Li Shao-Jun, Zhang Yu-Fen, Ma Se-Hui, Yi Yao, Yu Hong-Yan, Pei Lei, Feng Dan
Department of Pain Management, Wuhan First Hospital Department of Neurobiology, School of Basic Medicine, Tongji Medical College The Institute for Brain Research (IBR), Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2018 Aug;97(33):e11861. doi: 10.1097/MD.0000000000011861.
NLRP3 inflammasome plays a prominent role in the pathogenesis and progression of many diseases, such as type 2 diabetes mellitus, obesity, atherosclerosis, and Alzheimer's disease. However, little knowledge is known about the role of NLRP3 inflammasome in central post-stroke pain (CPSP).
We selected relevant studies by searching PubMed, Embase, and Medline from inception through February, 2018. We systematically reviewed available publications according to the terms "NLRP3 inflammasome" and "stroke" or "central post-stroke pain" in the title/abstract field.
We reviewed the articles and put forward two possible ways for NLRP3 inflammasome in CPSP. One way is that NLRP3 activation causes cerebral cortex injure, decreasing descending projection fiber to thalamus. Such condition may let GABAergic releases reduce, making the ventral basal (VB) neurons excitability increased. Finally, CPSP occur. Another way is that NLRP3 inflammasome leads to thalamic lesion and strengthens inflammatory response of microglia at the same time. Persistent inflammation causes GABAergic alteration in thalamus reticular neurons (TRN) to restrain VB interneurons functions, contributing to CPSP.
These possible mechanisms will help become knowledgeable about the occurrence CPSP and provide potential therapy for CPSP.
NLRP3炎性小体在许多疾病的发病机制和进展中发挥着重要作用,如2型糖尿病、肥胖症、动脉粥样硬化和阿尔茨海默病。然而,关于NLRP3炎性小体在中风后中枢性疼痛(CPSP)中的作用知之甚少。
我们通过检索从创刊到2018年2月的PubMed、Embase和Medline来选择相关研究。我们根据标题/摘要字段中的“NLRP3炎性小体”和“中风”或“中风后中枢性疼痛”等术语,系统地回顾了现有出版物。
我们回顾了这些文章,并提出了NLRP3炎性小体在CPSP中的两种可能途径。一种途径是NLRP3激活导致大脑皮层损伤,减少向丘脑的下行投射纤维。这种情况可能会使GABA能释放减少,使腹侧基底(VB)神经元的兴奋性增加。最终,发生CPSP。另一种途径是NLRP3炎性小体导致丘脑损伤,同时增强小胶质细胞的炎症反应。持续的炎症会导致丘脑网状神经元(TRN)的GABA能改变,从而抑制VB中间神经元的功能,导致CPSP。
这些可能的机制将有助于了解CPSP的发生,并为CPSP提供潜在的治疗方法。