From the Division of Gastroenterology, Hepatology, Pancreatology and Nutrition, Stead Family Department of Pediatrics, The University of Iowa, Iowa City, IA.
Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
Pancreas. 2021 Aug 1;50(7):906-915. doi: 10.1097/MPA.0000000000001899.
A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to focus on research gaps and opportunities in pancreatic pain. The event was held on July 21, 2021, and structured into 4 sessions: (1) pathophysiology; (2) biomarkers, mediators, and pharmacology of pain; (3) pain assessment; and (4) pain treatment challenges and opportunities. The current state of knowledge was reviewed; many knowledge gaps and research needs were identified that require further investigation. Common themes included the need to better understand the underlying mechanisms of pain in pancreatic diseases, the relationship of visceral neural pathways and central pain centers, the role of behavioral factors and disorders on the perception of pain, and differences in pain perception and processes in children when compared with adults. In addition, the role of genetic risk factors for pain and the mechanisms and role of placebos in pain treatment were discussed. Methods of pain assessment including quantitative sensory testing were examined, as well as the process of central sensitization of pain. Finally, newer approaches to pain management including cognitive behavioral therapy, nerve stimulation, experimental (nonopioid) drugs, and cannabinoid compounds were covered.
一个由美国国立糖尿病、消化和肾脏疾病研究所资助的研讨会,旨在关注胰腺痛研究中的差距和机遇。该活动于 2021 年 7 月 21 日举行,分为 4 个部分:(1)病理生理学;(2)疼痛的生物标志物、介质和药理学;(3)疼痛评估;(4)疼痛治疗的挑战和机遇。会上回顾了当前的知识状况,确定了许多需要进一步研究的知识差距和研究需求。共同的主题包括需要更好地了解胰腺疾病中疼痛的潜在机制、内脏神经通路和中枢疼痛中心的关系、行为因素和障碍对疼痛感知的作用,以及与成人相比,儿童在疼痛感知和处理方面的差异。此外,还讨论了疼痛的遗传风险因素以及安慰剂在疼痛治疗中的作用和机制。还检查了疼痛评估方法,包括定量感觉测试,以及疼痛的中枢敏化过程。最后,涵盖了疼痛管理的新方法,包括认知行为疗法、神经刺激、实验(非阿片类)药物和大麻素化合物。