Tsuda Makoto, Inoue Kazuhide
Department of Molecular and System Pharmacology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan.
Nihon Shinkei Seishin Yakurigaku Zasshi. 2006 Feb;26(1):57-61.
Physiological pain is an essential experience that alerts us to the presence of external or internal stimuli that are damaging or are potentially tissue-damaging. By contrast, pathological pain is not tied to the presence of tissue-damaging stimuli. One type of pathological pain-neuropathic pain--is often a consequence of nerve injury or of diseases such as diabetes, HIV AIDS or cancer, that damage peripheral nerves. Neuropathic pain can be agonizing, persistent over long periods, and, unfortunately, is often resistant to known pain-killers. Recent advances in our understanding of the mechanisms producing neuropathic pain have been made by defining causal roles of spinal microglia in the pathogenesis of neuropathic pain as several molecules including P2X4 receptors, which are present in activated microglia, have been found to be required molecular mediators. We expect that understanding the key roles of these molecules in spinal microglia may lead to new strategies for the management of neuropathic pain, strategies not previously anticipated by a neuron-centric view of pain plasticity in the dorsal horn.
生理性疼痛是一种重要的体验,它能提醒我们注意到存在着正在造成损害或可能造成组织损伤的外部或内部刺激。相比之下,病理性疼痛与造成组织损伤的刺激并无关联。病理性疼痛的一种类型——神经性疼痛——通常是神经损伤或诸如糖尿病、人类免疫缺陷病毒/获得性免疫综合征(HIV/AIDS)或癌症等损害外周神经的疾病所导致的后果。神经性疼痛可能极其痛苦,会长期持续,而且不幸的是,它往往对已知的止痛药有抗药性。通过确定脊髓小胶质细胞在神经性疼痛发病机制中的因果作用,我们对产生神经性疼痛的机制的理解有了最新进展,因为已发现包括存在于活化小胶质细胞中的P2X4受体在内的几种分子是必需的分子介质。我们期望,了解这些分子在脊髓小胶质细胞中的关键作用可能会带来治疗神经性疼痛的新策略,而这些策略是以前以背角疼痛可塑性的神经元中心观点未曾预料到的。