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将伤害性感受处理转化为人类疼痛模型。

Translating nociceptive processing into human pain models.

作者信息

Schmelz Martin

机构信息

Department of Anesthesiology, University of Heidelberg, Mannheim, Germany.

出版信息

Exp Brain Res. 2009 Jun;196(1):173-8. doi: 10.1007/s00221-009-1809-2. Epub 2009 Apr 29.

Abstract

As volunteers can easily communicate quality and intensity of painful stimuli, human pain models appear to be ideally suited to test analgesic compounds, but also to study pain mechanisms. Acute stimulation of nociceptors under physiologic conditions has proven not to be of particular use as an experimental pain model. In contrast, if the experimental models include sensitization of the peripheral or central pain processing they may indeed mimic certain aspects of chronic pain conditions. Peripheral inflammatory conditions can be induced experimentally with sensitization patterns correlating to clinical inflammatory pain. There are also well-characterized models of central sensitization, which mimic aspects of neuropathic pain patients such as touch evoked allodynia and punctate hyperalgesia. The main complaint of chronic pain patients, however, is spontaneous pain, but currently there is no human model available that would mimic chronic inflammatory or neuropathic pain. Thus, although being helpful for proof of concept studies and dose finding, current human pain models cannot replace patient studies for testing efficacy of analgesic compounds.

摘要

由于志愿者能够轻松传达疼痛刺激的性质和强度,人体疼痛模型似乎非常适合测试镇痛化合物,也适合研究疼痛机制。事实证明,在生理条件下对伤害感受器进行急性刺激作为一种实验性疼痛模型并没有特别的用途。相比之下,如果实验模型包括外周或中枢疼痛处理的敏化,那么它们确实可以模拟慢性疼痛状况的某些方面。外周炎症状况可以通过与临床炎症性疼痛相关的敏化模式进行实验诱导。也有特征明确的中枢敏化模型,它们模拟了神经性疼痛患者的一些方面,如触摸诱发的痛觉过敏和点状痛觉过敏。然而,慢性疼痛患者的主要抱怨是自发性疼痛,但目前还没有能够模拟慢性炎症性或神经性疼痛的人体模型。因此,尽管当前的人体疼痛模型有助于概念验证研究和剂量确定,但在测试镇痛化合物的疗效方面,它们无法替代患者研究。

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