Pain Medicine, The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Pediatrics and Critical Care Medicine, The George Washington University.
Department of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, Washington, DC.
Clin J Pain. 2019 Jun;35(6):473-480. doi: 10.1097/AJP.0000000000000705.
Understanding the molecular biology of opioid analgesia is essential for its proper implementation and mechanistic approach to its modulation in order to maximize analgesia and minimize undesired effects. By appreciating the molecular mechanisms intrinsic to opioid analgesia, one can manipulate a molecular target to augment or diminish a specific effect using adjuvant drugs, select an appropriate opioid for opioid rotation or define a molecular target for new opioid drug development. In this review, we present the cellular and molecular mechanisms of opioid analgesia and that of the associated phenomena of tolerance, dependence, and hyperalgesia. The specific mechanisms highlighted are those that presently can be clinically addressed.
了解阿片类镇痛药的分子生物学对于其正确实施以及对其进行调节的机制方法至关重要，目的是最大限度地提高镇痛效果并最小化不良反应。通过了解阿片类镇痛药内在的分子机制，人们可以利用辅助药物来操纵分子靶点，增强或减弱特定的效应，选择合适的阿片类药物进行阿片类药物的转换，或确定新的阿片类药物开发的分子靶点。在这篇综述中，我们介绍了阿片类镇痛药的细胞和分子机制，以及与之相关的耐受、依赖和痛觉过敏现象。重点介绍的特定机制是目前可以在临床上解决的机制。
