blocked K+ channel silencing and chronic pain development after nerve injury. Remarkably, RNA sequencing analysis revealed that G9a inhibition not only reactivated 40 of 42 silenced genes associated with K+ channels but also normalized 638 genes down- or upregulated by nerve injury. Thus G9a has a dominant function in transcriptional repression of K+ channels and in acute-to-chronic pain transition after nerve injury.

L. Djouhri, M. Al Otaibi, K. Kahlat, T. Smith, J. Sathish, X. Weng (2015)PERSISTENT HINDLIMB INFLAMMATION INDUCES CHANGES IN ACTIVATION PROPERTIES OF HYPERPOLARIZATION-ACTIVATED CURRENT (I-h) IN RAT C-FIBER NOCICEPTORS IN VIVO, In: Neuroscience301pp. 121-133 Elsevier

A hallmark of chronic inflammation is hypersensitivity to noxious and innocuous stimuli. This inflammatory pain hypersensitivity results partly from hyperexcitability of nociceptive dorsal root ganglion (DRG) neurons innervating inflamed tissue, although the underlying ionic mechanisms are not fully understood. However, we have previously shown that the nociceptor hyperexcitability is associated with increased expression of hyperpolarization-activated cyclic nucleotide-gated channel 2 (HCN2) protein and hyperpolarization-activated current (I-h) in C-nociceptors. Here we used in vivo voltage-clamp and current-clamp recordings, in deeply anesthetized rats, to determine whether activation properties of Ih in these C-nociceptors also change following persistent (not acute) hindlimb inflammation induced by complete Freund's adjuvant (CFA). Recordings were made from lumbar (L4/L5) C-nociceptive DRG neurons. Behavioral sensory testing was performed 5-7 days after CFA treatment, and all the CFA-treated group showed significant behavioral signs of mechanical and heat hypersensitivity, but not spontaneous pain. Compared with control, C-nociceptors recorded 57 days after CFA showed: (a) a significant increase in the incidence of spontaneous activity (from similar to 5% to 26%) albeit at low rate (0.14 +/- 0.08 Hz (Mean +/- SEM); range, 0.01-0.29 Hz), (b) a significant increase in the percentage of neurons expressing Ih (from 35%, n = 43-84%, n = 50) based on the presence of voltage "sag'' of > 10%, and (c) a significant increase in the conductance (Gh) of the somatic channels conducting Ih along with the corresponding Ih, Ih, activation rate, but not voltage dependence, in C-nociceptors. Given that activation of Ih depolarizes the neuronal membrane toward the threshold of action potential generation, these changes in Ih kinetics in CFA C-nociceptors may contribute to their hyperexcitability and thus to pain hypersensitivity associated with persistent inflammation. (C) 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Xiechuan Weng, Trevor Smith, Jean Sathish, Laiche Djouhri (2012)Chronic inflammatory pain is associated with increased excitability and hyperpolarization-activated current (I-h) in C- but not A delta-nociceptors, In: Pain (Amsterdam)153(4)pp. 900-914 Lippincott Williams & Wilkins

Inflammatory pain hypersensitivity results partly from hyperexcitability of nociceptive (damage-sensing) dorsal root ganglion (DRG) neurons innervating inflamed tissue. However, most of the evidence for this is derived from experiments using acute inflammatory states. Herein, we used several approaches to examine the impact of chronic or persistent inflammation on the excitability of nociceptive DRG neurons and on their expression of I-h and the underlying hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, which regulate neuronal excitability. Using in vivo intracellular recordings of somatic action potentials from L4/L5 DRG neurons in normal rats and rats with hindlimb inflammation induced by complete Freund's adjuvant (CFA), we demonstrate increased excitability of C- but not A delta-nociceptors, 5 to 7 days after CFA. This included an afterdischarge response to noxious pinch, which may contribute to inflammatory mechanohyperalgesia, and increased incidence of spontaneous activity (SA) and decreased electrical thresholds, which are likely to contribute to spontaneous pain and nociceptor sensitization, respectively. We also show, using voltage clamp in vivo, immunohistochemistry and behavioral assays that (1) the inflammation-induced nociceptor hyperexcitability is associated, in C- but not A delta-nociceptors, with increases in the mean I-h amplitude/density and in the proportion of I-h expressing neurons, (2) increased proportion of small DRG neurons (mainly IB4-negative) expressing HCN2 but not HCN1 or HCN3 channel protein, (3) increased HCN2- immunoreactivity in the spinal dorsal horn, and (4) attenuation of inflammatory mechanoallodynia with the selective I-h antagonist, ZD7288. Taken together, the findings suggest that C- but not A delta-nociceptors sustain chronic inflammatory pain and that I-h/HCN2 channels contribute to inflammation-induced C-nociceptor hyperexcitability. (C) 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.