Suppr超能文献

肠敏化的脊髓以上机制。

Supraspinal Mechanisms of Intestinal Hypersensitivity.

机构信息

Laboratory of Cortico-Visceral Physiology, Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Nab. Makarova, Saint Petersburg, 199034, Russia.

出版信息

Cell Mol Neurobiol. 2022 Mar;42(2):389-417. doi: 10.1007/s10571-020-00967-3. Epub 2020 Oct 8.

Abstract

Gut inflammation or injury causes intestinal hypersensitivity (IHS) and hyperalgesia, which can persist after the initiating pathology resolves, are often referred to somatic regions and exacerbated by psychological stress, anxiety or depression, suggesting the involvement of both the spinal cord and the brain. The supraspinal mechanisms of IHS remain to be fully elucidated, however, over the last decades the series of intestinal pathology-associated neuroplastic changes in the brain has been revealed, being potentially responsible for the phenomenon. This paper reviews current clinical and experimental data, including the authors' own findings, on these functional, structural, and neurochemical/molecular changes within cortical, subcortical and brainstem regions processing and modulating sensory signals from the gut. As concluded in the review, IHS can develop and maintain due to the bowel inflammation/injury-induced persistent hyperexcitability of viscerosensory brainstem and thalamic nuclei and sensitization of hypothalamic, amygdala, hippocampal, anterior insular, and anterior cingulate cortical areas implicated in the neuroendocrine, emotional and cognitive modulation of visceral sensation and pain. An additional contribution may come from the pathology-triggered dysfunction of the brainstem structures inhibiting nociception. The mechanism underlying IHS-associated regional hyperexcitability is enhanced NMDA-, AMPA- and group I metabotropic receptor-mediated glutamatergic neurotransmission in association with altered neuropeptide Y, corticotropin-releasing factor, and cannabinoid 1 receptor signaling. These alterations are at least partially mediated by brain microglia and local production of cytokines, especially tumor necrosis factor α. Studying the IHS-related brain neuroplasticity in greater depth may enable the development of new therapeutic approaches against chronic abdominal pain in inflammatory bowel disease.

摘要

肠道炎症或损伤会导致肠道高敏感(IHS)和痛觉过敏,这些症状在起始病理缓解后仍会持续存在,通常会被误认为是躯体区域的疼痛,并会因心理压力、焦虑或抑郁而加重,这表明脊髓和大脑都参与其中。然而,IHS 的中枢机制仍有待充分阐明。在过去的几十年中,人们揭示了与肠道病理学相关的一系列大脑神经可塑性变化,这些变化可能是导致这种现象的原因。本文综述了当前的临床和实验数据,包括作者自己的发现,这些数据涉及大脑中处理和调节来自肠道的感觉信号的皮质、皮质下和脑干区域的功能、结构和神经化学/分子变化。正如综述中总结的那样,由于肠道炎症/损伤引起的内脏感觉脑干和丘脑核持续过度兴奋,以及涉及内脏感觉和疼痛的神经内分泌、情绪和认知调节的下丘脑、杏仁核、海马、前岛叶和前扣带皮质区域的敏化,IHS 可以发展和维持。来自抑制伤害感受的脑干结构的病理学触发的功能障碍可能会有额外的贡献。IHS 相关区域过度兴奋的机制是 NMDA、AMPA 和 I 型代谢型谷氨酸能受体介导的谷氨酸能神经传递增强,与改变的神经肽 Y、促肾上腺皮质释放因子和大麻素 1 受体信号有关。这些改变至少部分是由大脑小胶质细胞和局部产生的细胞因子,特别是肿瘤坏死因子 α 介导的。更深入地研究 IHS 相关的大脑神经可塑性可能会为开发针对炎症性肠病慢性腹痛的新治疗方法提供帮助。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验