Duffy Samuel S, Lees Justin G, Perera Chamini J, Moalem-Taylor Gila
School of Medical Sciences, the University of New South Wales, UNSW Australia, Sydney, NSW 2052, Australia.
Med Chem. 2018 Feb 6;14(2):106-119. doi: 10.2174/1573406413666170906122508.
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). Of the plethora of motor and sensory disturbances experienced by sufferers, neuropathic pain is a highly prevalent and debilitating symptom, and at present remains extremely difficult to treat. Common forms of neuropathic pain seen in MS patients include central neuropathic pain, Lhermitte's phenomenon and trigeminal neuralgia, which are all speculated to arise from specific patterns of lesion formation.
Efficacious pharmacological interventions for the treatment of neuropathic pain associated with MS are lacking, and have been largely informed by drug trials in peripheral neuropathies and spinal cord injury.
METHOD/RESULTS: Neuropathic pain in MS is inadequately relieved by conventional analgesics, and first-line therapies are generally comprised of anti-depressive and anti-convulsive drugs. A range of alternatives have been proposed and tested with variable success, including cannabinoids and certain opioid analgesics. Animals with experimental autoimmune encephalomyelitis (EAE), an autoimmune model of MS, also exhibit neuropathic pain symptoms.
Studies aimed at understanding the mechanisms underlying EAE-induced neuropathic pain and investigating the efficacy of novel pharmacological interventions at the animal level offer an exciting area of future research, and may inform future therapeutic options for MS-associated neuropathic pain.
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性炎症性脱髓鞘疾病。在患者经历的众多运动和感觉障碍中，神经性疼痛是一种非常普遍且使人衰弱的症状，目前仍然极难治疗。MS患者中常见的神经性疼痛形式包括中枢性神经性疼痛、莱尔米特现象和三叉神经痛，据推测这些都源于特定的病变形成模式。
缺乏有效的药物干预来治疗与MS相关的神经性疼痛，目前主要是参考外周神经病变和脊髓损伤的药物试验。
方法/结果：传统镇痛药对MS中的神经性疼痛缓解不足，一线治疗通常包括抗抑郁药和抗惊厥药。已经提出并测试了一系列替代方法，但效果各异，包括大麻素和某些阿片类镇痛药。患有实验性自身免疫性脑脊髓炎（EAE）（一种MS的自身免疫模型）的动物也表现出神经性疼痛症状。
旨在了解EAE诱导的神经性疼痛背后机制并在动物水平研究新型药物干预疗效的研究，为未来研究提供了一个令人兴奋的领域，可能为MS相关神经性疼痛的未来治疗选择提供参考。
