Uçeyler Nurcan, Sommer Claudia
Department of Neurology, University of Würzburg, Würzburg, Germany.
Curr Pain Headache Rep. 2008 Jun;12(3):159-64. doi: 10.1007/s11916-008-0029-y.
Peripheral neuropathies of identical etiology can be painful or painless. The reason for this difference in clinical presentation is as yet unknown; however, immune mediators, particularly cytokines, may play a role. Cytokines are proteins that are produced by immune and nonimmune cells and are categorized as pro- and anti-inflammatory. The role of cytokines in the induction and maintenance of pain has been well established in animal models. Proinflammatory cytokines are mostly algesic, whereas anti-inflammatory cytokines have analgesic properties. Clinical research also gives evidence for the involvement of cytokines in painful and painless neuropathies. A proinflammatory cytokine profile seems to be associated with pain in peripheral neuropathies of different etiologies and in other painful disorders such as the complex regional pain syndrome. Specifically, an imbalance between pro- and anti-inflammatory cytokines may contribute to pain generation. A better understanding of the underlying pathophysiology may open new opportunities for the treatment of pain.
相同病因的周围神经病变可能有疼痛症状，也可能没有疼痛症状。目前尚不清楚这种临床表现差异的原因；然而，免疫介质，尤其是细胞因子，可能发挥了作用。细胞因子是由免疫细胞和非免疫细胞产生的蛋白质，分为促炎和抗炎两类。细胞因子在疼痛的诱导和维持中的作用在动物模型中已得到充分证实。促炎细胞因子大多具有致痛作用，而抗炎细胞因子具有镇痛特性。临床研究也证明细胞因子参与了疼痛性和无痛性神经病变。促炎细胞因子谱似乎与不同病因的周围神经病变以及其他疼痛性疾病（如复杂性区域疼痛综合征）中的疼痛有关。具体而言，促炎和抗炎细胞因子之间的失衡可能导致疼痛的产生。更好地理解潜在的病理生理学可能为疼痛治疗带来新的机会。
