Abstract
Epigenetic modulation by DNA methylation is associated with aberrant gene expression in sensory neurons, which consequently leads to pathological pain responses. In this study, we sought to investigate whether peripheral inflammation alters global DNA methylation in trigeminal ganglia (TG) and results in abnormal expression of pro-nociceptive genes. Our results show that peripheral inflammation remotely reduced the level of global DNA methylation in rat TG with a concurrent reduction in
Introduction
The study of epigenetic mechanisms underlying acute or persistent pain has been rapidly progressing in recent years.1,2 As a prototypical epigenetic factor, DNA methylation plays an important role in regulating gene expression, and alterations in DNA methylation are associated with a number of human diseases, including chronic pain conditions. Epigenetic modulation by DNA methylation is associated with hyperalgesic responses and aberrant gene expression in the central nervous system.3,4 The substantial amount of evidence accumulated thus far also indicates that alterations in DNA methylation in dorsal root ganglia (DRG) may play a critical role in the underlying mechanisms of many types of somatic chronic pain conditions.5-8
Gene-specific studies, genome-wide association studies, and the Pain Gene Database reveal that many genes that are involved in persistent pain contain CpG islands (CGIs) near their transcription start sites. These CGIs are highly sensitive to methylation, and some of these genes were found to either regulate or be regulated by DNA methylation. 9 The blockade of DNA methyltransferases (DNMTs), key enzymes involved in DNA methylation, modulates pain responses under inflammatory and neuropathic pain conditions.4,5,10 More recent studies showed that nerve injury induces upregulation of DNMT3a in DRG and that a global blockade of this increase in DRG attenuates neuropathic pain.7,8 However, both the identity of pro-nociceptive genes that are subject to epigenetic modulation via alterations in DNA methylation in trigeminal ganglia (TG) and the role of DNMTs in pathological orofacial pain conditions are not clearly established.
We have previously shown that inflammation of the masseter muscle in rats upregulates transcription of many pro-nociceptive genes in TG that have been implicated in pathological orofacial pain responses.
11
Among those genes, DNA methylation of the transient receptor potential ankyrin 1 (
Materials and methods
Animals
Adult male Sprague Dawley rats (250-350 g; Harlan, Indianapolis, IN) were used. All animals were housed in a temperature-controlled room under a 12:12 light-dark cycle with access to food and water
Muscle inflammation
Inflammation was induced by injecting 50 µl of 50% complete Freund’s adjuvant (CFA) in isotonic saline (Sigma, St. Louis, MO) into the mid-region of the masseter muscle unilaterally via a 27-gauge needle. Rats were briefly anesthetized with 3% isoflurane for the injection procedure. The characteristics of inflammation and behavioral responses following CFA injections in the rat masseter have been described previously.17,18
Primary TG/DRG culture
All animals were euthanized by decapitation under isoflurane anesthesia. Both TG or all DRG from each animal were dissected out and dissociated by sequential digestion with 0.1% collagenase D in DMEM-F12 medium (with L-glutamine) at 37°C for 30 minutes, followed by additional digestion with 0.25% trypsin and 50 μg DNase in the same medium plus 0.02% EDTA at 37°C for 15 minutes. After trituration, cells were plated on laminin pre-coated 24-well plates and cultured in a 37°C incubator at 5% CO2 for 1 to 3 days. For some studies, dissociated TG or DRG cells were transduced by pseudo LV virions 5 hours after seeding on wells and harvested 3 days after culture seeding for RNA or gDNA extraction. Cells dissociated from a given animal were seeded on a set of wells to complete selective experiments as one biological replicate.
Genomic DNA extraction
Genomic DNA (gDNA) was extracted from intact TG or dissociated TG cells according to the method described by Strauss 19 and quantified by absorbance at 260 nm (A260) on a Nanodrop (ThermoFisher, Waltham, MA). Biochemical quality of gDNA was evaluated by A260/A280 (1.75~1.9) and A260/A230 (>1.0) ratios. Molecular integrity was determined by electrophoresis on 0.9% agarose gels, producing a single band approximately 40 kb. Qualified gDNA was saved in TE buffer (pH 8.0) at –20°C until use for methylation assay or bisulfite modification.
Global DNA methylation assay
The concentration of 5-methylcytosine (5-mC) in gDNA was quantified using 5-mC DNA ELISA kit and was measured according to the manufacturer’s instructions (Zymo Research, Irvine, CA). Briefly, standard DNA used to establish the standard curve was prepared by mixing negative (unmethylated DNA at 100 ng/μl) and positive (completely methylated DNA at 100 ng/µl) controls at different proportions. Standard or sample gDNA of 100 ng each was mixed with 5-mC coating buffer up to 100 μl and denatured at 98°C for 5 minutes followed by quick transfer onto ice for 10 minutes. Denatured gDNA was coated onto 96-well plates by incubation at 37°C for 1 hour. Following 3 washes with 5-mC ELISA buffer, 200 μl of 5-mC ELISA buffer was added for another incubation at 37°C for 30 minutes. An antibody mixture consisting of anti-5-mC and secondary antibody in 5-mC ELISA buffer in the ratio of 1:2:2000 in 100 µl was added for incubation at 37°C for 1 hour. After washing, 100 µl HRP developer was added, and color development was achieved by incubation at room temperature for 1 hour. Then the absorbance at 450 nm was obtained from each reaction on a plate reader (BioTek Epoch 2, BioTek/Agilent, Santa Clara, CA) for the establishment of a standard curve and for the quantitative analyses of samples from the curve. The results were validated in triplicate for each standard and sample.
Drug administration
For
Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR)
TG was dissected from naïve rats and CFA-inflamed rats (3 days post CFA treatment) as well as from those receiving 5-Aza-dC injections. Total RNA was extracted from dissected TG or from dissociated TG cells in culture using an RNeasy kit (Qiagen Sciences, MD) followed by DNase treatment to remove possible contaminating gDNA. Reverse transcription was carried out using Superscript II kit (Invitrogen, CA) from 100 to 1000 ng of total RNA along with Oligo (dT) primer. Quantitative PCR analysis of cDNA equal to 20 ng RNA was performed on the Eppendorf Mastercycler EP Realplex 2.0. Primer sequences for
Design and validation of EGFP-DNMT3a chimeric construct
We cloned the full-length encoding sequence of the rat
Analyses of methylated DNA by bisulfite (BS) sequencing and methylated DNA immunoprecipitation (MeDIP)
Analysis of methylated DNA by BS sequencing was completed as described previously.
22
Briefly, BS conversion was performed for 100 ng purified gDNA with EZ DNA Methylation Gold kit (Zymo Research) according to the manufacturer’s instructions.
MeDIP was adapted from a published study. 23 Briefly, 300 ng of gDNA was sonicated to 200 to 1000 bp fragments using the Covaris S2 Ultrasonicator (intensity 5, 10% duty cycle, 200 cycles per burst, and 2 × 30 seconds with 30 seconds intervals). DNA fragmentation was verified on an Agilent BioAnalyzer gel. 100 ng of denatured fragmented DNA was immunoprecipitated with 0.2 µg of monoclonal 5 mC antibody (33D3, Abcam, Cambridge, MA), and then 1 µg rabbit anti-mouse IgG was added prior to the addition of magnetic Protein A/G beads (Invitrogen/ThermoFisher, Waltham, MA). After washing as described in the referenced protocol, precipitated DNA was subjected to Protease K digestion and phenol-chloroform extraction. Extracted DNA was used in qPCR with SYBR Green/ROX reagent and 10 µM primers designed for the TRPA1 gene or TRPV1 gene (primer sequences available upon request). The thermocycler program included a 95°C step for 4 minutes, followed by 50 cycles of 95°C for 15 seconds and Tm for 60 seconds. Non-precipitated DNA fragments were diluted accordingly and utilized as an input control, and the relative level of enrichment was calculated using the ΔΔCt method.
Statistical analysis
Statistical comparisons of 2 independent groups were made with Student’s
Results
Peripheral inflammation alters global DNA methylation and DNMT expression in TG
We first examined whether CFA-induced inflammation of the masseter muscle is associated with alterations in global DNA methylation in TG and whether the changes in DNA methylation were reversible. Masseter inflammation resulted in a significant decrease in the percent DNA methylation in TG from 1 day after CFA injection. The decrease was greatest on day 3 and reversed toward baseline by day 7 at a level comparable to day 1 (Figure 1A).

Effects of inflammation on DNA methylation and on enzymes that regulate DNA methylation in TG. (A) The extent of gDNA methylation was compared between naïve and CFA-treated rats (n = 5/group). (B) mRNA levels for
DNA is methylated by 3 active DNMTs in mammalian cells, that is, DNMT1, DNMT3a, and DNMT3b.
24
We predicted that inflammation-induced reduction in the global methylation level in TG would be accompanied primarily by a decrease in the level of DNMT expression. We examined the levels of DNMT transcripts in TG of naïve and CFA-inflamed rats 3 days after CFA treatment in light of the fact that the greatest reduction in global DNA methylation was at this time point. Our results indicated that the expression of
It has been known that the level of DNA methylation in a given cell is regulated not only by DNMTs, but also by enzymes that actively demethylate DNA. Although the molecular mechanism underlying active DNA demethylation is relatively poorly understood, growth arrest and DNA-damage-inducible protein 45 alpha (GADD45α), a nuclear protein involved in maintenance of genomic stability, is known to demethylate DNA via nucleotide excision repair to erase 5-mC.
25
Also, the mammalian DNA glycosylase-methyl-CpG binding domain protein 4 (MBD4) has been implicated in playing a role in active DNA demethylation by enzymatic removal of the methyl group from 5-mC.
26
Our data indicated that neither
Selection of target genes modulated by DNA methylation following masseter inflammation
Changes in global DNA methylation in TG may constitute composite responses of multiple genes. Here we hypothesized that pro-nociceptive genes may be upregulated at the transcriptional level following CFA-induced alteration of DNA methylation, thereby allowing their participation in the development of inflammatory mechanical hyperalgesia. To test this hypothesis, we used the following steps to select candidate molecules in a relatively unbiased manner: (1) identify pain-related genes that are significantly upregulated in TG following masseter inflammation from a genome wide assay study of our RNAseq analysis, 11 (2) conduct a literature search to identify molecules that have been demonstrated to contribute to inflammatory mechanical hyperalgesia arising from the masseter muscle, and (3) conduct genome browser searches to examine whether CGIs are predicted in genes that satisfy steps 1 and 2.
Previously, in RNAseq analysis, we selected 2320 candidate genes that the literature revealed to be relevant to nociceptors, implicated in pain mechanisms, enriched in small—to medium-sized sensory neurons, and enriched in TRPV1-lineage nociceptors.
11
Among these candidate genes, 622 genes showed differential expression in TG following masseter inflammation. Upon further literature search, we identified following pro-nociceptive genes that show a significant transcriptional increase during inflammation-induced mechanical hyperalgesia:
Effects of 5-Aza-dC on the expression of target genes in TG
In order to demonstrate that the transcription of these candidate genes is actually modified by DNA methylation, we pharmacologically inhibited DNA methylation and assessed the expression levels of these genes in TG under both in vitro and in vivo conditions. Treatment of TG primary cultures with 5-Aza-dC, a DNMT inhibitor, dose-dependently increased the expression of

Effects of 5-Aza-dC on mRNA level of pro-nociceptive genes in TG. (A) TG cultures treated with vehicle (PBS) or 1 of the 3 doses of 5-Aza-dC for 24 hours. N = 5 to 7. qRT-PCR was conducted as described in methods. *
Effects of DNMT overexpression in TG
Generally, DNMT3a is implicated in

Effects of LV-mediated DNMT3a overexpression on mRNA of pro-nociceptive genes in TG. mRNA fold changes in TG cultures treated with pseudo-viruses (LV-CMVeNR1-EGFP-DNMT3a for EGFP-DNMT3a or LV-CMVeNR1-EGFP for EGFP) were compared to those of untreated TG cultures (naïve). Median values with interquartile range in box plots are presented. N = 9. *
Percentage of assays showing fluctuation of target gene levels in either direction in TG cells transduced by indicated lentiviral vector.
DNA methylation of cytosine residues mostly occurs in CpG dinucleotides, which are abundant in CGI.
8
Searching the UCSC Genome Browser (genome.UCSC.edu), we found 1 and 3 CGIs associated with
To test the possibility of DNA methylation, we conducted BS modification of TG genomic DNA (gDNA) and cloned a 119 bp portion of the

Methylation analyses of the TRPA1 gene. (A) Schematic presentation of PCR primers for
To further test whether this methylation is indeed catalyzed by DNMT3a in TG neurons and to avoid the bias of individual clones in BS sequencing, we transduced dissociated DRG cells with LV-CMVeNR1-EGFP-DNMT3a or LV-CMVeNR1-EGFP, used MeDIP to enrich methylated DNA fragments (500-1000 bp) from gDNA of transduced cells, and detected CGIs of

Methylation analyses of the TRPV1 gene. (A) Schematic presentation of PCR primers for
Discussion
The main findings of this study are: (1) Inflammation in orofacial muscle tissue leads to both global reductions in DNA methylation and to downregulation of
Peripheral inflammation alters global methylation level in TG
Global methylation, which represents the overall state of the DNA methylation of a given tissue, has long been associated with cancer pathogenesis and progression.40-42 Relatively little information on changes in global methylation along nociceptive pathways is available. Nerve injury induces chronic, but reversible, reductions in global methylation in the mouse prefrontal cortex, which correlate with mechanical and thermal sensitivity in neuropathic mice. 4 A more recent study showed that nerve injury induces persistent reprogramming of global methylation in DRG and that DNA hypomethylation occurs during the chronic phase of neuropathic pain. 43 In addition, the same study demonstrated that pharmacological or dietetic induction of global DNA hypomethylation in DRG causes long-lasting hypersensitivity. These observations provide evidence that the status of global methylation in DRG is predictive of pain phenotypes under nerve injury conditions. However, functional correlations of global DNA methylation with pain responses appear to be tissue-specific since neither nerve injury 43 nor tissue injury 44 caused global DNA hypomethylation at the spinal cord level.
Our data showed time-dependent changes in global DNA methylation in TG following CFA-induced inflammation of the masseter muscle. Although the assessment was made transiently for 7 days following the inflammation, the time course of hypomethylation correlates well with the time course of inflammation-induced pain responses. 45 It is acknowledged that changes in global methylation are composite responses from a multitude of genes, including those that do not have any direct relevance to pain processing. There is a significant change in the TG transcriptome, which involves a substantial number of pain-related genes, 3 days following masseter inflammation, the time point at which the reduction of DNA methylation was the greatest. 11
Since global DNA methylation can be correlated with affected behaviors and physiology at a tissue-specific level, it would be interesting to investigate whether restoring the DNA hypomethylation in TG would attenuate inflammatory pain. Positive outcomes would provide further support for targeting global DNA methylation as a novel therapeutic approach for treating chronic and pathological pain conditions.
Peripheral inflammation leads to downregulation of DNMT1 and DNMT3a in TG
DNA methylation in mammalian genomes is dynamically regulated by complex interactions of multiple enzymes that either methylate or demethylate cytosine, a highly conserved epigenetic modification site in DNA.
27
Among those enzymes, the roles of DNMT1,
6
DNMT3a,7,8,35 DNMT3b,
46
MBDs,10,47 GADD45α,
48
and, most recently, TET
49
in pain mechanisms have been explored. Our data show that peripheral inflammation resulted in a significant downregulation of
There are, however, conflicting data on inflammation-induced changes in DNMT expression levels in sensory ganglia. In an instance, CFA-induced inflammation in the hindpaw led to a significant reduction of
A series of studies from a lab showed that restoring global DNMT expression levels within a tissue following a nerve injury is sufficient to alter pain responses,6-8 although the functional role of DNMT3a in mouse sensory neurons in persistent pain has recently been challenged. 36 Given that DNMTs could alter a multitude of genes that are either pro-nociceptive or anti-nociceptive, that DNMT expression levels are sensitive to changing tissue environments, and that DNMT is only one of many families enzymes involved in gene transcription, additional studies are warranted to confirm whether global changes in DNMT expression levels bear any functional relevance in pain modulation.
DNMT3a is involved in transcriptional regulation of pro-nociceptive genes in TG
DNMT-catalyzed methylation of CpG dinucleotides typically results in the repression of gene transcription. Under neuropathic and chemotherapy-induced nerve injury conditions with increased DNMT3a levels in DRG, transcription of anti-nociceptive genes in DRG, such as mu opioid receptor and various types of voltage-gated potassium channels, are repressed.7,8,35 A significant downregulation of DNMT3b has been associated with an increased expression of pro-nociceptive chemokine receptor
Our
The reduction of DNMT3a level under pathological pain condition can result in aberrant expression of multiple pro-nociceptive genes, ultimately leading to pathological pain responses. Therefore, it is possible that both pharmacological and gene expression approaches on DNMTs could non-specifically affect DNA methylation of a large number of genes that are both pro-nociceptive and anti-nociceptive, and the contribution of individual genes in pain responses cannot be directly assessed. Studies that modulate global DNMT activity pharmacologically or through forced DNMT3a expression in a target tissue only allow for the establishment of a correlation between DNA methylation and gene regulation. In this study, we examined 4 pro-nociceptive genes among those that can be targeted by such manipulation. Although those genes have already been amply studied in pain mechanisms, understanding how each individual gene is epigenetically regulated by DNA methylation at the transcription level under inflammatory conditions could shed additional light on nociceptor mechanisms underlying the development and maintenance of craniofacial muscle pain conditions. We certainly acknowledge that these genes by no means constitute the exclusive set of genes modulated by DNA methylation in TG under masseter inflammatory conditions. It will be interesting to examine whether specific manipulation of DNA methylation of a single selected gene in TG is able to alter pain responses.
Footnotes
Funding:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by NIH-NIDCR grant DE016062 (JYR).
Declaration of Conflicting Interests:
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Author Contributions
GB and JYR conceived and designed the studies, interpreted data, and wrote the manuscript. GB constructed pseudo LV viruses and finished MeDIP analysis. HR conducted TG/DRG culture, partial qRT-PCR, and all bisulfite analyses as well as contributed to manuscript proofreading and preparation of figures. YZ completed all animal studies. KL carried out global DNA methylation assay and partial qRT-PCR analyses. JYR did statistical analyses. All authors critically reviewed and approved the final manuscript.
