Ceccherelli F, Costa C, Ischia S, Ischia A, Giron G, Allegri G
Department of Anesthesiology and Intensive Care, University of Padua, Italy.
Funct Neurol. 1989 Oct-Dec;4(4):341-53.
The authors investigated the cerebral metabolism of tryptophan in patients suffering from malignant pain by means of CSF dosage of tryptophan (Trp), 5-hydroxytryptophan (5-HTP), serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA). The level of 5-HIAA in patients with pain was 66.48 +/- 13.67 ng/ml, while in those without pain was 25.05 +/- 13.25 ng/ml; the difference was statistically significant, p = 0.001. Trp, 5-HTP and 5-HT levels did not register significant differences in the two groups of patients, although a tendency to lower values was seen in patients with pain, supporting the hypothesis of increased turnover of this metabolic pathway in cancer patients. A statistically significant inverse correlation was also found between cerebral Trp levels and pain levels measured on the Scott-Huskisson visual analogue scale. The data obtained confirm the importance of the cerebral serotoninergic pathway in pain modulation and the interest which CSF analysis may have for the assessment of patients suffering from pain.
作者通过脑脊液中色氨酸（Trp）、5-羟色氨酸（5-HTP）、血清素（5-HT）和5-羟吲哚乙酸（5-HIAA）的剂量测定，研究了恶性疼痛患者大脑中色氨酸的代谢情况。疼痛患者的5-HIAA水平为66.48±13.67 ng/ml，而无疼痛患者的该水平为25.05±13.25 ng/ml；差异具有统计学意义，p = 0.001。两组患者的Trp、5-HTP和5-HT水平无显著差异，尽管疼痛患者有值降低的趋势，这支持了癌症患者该代谢途径周转率增加的假设。在大脑Trp水平与用斯科特-赫斯基森视觉模拟量表测量的疼痛水平之间还发现了具有统计学意义的负相关。所获得的数据证实了大脑5-羟色胺能通路在疼痛调节中的重要性，以及脑脊液分析对疼痛患者评估可能具有的意义。
