Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, 3 Genome CT, MSRB3 Room 6148, Durham, NC, 27710, USA.
Research Unit for the Neurobiology of Pain, Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
J Anesth. 2019 Feb;33(1):131-139. doi: 10.1007/s00540-018-2579-4. Epub 2018 Nov 17.
Inflammation is the body's response to injury and infection, involving a complex biological response of the somatosensory, immune, autonomic, and vascular systems. Inflammatory mediators such as prostaglandin, proinflammatory cytokines, and chemokines induce pain via direct activation of nociceptors, the primary sensory neurons that detect noxious stimuli. Neurogenic inflammation is triggered by nerve activation and results in neuropeptide release and rapid plasma extravasation and edema, contributing to pain conditions such as headache. Neuroinflammation is a localized inflammation in the peripheral nervous system (PNS) and central nervous system (CNS). A characteristic feature of neuroinflammation is the activation of glial cells in dorsal root ganglia, spinal cord, and brain which leads to the production of proinflammatory cytokines and chemokines in the PNS and CNS that drives peripheral sensitization and central sensitization. Here, we discuss the distinct roles of inflammation, neurogenic inflammation, and neuroinflammation in the regulation of different types of pain conditions, with a special focus on neuroinflammation in postoperative pain and opioid-induced hyperalgesia.
炎症是机体对损伤和感染的反应，涉及躯体感觉、免疫、自主和血管系统的复杂生物学反应。炎症介质（如前列腺素、促炎细胞因子和趋化因子）通过直接激活痛觉感受器（检测有害刺激的主要感觉神经元）诱导疼痛。神经源性炎症是由神经激活引发的，导致神经肽释放以及快速的血浆外渗和水肿，导致头痛等疼痛状况。神经炎症是周围神经系统（PNS）和中枢神经系统（CNS）中的局部炎症。神经炎症的一个特征是背根神经节、脊髓和大脑中的神经胶质细胞被激活，导致 PNS 和 CNS 中促炎细胞因子和趋化因子的产生，从而驱动外周致敏和中枢致敏。在这里，我们讨论了炎症、神经源性炎症和神经炎症在不同类型疼痛状况调节中的不同作用，特别关注术后疼痛和阿片类药物引起的痛觉过敏中的神经炎症。
