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疼痛与镇痛对脓毒症啮齿动物模型的影响

The Influence of Pain and Analgesia in Rodent Models of Sepsis.

作者信息

Carpenter Kelsey C, Hakenjos John M, Fry Christopher D, Nemzek Jean A

机构信息

Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, Michigan.

Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, Michigan;, Email:

出版信息

Comp Med. 2019 Dec 1;69(6):546-554. doi: 10.30802/AALAS-CM-19-000004. Epub 2019 Jun 18.

Abstract

Sepsis is a multifaceted host response to infection that dramatically affects patient outcomes and the cost of health care. Animal models are necessary to replicate the complexity and heterogeneity of clinical sepsis. However, these models entail a high risk of pain and distress due to tissue trauma, inflammation, endotoxin-mediated hyperalgesia, and other mechanisms. Several recent studies and initiatives address the need to improve the welfare of animals through analgesics and standardize the models used in preclinical sepsis research. Ultimately, the goal is to provide high-fidelity, humane animal models that better replicate the clinical course of sepsis, to provide more effective translation and advance therapeutic discovery. The purpose of this review is to discuss the current understanding of the roles of pain and analgesia in rodent models of sepsis. The current definitions of sepsis along with an overview of pain in human sepsis are described. Finally, welfare concerns associated with animal models of sepsis and the most recent considerations for relief of pain and distress are reviewed.

摘要

脓毒症是机体对感染的一种多方面反应,会显著影响患者的预后及医疗成本。动物模型对于复制临床脓毒症的复杂性和异质性是必要的。然而,由于组织创伤、炎症、内毒素介导的痛觉过敏及其他机制,这些模型存在较高的疼痛和痛苦风险。最近的几项研究和倡议提出,需要通过使用镇痛药来改善动物福利,并规范临床前脓毒症研究中使用的模型。最终目标是提供能更好地复制脓毒症临床病程的高保真、人道的动物模型,以实现更有效的转化并推动治疗方法的发现。本综述的目的是讨论目前对疼痛和镇痛在脓毒症啮齿动物模型中作用的理解。文中描述了脓毒症的当前定义以及人类脓毒症中疼痛的概述。最后,对与脓毒症动物模型相关的福利问题以及缓解疼痛和痛苦的最新考量进行了综述。

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