Department of Anesthesiology, Wayne State University/Detroit Medical Center, Harper University Hospital, MI 48201, USA.
Pain Med. 2011 May;12(5):808-22. doi: 10.1111/j.1526-4637.2011.01120.x.
Chronic neuropathic pain has been an enigma to physicians and researchers for decades. A better understanding of its pathophysiology has given us more insight into its various mechanisms and possible treatment options. We now have an understanding of the role of various ionic channels, biologically active molecules involved in pain, and also the intricate pain pathways where possible interventions might lead to substantial pain relief. The recent research on laboratory animals using virus-based vectors for gene transfer at targeted sites is very promising and may lead to additional human clinical trials. However, one needs to be aware that this "novel" approach is still in its infancy and that many of its details need to be further elucidated. The purpose of this article is to thoroughly review the current available literature and analyze the deficiencies in our current knowledge.
Literature review.
After an extensive online literature search, a total of 133 articles were selected to synthesize a comprehensive review about chronic neuropathic pain and gene therapy in order to understand the concepts and mechanisms.
Most of the studies have shown benefits of gene therapy in animal models, and recently, phase 1 human trials using herpes simplex virus vector have started for intractable cancer pain.
Although animal data have shown safety and efficacy, and initial human trials have been promising, additional studies in humans are required to more completely understand the actual benefits and risks of using gene therapy for the treatment of chronic neuropathic pain.
慢性神经性疼痛几十年来一直是医生和研究人员的难题。对其病理生理学的更好理解使我们更深入地了解其各种机制和可能的治疗选择。我们现在了解了各种离子通道、参与疼痛的生物活性分子的作用，以及可能的干预措施可能导致明显疼痛缓解的复杂疼痛途径。最近，在实验室动物身上使用基于病毒的载体在靶向部位进行基因转移的研究非常有前景，可能会导致更多的人类临床试验。然而，人们需要意识到这种“新颖”的方法仍处于起步阶段，许多细节需要进一步阐明。本文的目的是全面回顾现有文献，并分析我们现有知识的不足。
文献回顾。
经过广泛的在线文献检索，共选择了 133 篇文章，对慢性神经性疼痛和基因治疗进行综合综述，以了解相关概念和机制。
大多数研究表明基因治疗在动物模型中的益处，最近，开始了使用单纯疱疹病毒载体的难治性癌症疼痛的 1 期人体试验。
尽管动物数据显示出安全性和有效性，并且初步的人体试验也很有前景，但需要在人类中进行更多的研究，以更全面地了解使用基因治疗治疗慢性神经性疼痛的实际益处和风险。
