Department of Anesthesiology, University of Arizona College of Medicine, Tucson, AZ 85719, USA.
Department of Anesthesiology, New York Medical College, Valhalla, NY 10595, USA.
Int J Mol Sci. 2022 Feb 15;23(4):2128. doi: 10.3390/ijms23042128.
Pain-acute, chronic and debilitating-is the most feared neurotoxicity resulting from a survivable venomous snake bite. The purpose of this review is to present in a novel paradigm what we know about the molecular mechanisms responsible for pain after envenomation. Progressing from known pain modulating peptides and enzymes, to tissue level interactions with venom resulting in pain, to organ system level pain syndromes, to geographical level distribution of pain syndromes, the present work demonstrates that understanding the mechanisms responsible for pain is dependent on "location, location, location". It is our hope that this work can serve to inspire the molecular and epidemiologic investigations needed to better understand the neurotoxic mechanisms responsible for these snake venom mediated diverse pain syndromes and ultimately lead to agent specific treatments beyond anti-venom alone.
疼痛——急性、慢性且使人虚弱——是最令人恐惧的神经毒性反应，由可存活的毒蛇咬伤引起。本综述旨在以新颖的范例呈现我们对毒液导致疼痛的分子机制的了解。从已知的疼痛调节肽和酶，到与毒液在组织水平上的相互作用导致疼痛，再到器官系统水平的疼痛综合征，再到疼痛综合征的地理水平分布，本工作表明，理解导致疼痛的机制取决于“位置、位置、位置”。我们希望这项工作能够激发分子和流行病学研究的需要，以更好地理解这些蛇毒介导的不同疼痛综合征的神经毒性机制，并最终导致除抗蛇毒血清之外的特定于药剂的治疗方法。
