Noh Ain' Sabreena Mohd, Ismail Che Aishah Nazariah
Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Malays J Med Sci. 2020 Feb;27(1):6-21. doi: 10.21315/mjms2020.27.1.2. Epub 2020 Feb 27.
Chronic pain is a debilitating condition that occurs after tissue damage, which substantially affects the patient's emotional state and physical activity. The chronic pain in rheumatoid arthritis (RA) is the result of various autoimmune-induced inflammatory reactions in the joints. Both types of peripheral and central pain processing can lead to sensitisation. Non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs) can result in potent anti-inflammatory effect. However, these drugs are not able to suppress the pain from RA for a prolonged period. For years, researchers have examined the role of the N-methyl-D-aspartic acid receptor 2B (NR2B) subunit of N-methyl-D-aspartate receptors (NMDAR) in chronic and neuropathic pain models. This NMDAR subtype can be found in at the peripheral and central nervous system and it represents an effective therapy for RA pain management. This review focuses on the NR2B subunit of NMDAR and the different pathways leading to its activation. Furthermore, specific attention is given to the possible involvement of NR2B subunit in the peripheral and central pathogenesis of RA.
慢性疼痛是一种在组织损伤后出现的使人衰弱的病症，它会严重影响患者的情绪状态和身体活动。类风湿性关节炎（RA）中的慢性疼痛是关节中各种自身免疫诱导的炎症反应的结果。外周和中枢疼痛处理这两种类型都可导致敏化。非甾体抗炎药（NSAIDs）和改善病情抗风湿药（DMARDs）可产生强效抗炎作用。然而，这些药物无法长期抑制RA引起的疼痛。多年来，研究人员一直在研究N-甲基-D-天冬氨酸受体（NMDAR）的N-甲基-D-天冬氨酸受体2B（NR2B）亚基在慢性和神经性疼痛模型中的作用。这种NMDAR亚型可在周围和中枢神经系统中发现，它是RA疼痛管理的一种有效疗法。本综述重点关注NMDAR的NR2B亚基以及导致其激活的不同途径。此外，还特别关注NR2B亚基在RA外周和中枢发病机制中的可能作用。
