Zouikr Ihssane, Karshikoff Bianka
Laboratory for Molecular Mechanisms of Thalamus Development, RIKEN BSI , Wako , Japan.
Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Solna, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.
Front Immunol. 2017 Mar 13;8:276. doi: 10.3389/fimmu.2017.00276. eCollection 2017.
Chronic pain is a debilitating condition that still is challenging both clinicians and researchers. Despite intense research, it is still not clear why some individuals develop chronic pain while others do not or how to heal this disease. In this review, we argue for a multisystem approach to understand chronic pain. Pain is not only to be viewed simply as a result of aberrant neuronal activity but also as a result of adverse early-life experiences that impact an individual's endocrine, immune, and nervous systems and changes which in turn program the pain system. First, we give an overview of the ontogeny of the central nervous system, endocrine, and immune systems and their windows of vulnerability. Thereafter, we summarize human and animal findings from our laboratories and others that point to an important role of the endocrine and immune systems in modulating pain sensitivity. Taking "early-life history" into account, together with the past and current immunological and endocrine status of chronic pain patients, is a necessary step to understand chronic pain pathophysiology and assist clinicians in tailoring the best therapeutic approach.
慢性疼痛是一种使人衰弱的病症，至今仍对临床医生和研究人员构成挑战。尽管进行了深入研究，但仍不清楚为什么有些人会患上慢性疼痛而另一些人不会，也不清楚如何治愈这种疾病。在本综述中，我们主张采用多系统方法来理解慢性疼痛。疼痛不应仅仅被视为异常神经元活动的结果，还应被视为早期不良生活经历的结果，这些经历会影响个体的内分泌、免疫和神经系统，进而导致疼痛系统发生变化。首先，我们概述中枢神经系统、内分泌系统和免疫系统的个体发生及其脆弱期。此后，我们总结了来自我们实验室及其他实验室的人类和动物研究结果，这些结果表明内分泌系统和免疫系统在调节疼痛敏感性方面具有重要作用。将“早期生活史”与慢性疼痛患者过去和当前的免疫及内分泌状况相结合，是理解慢性疼痛病理生理学并协助临床医生制定最佳治疗方法的必要步骤。
