Laboratory of Pain and Signaling, Butantan Institute, São Paulo, Brazil.
Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
Br J Pharmacol. 2022 Apr;179(8):1640-1660. doi: 10.1111/bph.15584. Epub 2021 Jul 1.
Depression and anxiety commonly occur in chronic pain states and the coexistence of these diseases worsens outcomes for both disorders and may reduce treatment adherence and response. Despite the advances in the knowledge of chronic pain mechanisms, pharmacological treatment is still unsatisfactory. Research based on exposure to environmental enrichment is currently under investigation and seems to offer a promising low-cost strategy with no side effects. In this review, we discuss the role of inflammation as a major biological substrate and aetiological factor of chronic pain and depression/anxiety and report a collection of preclinical evidence of the effects and mechanisms of environmental enrichment. As microglia participates in the development of both conditions, we also discuss microglia as a potential target underlying the beneficial actions of environmental enrichment in chronic pain and comorbid depression/anxiety. We also discuss how alternative interventions under clinical guidelines, such as environmental enrichment, may improve treatment compliance and patient outcomes. LINKED ARTICLES: This article is part of a themed issue on Building Bridges in Neuropharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.8/issuetoc.
抑郁和焦虑在慢性疼痛状态中常见，这些疾病的共存会使两种疾病的预后恶化，可能降低治疗的依从性和反应性。尽管人们对慢性疼痛机制的认识有所提高，但药物治疗仍不尽如人意。目前正在对基于暴露于环境丰富度的研究进行调查，这种方法似乎是一种有前途的、低成本的策略，没有副作用。在这篇综述中，我们讨论了炎症作为慢性疼痛和抑郁/焦虑的主要生物学基质和病因因素的作用，并报告了一系列关于环境丰富度的影响和机制的临床前证据。由于小胶质细胞参与了这两种疾病的发展，我们还讨论了小胶质细胞作为环境丰富度对慢性疼痛和共病性抑郁/焦虑的有益作用的潜在靶点。我们还讨论了如何根据临床指南，如环境丰富度，来提高治疗的依从性和患者的治疗效果。相关文章：本文是神经药理学专题中关于“建立联系”的一部分。要查看该部分的其他文章，请访问 http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.8/issuetoc.
