TLR4 ⁺ Dermal fibroblasts induce acute and transitional pain states

The prominence of non-neuronal cells driving pain states has gained attention in recent years. Fibroblasts, a major stromal cell, perform essential functions during inflammation, tissue remodeling, and wound healing; however, recent studies suggest that fibroblasts may play a role in pain. Toll-like receptor 4 (TLR4) is an essential component of the innate immune system and activation of the receptor promotes pain. This study utilized a novel mouse model with dermal fibroblast specific expression of TLR4 on a TLR4-null background, which allows us to understand the sufficiency of skin fibroblast activation in pain development. Here we demonstrate that dermal fibroblast activation induces both acute inflammatory pain and hyperalgesic priming in both male and female mice. In vivo , activated dermal fibroblasts change cellular morphology in mice and humans. In vitro we observed pro-inflammatory cytokine production and activation of calcium signaling pathways. These data demonstrate that dermal fibroblast activation can cause acute pain and drive mechanisms involved in the transition to chronic pain.