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. 2018 Jan 9;159(4):739–748. doi: 10.1097/j.pain.0000000000001137

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Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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Figure 5. — Effect of hyaluronan (Synvisc) on movement-evoked nerve impulse activity in MSU-inflamed joints. (A) Time course of the change in nerve impulse discharges evoked by complete movement cycles (OR + NOR + IR + NIR) measured in 23 single nerve fibers of joints injected with amorphous MSU 3 hours before, expressed as % of the mean ± SEM of the control response value. Black symbols show the data in MSU-inflamed knee joints that did not receive additional treatment (n = 7), red filled circles in MSU-inflamed knee joints that additionally received an intra-articular injection of Synvisc (red arrow, n = 7), and purple symbols represent the data in joints receiving an intra-articular injection of NaCl 0.9% (vehicle of Synvisc, purple arrow, n = 9). The response values of these fibers previous to treatments are represented as empty symbols. (B) Example of the impulse activity recorded in a single fiber innervating a knee joint inflamed 3 hours earlier by MSU injection (upper panel) to illustrate the firing frequency reduction observed 2 hours after intra-articular injection of Synvisc (middle panel). In both cases, the upper traces represent the instantaneous frequency and the lower traces the original recordings of nerve impulse activity. The bottom panel depicts the sequence of nonnoxious and noxious rotations applied as stimuli. (C and D) Mean nerve impulse activity in joints injected 3 hours earlier with MSU, expressed as percentage of the activity evoked by the movements performed during the first hour (control period, taken as 100%). Empty columns represent the mean values of the last 3 movements of the control period, before any experimental maneuver. The remaining columns show the mean value of the 12 movements performed during each of the indicated periods, for the nonnoxious (OR + IR) (C) and the noxious (NOR + NIR) (D) components of the movement. Unpaired t test, ***P < 0.001, **P < 0.01, *P < 0.05. (E) Ongoing activity frequency values of joint nerve fibers (n = 7) 3 hours after intra-articular injection of MSU (open black squares) and 8 hours after intra-articular injection of MSU (filled black squares); in nerve fibers (n = 8) 3 hours after intra-articular injection of MSU (empty purple triangles) and 8 hours after MSU injection but receiving also 4 hours after MSU an intra-articular injection of saline (NaCl 0.9%, filled purple triangles); and in joint nerve fibers (n = 8) 3 hours after i.a. injection of amorphous MSU (empty red circles) and 8 hours after amorphous MSU injection but receiving also 4 hours after MSU an i.a. injection of Synvisc (red filled circles). Green circles correspond to mean values in each case. IR, inward rotation; MSU, monosodium urate; NIR, noxious inward rotation; NOR, noxious outward rotation; OR, outward rotation.