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慢性炎性疼痛与神经血管单元:神经胶质细胞在维持血脑屏障完整性中起核心作用?

Chronic inflammatory pain and the neurovascular unit: a central role for glia in maintaining BBB integrity?

作者信息

Willis C L, Brooks T A, Davis T P

机构信息

Department of Medical Pharmacology, College of Medicine, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724-5050, USA.

出版信息

Curr Pharm Des. 2008;14(16):1625-43. doi: 10.2174/138161208784705414.

Abstract

Pain is a complex phenomenon involving both a peripheral innate immune response and a CNS response as well as activation of the hypothalamic-pituitary-adrenal axis. The peripheral innate immune response to injury involves the rapid production and local release of proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-/alpha), interleukin-1 (IL-1) and IL-6. Recent studies into the CNS response to peripheral chronic inflammatory pain strongly implicates a role for glia, and local synthesis of proinflammatory cytokines and growth factors. A characteristic feature of CNS inflammation is gliosis, in which inflammatory mediators activate glial cells (e.g. astrocytes and microglia, macrophages and leukocytes) which have been shown to induce and maintain hyperalgesia. In addition, inflammatory pain induces changes in blood-brain barrier (BBB) permeability and alters transport of clinically relevant drugs used to treat pain into the brain. Despite the increasing body of evidence for the involvement of glia in chronic pain and the role of glia in maintaining the BBB, few studies have addressed glial/endothelial interactions and the mechanisms by which glia may regulate the BBB during inflammatory pain. Further studies into the cellular mechanisms of glial/endothelial interactions may identify novel therapeutic targets for reversing chronic inflammatory induced BBB dysfunction and innovate therapies for modulating the severity of chronic inflammatory pain.

摘要

疼痛是一种复杂的现象,涉及外周先天性免疫反应、中枢神经系统反应以及下丘脑 - 垂体 - 肾上腺轴的激活。对损伤的外周先天性免疫反应涉及促炎细胞因子如肿瘤坏死因子 -α(TNF-α)、白细胞介素 -1(IL-1)和IL-6的快速产生和局部释放。最近对中枢神经系统对外周慢性炎性疼痛反应的研究强烈表明神经胶质细胞、促炎细胞因子和生长因子的局部合成起了作用。中枢神经系统炎症的一个特征是胶质细胞增生,其中炎症介质激活神经胶质细胞(如星形胶质细胞和小胶质细胞、巨噬细胞和白细胞),这些细胞已被证明可诱导和维持痛觉过敏。此外,炎性疼痛会导致血脑屏障(BBB)通透性改变,并改变用于治疗疼痛的临床相关药物进入大脑的转运。尽管越来越多的证据表明神经胶质细胞参与慢性疼痛以及神经胶质细胞在维持血脑屏障中的作用,但很少有研究涉及神经胶质细胞/内皮细胞相互作用以及神经胶质细胞在炎性疼痛期间调节血脑屏障的机制。对神经胶质细胞/内皮细胞相互作用的细胞机制进行进一步研究,可能会确定逆转慢性炎症诱导的血脑屏障功能障碍的新治疗靶点,并创新调节慢性炎性疼痛严重程度的疗法。

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