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疼痛的病理生理学与神经调节机制:一篇叙述性综述(神经元项目)

Pathophysiology of Pain and Mechanisms of Neuromodulation: A Narrative Review (A Neuron Project).

作者信息

Karcz Marcin, Abd-Elsayed Alaa, Chakravarthy Krishnan, Aman Mansoor M, Strand Natalie, Malinowski Mark N, Latif Usman, Dickerson David, Suvar Tolga, Lubenow Timothy, Peskin Evan, D'Souza Ryan, Cornidez Eric, Dudas Andrew, Lam Christopher, Farrell Ii Michael, Sim Geum Yeon, Sebai Mohamad, Garcia Rosa, Bracero Lucas, Ibrahim Yussr, Mahmood Syed Jafar, Lawandy Marco, Jimenez Daniel, Shahgholi Leili, Sochacki Kamil, Ramadan Mohamed Ehab, Tieppo Francio Vinicius, Sayed Dawood, Deer Timothy

机构信息

The Spine and Nerve Centers of the Virginias, Charleston, WV, USA.

Department of Anesthesiology, University of Wisconsin, Madison, WI, USA.

出版信息

J Pain Res. 2024 Nov 16;17:3757-3790. doi: 10.2147/JPR.S475351. eCollection 2024.

Abstract

Pain serves as a vital innate defense mechanism that can significantly impact an individual's quality of life. Understanding the physiological effects of pain well plays an important role in developing novel pain treatments. Nociceptor neurons play a key role in pain and inflammation. Interactions between nociceptors and the immune system occur both at the site of injury and within the central nervous system. Modulating chemical mediators and nociceptor activity offers promising new approaches to pain management. Essentially, the sensory nervous system is essential for modulating the body's protective response, making it critical to understand these interactions to discover new pain treatment strategies. New innovations in neuromodulation have led to alternatives to opioids individuals with chronic pain with consequent improvement in disease-based treatment and nerve targeting. New neural targets from cellular and structural perspectives have revolutionized the field of neuromodulation. This narrative review aims to elucidate the mechanisms of pain transmission and processing, examine the characteristics and properties of nociceptors, and explore how the immune system influences pain perception. It further provides an updated overview of the physiology of pain and neuromodulatory mechanisms essential for managing acute and chronic pain. We assess the current understanding of different pain types, focusing on key molecules involved in each type and their physiological effects. Additionally, we compare painful and painless neuropathies and discuss the neuroimmune interactions involved in pain manifestation.

摘要

疼痛是一种重要的先天性防御机制,会对个体的生活质量产生重大影响。深入了解疼痛的生理效应对于开发新型疼痛治疗方法起着重要作用。伤害感受器神经元在疼痛和炎症中起关键作用。伤害感受器与免疫系统之间的相互作用发生在损伤部位和中枢神经系统内。调节化学介质和伤害感受器活性为疼痛管理提供了有前景的新方法。从本质上讲,感觉神经系统对于调节身体的保护反应至关重要,因此了解这些相互作用对于发现新的疼痛治疗策略至关重要。神经调节方面的新创新为慢性疼痛患者提供了阿片类药物的替代方案,从而改善了基于疾病的治疗和神经靶向治疗。从细胞和结构角度来看,新的神经靶点彻底改变了神经调节领域。这篇叙述性综述旨在阐明疼痛传递和处理的机制,研究伤害感受器的特征和特性,并探讨免疫系统如何影响疼痛感知。它还进一步提供了疼痛生理学和管理急性和慢性疼痛所必需的神经调节机制的最新概述。我们评估了目前对不同类型疼痛的理解,重点关注每种类型中涉及的关键分子及其生理效应。此外,我们比较了疼痛性和无痛性神经病变,并讨论了疼痛表现中涉及的神经免疫相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d26/11581984/16f3a6fc824e/JPR-17-3757-g0001.jpg

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