Mouraux André, Bannister Kirsty, Becker Susanne, Finn David P, Pickering Gisèle, Pogatzki-Zahn Esther, Graven-Nielsen Thomas
Institute of Neuroscience (IONS), UCLouvain, Brussels, Belgium.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Eur J Pain. 2021 Apr;25(4):731-756. doi: 10.1002/ejp.1730. Epub 2021 Feb 24.
For decades, basic research on the underlying mechanisms of nociception has held promise to translate into efficacious treatments for patients with pain. Despite great improvement in the understanding of pain physiology and pathophysiology, translation to novel, effective treatments for acute and chronic pain has however been limited, and they remain an unmet medical need. In this opinion paper bringing together pain researchers from very different disciplines, the opportunities and challenges of translational pain research are discussed. The many factors that may prevent the successful translation of bench observations into useful and effective clinical applications are reviewed, including interspecies differences, limited validity of currently available preclinical disease models of pain, and limitations of currently used methods to assess nociception and pain in non-human and human models of pain. Many paths are explored to address these issues, including the backward translation of observations made in patients and human volunteers into new disease models that are more clinically relevant, improved generalization by taking into account age and sex differences, and the integration of psychobiology into translational pain research. Finally, it is argued that preclinical and clinical stages of developing new treatments for pain can be improved by better preclinical models of pathological pain conditions alongside revised methods to assess treatment-induced effects on nociception in human and non-human animals. Significance: For decades, basic research of the underlying mechanisms of nociception has held promise to translate into efficacious treatments for patients with pain. Despite great improvement in the understanding of pain physiology and pathophysiology, translation to novel, effective treatments for acute and chronic pain has however been limited, and they remain an unmet medical need.
几十年来，关于伤害感受潜在机制的基础研究一直有望转化为对疼痛患者有效的治疗方法。尽管在疼痛生理学和病理生理学的理解上有了很大进步，但向急性和慢性疼痛的新型有效治疗方法的转化仍然有限，它们仍然是未满足的医疗需求。在这篇汇集了来自非常不同学科的疼痛研究人员的观点论文中，讨论了转化性疼痛研究的机遇和挑战。回顾了可能阻碍将实验室观察成功转化为有用且有效的临床应用的诸多因素，包括种间差异、当前可用的临床前疼痛疾病模型有效性有限，以及当前用于评估非人类和人类疼痛模型中伤害感受和疼痛的方法的局限性。探讨了许多解决这些问题的途径，包括将患者和人类志愿者的观察结果反向转化为更具临床相关性的新疾病模型、通过考虑年龄和性别差异来改进普遍性，以及将心理生物学整合到转化性疼痛研究中。最后，有人认为，通过更好的病理性疼痛状况临床前模型以及修订评估治疗对人类和非人类动物伤害感受影响的方法，可以改善疼痛新疗法开发的临床前和临床阶段。意义：几十年来，关于伤害感受潜在机制的基础研究一直有望转化为对疼痛患者有效的治疗方法。尽管在疼痛生理学和病理生理学的理解上有了很大进步，但向急性和慢性疼痛的新型有效治疗方法的转化仍然有限，它们仍然是未满足的医疗需求。
