Department of Physiology, Nihon University School of Dentistry, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan.
Department of Physiology, Nihon University School of Dentistry, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan.
J Oral Biosci. 2022 Sep;64(3):263-270. doi: 10.1016/j.job.2022.07.001. Epub 2022 Jul 14.
Pain is a warning signal for the body defense mechanisms and is a critical sensation for supporting life. However, there are still many unclear points about the pathophysiological mechanism of orofacial pain. This situation makes it difficult for many clinicians to treat orofacial pain hypersensitivity.
Noxious information on the orofacial region received by trigeminal ganglion neurons is recognized as "orofacial pain" by being transmitted to the somatosensory cortex and limbic system via the spinal trigeminal nucleus and the thalamic sensory nuclei. Orofacial inflammation or trigeminal nerve injury causes neuropathic changes in various nociceptive signaling pathways, resulting in persistent orofacial pain. It is also considered that persistent orofacial pain is triggered by plastic changes in nociceptive signaling pathways involving various cells such as satellite glial cells, astrocytes, microglia, and macrophages, as well as nociceptive neurons.
Recent studies have shown that hyperexcitability of nociceptive neurons in the nociceptive signaling pathways of the orofacial region caused by a variety of factors causes persistent orofacial pain. This review outlines the pathophysiology of orofacial pain along with the results of our study.
疼痛是身体防御机制的警告信号,是支持生命的关键感觉。然而,关于口腔颌面部疼痛的病理生理机制仍有许多不清楚的地方。这种情况使得许多临床医生难以治疗口腔颌面部疼痛过敏。
三叉神经节神经元接收到的关于口腔颌面部的有害信息,通过脊髓三叉神经核和丘脑感觉核传递到躯体感觉皮层和边缘系统,被识别为“口腔颌面部疼痛”。口腔颌面部炎症或三叉神经损伤导致各种伤害性信号通路发生神经病理性改变,导致持续性口腔颌面部疼痛。也有人认为,持续性口腔颌面部疼痛是由涉及卫星胶质细胞、星形胶质细胞、小胶质细胞和巨噬细胞以及伤害性神经元等各种细胞的伤害性信号通路的可塑性变化触发的。
最近的研究表明,口腔颌面部伤害性信号通路中伤害性神经元的过度兴奋是由多种因素引起的,导致持续性口腔颌面部疼痛。本综述概述了口腔颌面部疼痛的病理生理学,以及我们研究的结果。