Center for Pain Research, Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Nat Med. 2010 Nov;16(11):1248-57. doi: 10.1038/nm.2235. Epub 2010 Oct 14.
The incidence of chronic pain is estimated to be 20-25% worldwide. Few patients with chronic pain obtain complete relief from the drugs that are currently available, and more than half report inadequate relief. Underlying the challenge of developing better drugs to manage chronic pain is incomplete understanding of the heterogeneity of mechanisms that contribute to the transition from acute tissue insult to chronic pain and to pain conditions for which the underlying pathology is not apparent. An intact central nervous system (CNS) is required for the conscious perception of pain, and changes in the CNS are clearly evident in chronic pain states. However, the blockage of nociceptive input into the CNS can effectively relieve or markedly attenuate discomfort and pain, revealing the importance of ongoing peripheral input to the maintenance of chronic pain. Accordingly, we focus here on nociceptors: their excitability, their heterogeneity and their role in initiating and maintaining pain.
慢性疼痛的发病率估计在全球范围内为 20-25%。目前可用的药物很少能使慢性疼痛患者完全缓解，超过一半的患者报告缓解不足。开发更好的药物来管理慢性疼痛的挑战在于，人们对导致从急性组织损伤向慢性疼痛以及潜在病理不明显的疼痛状况转变的机制的异质性理解不完整。中枢神经系统（CNS）的完整对于疼痛的意识感知是必需的，而在慢性疼痛状态下，CNS 的变化是显而易见的。然而，阻断传入中枢神经系统的伤害性输入可以有效地缓解或明显减轻不适和疼痛，这表明持续的外周输入对维持慢性疼痛的重要性。因此，我们在这里重点关注伤害感受器：它们的兴奋性、它们的异质性以及它们在引发和维持疼痛中的作用。
