Yekkirala Ajay S, Roberson David P, Bean Bruce P, Woolf Clifford J
Department of Neurobiology, Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, Massachusetts 02115, USA.
FM Kirby Neurobiology Center Boston Children's Hospital, 300 Longwood Avenue, Boston, Massachusetts 02115, USA.
Nat Rev Drug Discov. 2017 Aug;16(8):545-564. doi: 10.1038/nrd.2017.87. Epub 2017 Jun 9.
Acute and chronic pain complaints, although common, are generally poorly served by existing therapies. This unmet clinical need reflects a failure to develop novel classes of analgesics with superior efficacy, diminished adverse effects and a lower abuse liability than those currently available. Reasons for this include the heterogeneity of clinical pain conditions, the complexity and diversity of underlying pathophysiological mechanisms, and the unreliability of some preclinical pain models. However, recent advances in our understanding of the neurobiology of pain are beginning to offer opportunities for developing novel therapeutic strategies and revisiting existing targets, including modulating ion channels, enzymes and G-protein-coupled receptors.
急慢性疼痛主诉虽然常见,但现有治疗方法通常难以满足需求。这种未得到满足的临床需求反映出未能开发出疗效优于现有药物、副作用更少且滥用可能性更低的新型镇痛药。原因包括临床疼痛状况的异质性、潜在病理生理机制的复杂性和多样性,以及一些临床前疼痛模型的不可靠性。然而,我们对疼痛神经生物学理解的最新进展开始为开发新的治疗策略和重新审视现有靶点提供机会,包括调节离子通道、酶和G蛋白偶联受体。