κ 阿片样物质信号在慢性疼痛和阿片类药物成瘾的交叉点。
Kappa Opioid Signaling at the Crossroads of Chronic Pain and Opioid Addiction.
机构信息
Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Shirley and Stefan Hatos Center for Neuropharmacology, University of California Los Angeles, Los Angeles, CA, USA.
出版信息
Handb Exp Pharmacol. 2022;271:315-350. doi: 10.1007/164_2021_434.
Pain is complex and is a unique experience for individuals in that no two people will have exactly the same physiological and emotional response to the same noxious stimulus or injury. Pain is composed of two essential processes: a sensory component that allows for discrimination of the intensity and location of a painful stimulus and an emotional component that underlies the affective, motivational, unpleasant, and aversive response to a painful stimulus. Kappa opioid receptor (KOR) activation in the periphery and throughout the neuroaxis modulates both of these components of the pain experience. In this chapter we focus on recent findings that KORs contribute to the emotional, aversive nature of chronic pain, including how expression in the limbic circuitry contributes to anhedonic states and components of opioid misuse disorder. While the primary focus is on preclinical pain models, we also highlight clinical or human research where there is strong evidence for KOR involvement in negative affective states associated with chronic pain and opioid misuse.
疼痛是复杂的，每个人的体验都是独特的，因为没有两个人会对相同的有害刺激或损伤产生完全相同的生理和情绪反应。疼痛由两个基本过程组成：一个感觉成分，用于区分疼痛刺激的强度和位置，一个情绪成分，是对疼痛刺激的情感、动机、不愉快和厌恶反应的基础。κ 阿片受体（KOR）在外周和整个神经轴中的激活调节疼痛体验的这两个成分。在本章中，我们重点介绍了最近的发现，即 KOR 有助于慢性疼痛的情绪、厌恶性质，包括在边缘回路中的表达如何导致快感缺失状态和阿片类药物滥用障碍的成分。虽然主要重点是临床前疼痛模型，但我们也强调了临床或人类研究中，有强有力的证据表明 KOR 参与与慢性疼痛和阿片类药物滥用相关的消极情感状态。
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