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用于疼痛治疗的胰高血糖素样肽-1受体激动剂的进展及其未来潜力。

Advances in GLP-1 receptor agonists for pain treatment and their future potential.

作者信息

He Yongtao, Xu Biao, Zhang Mengna, Chen Dan, Wu Shuyuan, Gao Jie, Liu Yongpeng, Zhang Zixin, Kuang Junzhe, Fang Quan

机构信息

Institute of Physiology, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, PR China.

出版信息

J Headache Pain. 2025 Feb 27;26(1):46. doi: 10.1186/s10194-025-01979-4.

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) show substantial efficacy in regulating blood glucose levels and lipid metabolism, initially as an effective treatment for diabetes mellitus. In recent years, GLP-1RAs have become a focal point in the medical community due to their innovative treatment mechanisms, robust therapeutic efficacy, and expansive development prospects. Notably, GLP-1RAs benefit pain management through their neuroprotective and metabolic regulatory properties, such as inhibiting inflammation responses and oxidative stress, promoting β-endorphin release and modulating several other crucial biological pathways. Hence GLP-1RAs hold promise for repurposing as treatments for pain disorders. In this narrative review, we thoroughly trace the current preclinical and clinical evidence of seven pain modalities, including inflammatory pain, osteoarthritis, visceral pain, neuropathic pain, diabetic neuropathy, cancer pain and headache, to support the efficacy and underlying biological mechanisms of GLP-1RAs as therapeutic agents for pain suffering. Despite these promising findings, further research is necessary to establish their long-term efficacy, optimal dosing strategies, and potential synergistic interactions of GLP-1RAs with existing pain management therapies. Future clinical trials should aim to distinguish the direct analgesic effects of GLP-1RAs from their metabolic benefits and explore their broader applications in pain conditions. The ongoing exploration of new indications for GLP-1RAs further highlights their transformative potential in advancing medical treatments across diverse clinical fields.

摘要

胰高血糖素样肽-1受体激动剂(GLP-1RAs)在调节血糖水平和脂质代谢方面显示出显著疗效,最初是作为糖尿病的一种有效治疗方法。近年来,GLP-1RAs因其创新的治疗机制、强大的治疗效果和广阔的发展前景,已成为医学界的一个焦点。值得注意的是,GLP-1RAs通过其神经保护和代谢调节特性有益于疼痛管理,例如抑制炎症反应和氧化应激、促进β-内啡肽释放以及调节其他几个关键的生物学途径。因此,GLP-1RAs有望被重新用作疼痛疾病的治疗方法。在这篇叙述性综述中,我们全面追溯了七种疼痛模式(包括炎性疼痛、骨关节炎、内脏痛、神经性疼痛、糖尿病性神经病变、癌痛和头痛)目前的临床前和临床证据,以支持GLP-1RAs作为疼痛治疗药物的疗效及潜在生物学机制。尽管有这些令人鼓舞的发现,但仍需要进一步研究来确定它们的长期疗效、最佳给药策略以及GLP-1RAs与现有疼痛管理疗法的潜在协同相互作用。未来的临床试验应旨在区分GLP-1RAs的直接镇痛作用与其代谢益处,并探索它们在疼痛病症中的更广泛应用。对GLP-1RAs新适应症的持续探索进一步凸显了它们在推进跨不同临床领域医学治疗方面的变革潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a5/11869436/b15b1f326a6e/10194_2025_1979_Fig1_HTML.jpg

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