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奥沙利铂所致神经病变中的疼痛——外周和中枢伤害性感受系统的敏化

Pain in oxaliplatin-induced neuropathy--sensitisation in the peripheral and central nociceptive system.

作者信息

Binder Andreas, Stengel Maike, Maag Rainer, Wasner Gunnar, Schoch Robert, Moosig Frank, Schommer Bernhard, Baron Ralf

机构信息

Division of Neurological Pain Research and Therapy, Christian-Albrechts-Universität Kiel, Schittenhelmstrasse 10, 24105 Kiel, Germany.

出版信息

Eur J Cancer. 2007 Dec;43(18):2658-63. doi: 10.1016/j.ejca.2007.07.030. Epub 2007 Sep 12.

Abstract

BACKGROUND

This study aimed to determine the somatosensory characteristics and pain types in patients with acute oxaliplatin-induced neuropathy and to relate this profile to the hereby detected underlying pathophysiological mechanisms.

PATIENTS AND METHODS

Sixteen patients treated with oxaliplatin for cancer were characterised with neurological assessment and a standardised and validated set for quantitative sensory testing (QST). Patients were allocated to two groups depending on the presence or absence of pain symptoms of acute neuropathy.

RESULTS

Comparison with normative data revealed in patients with pain symptoms a characteristic somatosensory profile of cold and mechanical hyperalgesia. Group-to-group analysis revealed additional heat hyperalgesia and warm hypoesthesia.

CONCLUSION

Pain symptoms of acute oxaliplatin-induced neuropathy are related to signs of sensitisation within the peripheral (cold and heat hyperalgesia) and central nervous nociceptive system (mechanical hyperalgesia). This strengthens the rationale for treatment with anticonvulsants and antidepressants and fosters research on ion channel and receptor related mechanisms.

摘要

背景

本研究旨在确定急性奥沙利铂诱导的神经病变患者的躯体感觉特征和疼痛类型,并将此特征与在此检测到的潜在病理生理机制相关联。

患者与方法

对16例接受奥沙利铂治疗癌症的患者进行神经学评估以及一套标准化且经过验证的定量感觉测试(QST)。根据是否存在急性神经病变的疼痛症状,将患者分为两组。

结果

与正常数据相比,有疼痛症状的患者表现出冷觉和机械性痛觉过敏的特征性躯体感觉特征。组间分析显示还存在热痛觉过敏和温觉减退。

结论

急性奥沙利铂诱导的神经病变的疼痛症状与外周(冷觉和热觉过敏)和中枢神经伤害感受系统(机械性痛觉过敏)内的敏化迹象有关。这加强了使用抗惊厥药和抗抑郁药进行治疗的理论依据,并促进了对离子通道和受体相关机制的研究。

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