Rygh L J, Fagerlund T H, Svendsen F
Fysiologisk institutt og Locus for Nevrovitenskapene Det medisinske fakultet Universitetet i Bergen Arstadveien 19 5009 Bergen.
Tidsskr Nor Laegeforen. 2001 Jun 20;121(16):1917-22.
The recent rapid progress in pain research is due in large part to advances in genetics and cell and molecular biology. We now know that chronic pain (hypersensitivity due to inflammation or nerve injury) and acute nociceptive pain are different and must be treated accordingly. We will continue to reveal sophisticated mechanisms underlying different kinds of pain that can be targeted to inhibit nociceptive transmission and produce analgesia.
This review is based upon literature collected through the authors' own reading and through PubMed searches. New hopes for future pain treatments are discussed. Further, the impact of genetic factors on pain sensitivity and pain modulation are discussed, and conceivable therapeutic approaches based on genetic techniques are mentioned.
At the level of the peripheral nerve, many novel targets have recently been identified: the tetrodotoxin-resistant sodium channel, the vanilloid receptor and different calcium channels are very interesting. In the spinal cord, different approaches can be used: to either block excitatory input or to increase inhibitory control or to do both at the same time. The mechanisms for hypersensitivity are being identified and offer multiple possible targets for novel analgesics.
Many interesting targets for analgetics has emerged during that last few years, lending great hope for new and better (i.e. with less side effects) analgesic drugs in the future.
疼痛研究最近的快速进展在很大程度上归功于遗传学以及细胞与分子生物学的进步。我们现在知道，慢性疼痛（由炎症或神经损伤引起的超敏反应）与急性伤害性疼痛不同，必须相应地进行治疗。我们将继续揭示不同类型疼痛背后的复杂机制，这些机制可作为靶点来抑制伤害性信号传递并产生镇痛作用。
本综述基于作者自身阅读以及通过PubMed检索收集的文献。讨论了未来疼痛治疗的新希望。此外，还讨论了遗传因素对疼痛敏感性和疼痛调节的影响，并提及了基于遗传技术的可设想治疗方法。
在周围神经层面，最近已确定了许多新靶点：耐河豚毒素的钠通道、香草酸受体和不同的钙通道都非常令人关注。在脊髓层面，可以采用不同方法：要么阻断兴奋性输入，要么增强抑制性控制，或者同时进行这两种操作。超敏反应的机制正在被确定，为新型镇痛药提供了多个可能的靶点。
在过去几年中出现了许多有趣的镇痛药靶点，为未来研发新的、更好的（即副作用更少的）镇痛药带来了巨大希望。
