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Wnt信号通路:慢性疼痛的潜在治疗靶点。

Wnt signaling: A prospective therapeutic target for chronic pain.

作者信息

Zhou Ya-Qun, Tian Xue-Bi, Tian Yu-Ke, Mei Wei, Liu Dai-Qiang, Ye Da-Wei

机构信息

Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

出版信息

Pharmacol Ther. 2022 Mar;231:107984. doi: 10.1016/j.pharmthera.2021.107984. Epub 2021 Sep 2.

Abstract

Despite the rapid advance over the past decades to design effective therapeutic pharmacological interventions, chronic pain remains to be an unresolved healthcare concern. Long term use of opioids, the first line analgesics, often causes detrimental side effects. Therefore, a profound understanding of the mechanisms underlying the development and maintenance of chronic pain states is urgently needed for the management of chronic pain. Substantial evidence indicates aberrant activation of Wnt signaling pathways in sciatic nerve, dorsal root ganglia and spinal cord dorsal horn in rodent models of chronic pain. Moreover, growing evidence shows that pharmacological blockage of aberrant activation of Wnt signaling pathways attenuates pain behaviors in animal models of chronic pain. Importantly, both intrathecal injection of Wnt agonists and Wnt ligands to naïve rats lead to the development of mechanical allodynia, which was inhibited by Wnt inhibitors. In this review, we summarized and discussed the therapeutic potential of pharmacological inhibitors of Wnt signaling in chronic pain in preclinical studies. These evidence showed that aberrant activation of Wnt signaling pathways contributed to chronic pain via enhancing neuroinflammation, regulating synaptic plasticity and reducing intraepidermal nerve fiber density. However, these findings raise further questions. Overall, despite the future challenges, these pioneering studies suggest that Wnt signaling is a promising therapeutic target for chronic pain.

摘要

尽管在过去几十年里迅速推进了有效治疗性药理干预措施的设计,但慢性疼痛仍然是一个尚未解决的医疗保健问题。长期使用作为一线镇痛药的阿片类药物往往会导致有害的副作用。因此,为了管理慢性疼痛,迫切需要深入了解慢性疼痛状态发生和维持的潜在机制。大量证据表明,在慢性疼痛的啮齿动物模型中,坐骨神经、背根神经节和脊髓背角中的Wnt信号通路存在异常激活。此外,越来越多的证据表明,对Wnt信号通路异常激活的药理学阻断可减轻慢性疼痛动物模型中的疼痛行为。重要的是,向未处理的大鼠鞘内注射Wnt激动剂和Wnt配体都会导致机械性异常性疼痛的发生,而这会被Wnt抑制剂所抑制。在这篇综述中,我们总结并讨论了在临床前研究中Wnt信号通路的药理学抑制剂在慢性疼痛中的治疗潜力。这些证据表明,Wnt信号通路的异常激活通过增强神经炎症、调节突触可塑性和降低表皮内神经纤维密度而导致慢性疼痛。然而,这些发现也引发了进一步的问题。总体而言,尽管面临未来的挑战,但这些开创性研究表明,Wnt信号是慢性疼痛一个有前景的治疗靶点。

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