Blackburn-Munro G, Blackburn-Munro R E
Laboratory of Neuroendocrinology, Department of Biomedical Sciences, University of Edinburgh, Hugh Robson Building, George Square, Edinburgh, EH8 9XD, UK.
J Neuroendocrinol. 2001 Dec;13(12):1009-23. doi: 10.1046/j.0007-1331.2001.00727.x.
Chronic pain and depressive illness are debilitating disease states that are variably resistant to currently available therapeutic agents. Animal models of chronic pain are associated with activation of the hypothalamo-pituitary-adrenal (HPA) axis, upon which chronic pain acts as an inescapable stressor. Inescapable stress is also associated with 'depressive-like' symptoms in experimental animals. Based on reports of the comorbidity between chronic pain and depressive illness in human patients, it is possible that these disease states are linked, via chronic stress-induced HPA dysfunction. Here, we discuss the possible involvement of the HPA axis in the aetiology of both chronic pain and clinical depression, and suggest a strategy for the development of novel pharmacotherapies.
慢性疼痛和抑郁症是使人衰弱的疾病状态，对目前可用的治疗药物具有不同程度的耐药性。慢性疼痛的动物模型与下丘脑 - 垂体 - 肾上腺（HPA）轴的激活有关，慢性疼痛在该轴上充当无法逃避的应激源。无法逃避的应激也与实验动物的“抑郁样”症状有关。基于人类患者慢性疼痛和抑郁症共病的报告，这些疾病状态可能通过慢性应激诱导的HPA功能障碍而相互关联。在此，我们讨论HPA轴在慢性疼痛和临床抑郁症病因学中可能的作用，并提出开发新型药物疗法的策略。
