Ospelnikova T P, Shitova A D, Voskresenskaya O N, Ermilova E V
Mechnikov Research Institute for Vaccines and Sera, Moscow, Russia.
Gamalei National Research Center for Epidemiology and Microbiology, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(6):7-13. doi: 10.17116/jnevro20221220617.
The problem of chronic pain is a significant question of nowadays medicine due to its high prevalence and treatment ineffectiveness in most cases. It has been proved by means of neuroimaging methods that chronic pain is always associated with glial activation in central nervous system, leading to the disturbance of glial cells participation in the eregulation of neuron microenvironment and neurotransmitter exchange. As a result, interneuronal communication in nociceptive pathways is interrupted and pathological neuroplasticity processes develop, causing the formation of pathological circuits, selfregilated by means of positive feedback. Thus, intervention that is directed to neuroinflammation suppression can by pathogeneticaly approved and effective method to treat chronic pain. In this review basic mechanisms of the inflammation initiation and maintaining in central nervous system in chronic pain are considered, pathological self-regulated circuits with neurons and immune cells are described and current chronic pain medications with antiinflammatiry and antinociceptive properties are listed.
由于慢性疼痛的高患病率以及在大多数情况下治疗无效，它已成为当今医学的一个重要问题。神经影像学方法已证明，慢性疼痛总是与中枢神经系统中的胶质细胞激活相关，导致胶质细胞参与神经元微环境调节和神经递质交换受到干扰。结果，伤害性感受通路中的神经元间通讯被中断，病理性神经可塑性过程发展，导致通过正反馈自我调节的病理回路形成。因此，针对神经炎症抑制的干预可以是经病理证实的治疗慢性疼痛的有效方法。在本综述中，我们考虑了慢性疼痛中中枢神经系统炎症引发和维持的基本机制，描述了神经元和免疫细胞组成的病理性自我调节回路，并列出了目前具有抗炎和抗伤害感受特性的慢性疼痛药物。
