Diabetes mellitus is associated with one or more kinds of stimulus-evoked pain including hyperalgesia and allodynia. The mechanisms underlying painful diabetic neuropathy remain poorly understood. Previous studies demonstrate an important role of vanilloid receptor 1 (VR1) in inflammation and injury-induced pain. Here we investigated the function and expression of VR1 in dorsal root ganglion (DRG) neurons isolated from streptozotocin-induced diabetic rats between 4 and 8 weeks after onset of diabetes. DRG neurons from diabetic rats showed significant increases in capsaicin-and protonactivated inward currents. These evoked currents were completely blocked by the capsaicin antagonist capsazepine. Capsaicin-induced desensitization of VR1 was down-regulated, whereas VR1 re-sensitization was upregulated in DRG neurons from diabetic rats. The protein kinase C (PKC) activator phorbol 12-myristate 13-acetate blunted VR1 desensitization, and this effect was reversible in the presence of the PKC inhibitor bisindolylmaleimide I. Compared with the controls, VR1 protein was decreased in DRG whole-cell homogenates from diabetic rats, but increased levels of VR1 protein were observed on plasma membranes. Of interest, the tetrameric form of VR1 increased significantly in DRGs from diabetic rats. Increased phosphorylation levels of VR1 were also observed in DRG neurons from diabetic rats. Colocalization studies demonstrated that VR1 expression was increased in large myelinated A-fiber DRG neurons, whereas it was decreased in small unmyelinated C-fiber neurons as a result of diabetes. These results suggest that painful diabetic neuropathy is associated with altered cell-specific expression of the VR1 receptor that is coupled to increased function through PKC-mediated phosphorylation, oligomerization, and targeted expression on the cell surface membrane.Painful neuropathy is one of the most common complications in early to intermediate stages of diabetes mellitus. Diabetic patients frequently exhibit one or more kinds of stimulusevoked pain, including increased responsiveness to noxious stimuli (hyperalgesia) as well as a hyper-responsiveness to normally innocuous stimuli (allodynia) that are often concurrent with a paradoxical loss of stimulus-evoked sensation (1, 2). The underlying mechanisms of painful diabetic neuropathy remain elusive. Similar to human painful diabetic neuropathy, animal models such as streptozotocin (STZ) 1 -induced diabetic mice or rats demonstrate early functional and biochemical abnormalities including thermal hyperalgesia and mechanical allodynia (3-6). It has been suggested that hyperactivity of small, unmyelinated C-fibers results in hyperalgesia and allodynia in this model (6, 7). Khan et al. (4) reported that A-fiber afferents in diabetic rats developed abnormal spontaneous discharges and increased sensitivity to mechanical stimuli, suggesting a role of large A-fiber neurons in addition to nociceptive C-fibers in the development of diabetic neuropathic pain.Capsaicin, the pungent ingredient in hot p...