疼痛与抑郁共病的艰难时刻：内源性大麻素系统
High Times for Painful Blues: The Endocannabinoid System in Pain-Depression Comorbidity.
作者信息
Fitzgibbon Marie, Finn David P, Roche Michelle
机构信息
Physiology (Ms Fitzgibbon and Dr Roche), and Pharmacology and Therapeutics (Dr Finn), School of Medicine, Galway Neuroscience Centre and Centre for Pain Research (Ms Fitzgibbon, Dr Finn, and Dr Roche), National Centre for Biomedical Engineering Science, National University of Ireland Galway, Ireland.
出版信息
Int J Neuropsychopharmacol. 2015 Sep 5;19(3):pyv095. doi: 10.1093/ijnp/pyv095.
Depression and pain are two of the most debilitating disorders worldwide and have an estimated cooccurrence of up to 80%. Comorbidity of these disorders is more difficult to treat, associated with significant disability and impaired health-related quality of life than either condition alone, resulting in enormous social and economic cost. Several neural substrates have been identified as potential mediators in the association between depression and pain, including neuroanatomical reorganization, monoamine and neurotrophin depletion, dysregulation of the hypothalamo-pituitary-adrenal axis, and neuroinflammation. However, the past decade has seen mounting evidence supporting a role for the endogenous cannabinoid (endocannabinoid) system in affective and nociceptive processing, and thus, alterations in this system may play a key role in reciprocal interactions between depression and pain. This review will provide an overview of the preclinical evidence supporting an interaction between depression and pain and the evidence supporting a role for the endocannabinoid system in this interaction.
抑郁症和疼痛是全球范围内最具致残性的两种疾病，估计共病率高达80%。与单独的任何一种疾病相比，这些疾病的共病更难治疗，与严重残疾和健康相关生活质量受损有关，导致巨大的社会和经济成本。几种神经基质已被确定为抑郁症和疼痛之间关联的潜在调节因子，包括神经解剖重组、单胺和神经营养因子耗竭、下丘脑-垂体-肾上腺轴失调以及神经炎症。然而，在过去十年中，越来越多的证据支持内源性大麻素（内源性大麻素）系统在情感和伤害性处理中发挥作用，因此，该系统的改变可能在抑郁症和疼痛之间的相互作用中起关键作用。本综述将概述支持抑郁症和疼痛之间相互作用的临床前证据，以及支持内源性大麻素系统在这种相互作用中发挥作用的证据。
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