School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas.
Department of Neurobiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Pain Med. 2018 Aug 1;19(8):1525-1549. doi: 10.1093/pm/pnx108.
Persistent pain causes untold misery worldwide and is a leading cause of disability. Despite its astonishing prevalence, pain is undertreated, at least in part because existing therapeutics are ineffective or cause intolerable side effects. In this review, we cover new findings about the neurobiology of pain and argue that all but the most transient forms of pain needed to avoid tissue damage should be approached as a disease where a cure can be the goal of all treatment plans, even if attaining this goal is not yet always possible.
We reviewed the literature to highlight recent advances in the area of the neurobiology of pain.
We discuss barriers that are currently hindering the achievement of this goal, as well as the development of new therapeutic strategies. We also discuss innovations in the field that are creating new opportunities to treat and even reverse persistent pain, some of which are in late-phase clinical trials.
We conclude that the confluence of new basic science discoveries and development of new technologies are creating a path toward pain therapeutics that should offer significant hope of a cure for patients and practitioners alike. Classification of Evidence. Our review points to new areas of inquiry for the pain field to advance the goal of developing new therapeutics to treat chronic pain.
持续性疼痛在全球范围内造成了难以言喻的痛苦,是导致残疾的主要原因之一。尽管其发病率惊人,但疼痛的治疗效果不佳,至少部分原因是现有的治疗方法无效或会引起无法忍受的副作用。在这篇综述中,我们将介绍有关疼痛神经生物学的新发现,并认为,除了为避免组织损伤而需要的最短暂的疼痛形式外,所有疼痛都应被视为一种疾病,所有治疗方案都应以治愈为目标,即使目前并非总能实现这一目标。
我们回顾了文献,以突出疼痛神经生物学领域的最新进展。
我们讨论了目前阻碍实现这一目标的障碍,以及新治疗策略的发展。我们还讨论了该领域的创新,这些创新为治疗甚至逆转持续性疼痛创造了新的机会,其中一些已经进入后期临床试验。
我们得出结论,新的基础科学发现和新技术的发展正在为疼痛治疗学开辟道路,这应该为患者和从业者带来治愈慢性疼痛的巨大希望。证据分类。我们的综述指出了疼痛领域新的研究领域,以推进开发新疗法治疗慢性疼痛的目标。