Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy.
Mediators Inflamm. 2013;2013:648268. doi: 10.1155/2013/648268. Epub 2013 Jun 5.
Chronic pain is a debilitating condition with major socioeconomic impact, whose neurobiological basis is still not clear. An involvement of the neurovascular unit (NVU) has been recently proposed. In particular, the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB), two NVU key players, may be affected during the development of chronic pain; in particular, transient permeabilization of the barrier is suggested by several inflammatory- and nerve-injury-based pain models, and we argue that the clarification of molecular BBB/BSCB permeabilization events will shed new light in understanding chronic pain mechanisms. Possible biases in experiments supporting this theory and its translational potentials are discussed. Moving beyond an exclusive focus on the role of the endothelium, we propose that our understanding of the mechanisms subserving chronic pain will benefit from the extension of research efforts to the NVU as a whole. In this view, the available evidence on the interaction between analgesic drugs and the NVU is here reviewed. Chronic pain comorbidities, such as neuroinflammatory and neurodegenerative diseases, are also discussed in view of NVU changes, together with innovative pharmacological solutions targeting NVU components in chronic pain treatment.
慢性疼痛是一种具有重大社会经济影响的衰弱性疾病，其神经生物学基础尚不清楚。最近有人提出了神经血管单元（NVU）的参与。特别是，血脑屏障（BBB）和血脊髓屏障（BSCB），作为 NVU 的两个关键组成部分，可能会在慢性疼痛的发展过程中受到影响；特别是，几种炎症和神经损伤性疼痛模型表明屏障会出现短暂的通透性增加，我们认为，阐明分子 BBB/BSCB 通透性事件将为理解慢性疼痛机制提供新的线索。本文讨论了支持这一理论的实验中可能存在的偏见及其转化潜力。超越对内皮细胞作用的单一关注，我们提出，我们对支持慢性疼痛机制的研究将受益于将研究扩展到整个 NVU。在这种观点下，本文综述了关于镇痛药物与 NVU 相互作用的现有证据。还讨论了慢性疼痛的共病，如神经炎症和神经退行性疾病，以及针对 NVU 成分的创新药物治疗方案在慢性疼痛治疗中的应用。
