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疼痛相关性心肌缺血再灌注损伤的机遇与挑战

Opportunities and challenges of pain-related myocardial ischemia-reperfusion injury.

作者信息

Jiang Wenhua, Yin Yue, Gu Xiaoming, Zhang Zihui, Ma Heng

机构信息

Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China.

Department of Physiology and Pathophysiology, Fourth Military Medical University, Xi'an, China.

出版信息

Front Physiol. 2022 Sep 2;13:900664. doi: 10.3389/fphys.2022.900664. eCollection 2022.

Abstract

Pain is one of the most serious problems plaguing human health today. Pain is not an independent pathophysiological condition and is associated with a high impact on elevated disability and organ dysfunction. Several lines of evidence suggested the associations of pain with cardiovascular diseases, especially myocardial ischemia-reperfusion (I/R) injury, while the role of pain in I/R injury and related mechanisms are not yet comprehensively assessed. In this review, we attempted to explore the role of pain in myocardial I/R injury, and we concluded that acute pain protects myocardial ischemia-reperfusion injury and chronic pain aggravates cardiac ischemia-reperfusion injury. In addition, the construction of different pain models and animal models commonly used to study the role of pain in myocardial I/R injury were discussed in detail, and the potential mechanism of pain-related myocardial I/R injury was summarized. Finally, the future research direction was prospected. That is, the remote regulation of pain to cardiac function requires peripheral pain signals to be transmitted from the peripheral to the cardiac autonomic nervous system, which then affects autonomic innervation during cardiac ischemia-reperfusion injury and finally affects the cardiac function.

摘要

疼痛是当今困扰人类健康的最严重问题之一。疼痛并非一种独立的病理生理状况,且与高致残率及器官功能障碍密切相关。多项证据表明疼痛与心血管疾病相关,尤其是心肌缺血再灌注(I/R)损伤,然而疼痛在I/R损伤中的作用及其相关机制尚未得到全面评估。在本综述中,我们试图探究疼痛在心肌I/R损伤中的作用,我们得出的结论是急性疼痛可保护心肌缺血再灌注损伤,而慢性疼痛会加重心脏缺血再灌注损伤。此外,还详细讨论了常用于研究疼痛在心肌I/R损伤中作用的不同疼痛模型和动物模型的构建,并总结了疼痛相关心肌I/R损伤的潜在机制。最后,对未来的研究方向进行了展望。即疼痛对心脏功能的远程调节需要外周疼痛信号从外周传递至心脏自主神经系统,进而在心脏缺血再灌注损伤期间影响自主神经支配,最终影响心脏功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d2a/9481353/02758ade0280/fphys-13-900664-g001.jpg

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