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伤害感受器:热觉过敏和热痛。

Nociceptors: thermal allodynia and thermal pain.

作者信息

Viana Félix

机构信息

Alicante Institute of Neurosciences, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas, San Juan de Alicante, Spain.

出版信息

Handb Clin Neurol. 2018;156:103-119. doi: 10.1016/B978-0-444-63912-7.00006-0.

Abstract

The sensation of pain plays a vital protecting role, alerting organisms about potentially damaging stimuli. Tissue injury is detected by nerve endings of specialized peripheral sensory neurons called nociceptors that are equipped with different ion channels activated by thermal, mechanic, and chemical stimuli. Several transient receptor potential channels have been identified as molecular transducers of thermal stimuli in pain-sensing neurons. Skin injury or inflammation leads to increased sensitivity to thermal and mechanic stimuli, clinically defined as allodynia or hyperalgesia. This hypersensitivity is also characteristic of systemic inflammatory disorders and neuropathic pain conditions. Mechanisms of thermal hyperalgesia include peripheral sensitization of nociceptor afferents and maladaptive changes in pain-encoding neurons within the central nervous system. An important aspect of pain management involves attempts to minimize the development of nociceptor hypersensitivity. However, knowledge about the cellular and molecular mechanisms causing thermal hyperalgesia and allodynia in human subjects is still limited, and such knowledge would be an essential step for the development of more effective therapies.

摘要

疼痛的感觉起着至关重要的保护作用,提醒生物体注意潜在的有害刺激。组织损伤由称为伤害感受器的特殊外周感觉神经元的神经末梢检测到,这些神经末梢配备有由热、机械和化学刺激激活的不同离子通道。几种瞬时受体电位通道已被确定为疼痛感知神经元中热刺激的分子转换器。皮肤损伤或炎症会导致对热和机械刺激的敏感性增加,临床上定义为异常性疼痛或痛觉过敏。这种超敏反应也是全身性炎症性疾病和神经性疼痛病症的特征。热痛觉过敏的机制包括伤害感受器传入神经的外周敏化以及中枢神经系统内疼痛编码神经元的适应不良变化。疼痛管理的一个重要方面涉及尽量减少伤害感受器超敏反应的发展。然而,关于导致人类受试者热痛觉过敏和异常性疼痛的细胞和分子机制的知识仍然有限,而这些知识对于开发更有效的治疗方法将是必不可少的一步。

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