MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Trends Pharmacol Sci. 2012 Nov;33(11):568-73. doi: 10.1016/j.tips.2012.08.001. Epub 2012 Sep 6.
The current gap between basic science research and the development of new analgesics presents a serious challenge for the future of pain medicine. This challenge is particularly difficult in the search for better treatment for comorbid chronic pain conditions because: (i) animal 'pain' models do not simulate multidimensional clinical pain conditions; (ii) animal behavioral testing does not assess subjective pain experience; (iii) preclinical data provide little assurance regarding the direction of new analgesic development; and (iv) clinical trials routinely use over-sanitized study populations and fail to capture the multidisciplinary consequences of comorbid chronic pain. Therefore, a paradigm shift in translational pain research is necessary to transform the current strategy from focusing on molecular switches of nociception to studying pain as a system-based integral response that includes psychosocial comorbidities. Several key issues of translational pain research are discussed in this review.
当前基础科学研究与新型镇痛药开发之间存在的差距，给未来的疼痛医学带来了严峻的挑战。在寻求治疗共病性慢性疼痛的更好方法时，这一挑战尤其困难，原因在于：（i）动物“疼痛”模型无法模拟多维临床疼痛状况；（ii）动物行为测试无法评估主观疼痛体验；（iii）临床前数据几乎无法保证新镇痛药开发的方向；（iv）临床试验通常采用过度净化的研究人群，无法捕捉共病性慢性疼痛的多学科后果。因此，有必要在转化疼痛研究中进行范式转变，将当前的策略从关注伤害感受的分子开关，转变为将疼痛作为包括心理社会共病在内的系统整体反应来进行研究。本文综述讨论了转化疼痛研究中的几个关键问题。
