NEMA Research, Inc, Naples, USA.
Paolo Procacci Foundation, Rome, Italy.
Expert Opin Pharmacother. 2022 Jan;23(1):105-116. doi: 10.1080/14656566.2021.1970135. Epub 2021 Aug 30.
The definition of nociplastic pain in 2016 has changed the way maladaptive chronic pain is viewed in that it may emerge without neural lesions or neural disease. Many endogenous and pharmacologic substances are being investigated for their role in treating the pain associated with neuronal plasticity.
The authors review promising pharmacologic agents for the treatment of pain associated with maladaptive neuronal plasticity. The authors then provide the reader with their expert opinion and provide their perspectives for the future.
An imbalance between the amplification of ascending pain signals and the poor activation of descending inhibitory signals may be at the root of many chronic pain syndromes. The inhibitory activity of noradrenaline reuptake may play a role in neuropathic and nociplastic analgesia. A better understanding of the brain's pain matrix, its signaling cascades, and the complex bidirectional communication between the immune system and the nervous system may help meet the urgent and unmet medical need for safe, effective chronic pain treatment, particularly for pain with a neuropathic and/or nociplastic component.
2016 年，病理性疼痛的定义发生了改变，它可能在没有神经损伤或神经疾病的情况下出现，这改变了人们对适应性慢性疼痛的看法。许多内源性和药理学物质正在被研究，以了解它们在治疗与神经元可塑性相关的疼痛方面的作用。
作者回顾了有前途的用于治疗与适应性神经元可塑性相关的疼痛的药理学药物。然后，作者为读者提供了他们的专家意见，并对未来提出了看法。
上行疼痛信号的放大与下行抑制信号的激活不良之间的不平衡可能是许多慢性疼痛综合征的根源。去甲肾上腺素再摄取的抑制活性可能在神经病理性和病理性疼痛镇痛中发挥作用。更好地了解大脑的疼痛矩阵、其信号级联以及免疫系统和神经系统之间复杂的双向通讯，可能有助于满足安全、有效治疗慢性疼痛的迫切和未满足的医疗需求，特别是对具有神经病理性和/或病理性成分的疼痛。
