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p38作为吗啡耐受新治疗靶点的研究进展及吗啡耐受的治疗现状

Research progress of p38 as a new therapeutic target against morphine tolerance and the current status of therapy of morphine tolerance.

作者信息

Fu Xiao, Zhang Yanhong

机构信息

Inner Mongolia Medical University, Hohhot, China.

Department of Anesthesiology, People's Hospital Affiliated to Inner Mongolia Medical University, Hohhot, China.

出版信息

J Drug Target. 2023 Feb;31(2):152-165. doi: 10.1080/1061186X.2022.2138895. Epub 2022 Nov 2.

Abstract

With the development of the medical industry, new painkillers continue to appear in people's field of vision, but so far no painkiller can replace morphine. While morphine has a strong analgesic effect, it is also easy to produce pain sensitivity and tolerance. Due to the great inter-individual differences in patient responses, there are few clear instructions on how to optimise morphine administration regimens, which complicates clinicians' treatment strategies and limits the effectiveness of morphine in long-term pain therapy. P38MAPK is a key member of the MAPK family. Across recent years, it has been discovered that p38MAPK rises dramatically in a wide range of morphine tolerance animal models. Morphine tolerance can be reduced or reversed by inhibiting p38MAPK. However, the role and specific mechanism of p38MAPK are not clear. In this review, we synthesise the relevant findings, highlight the function and potential mechanism of p38MAPK in morphine tolerance, as well as the present status and efficacy of morphine tolerance therapy, and underline the future promise of p38MAPK targeted morphine tolerance treatment.

摘要

随着医药行业的发展,新型止痛药不断出现在人们的视野中,但迄今为止,尚无一种止痛药能够取代吗啡。吗啡虽具有强大的镇痛作用,但也容易产生痛觉敏感和耐受性。由于患者反应存在很大的个体差异,关于如何优化吗啡给药方案的明确指导很少,这使得临床医生的治疗策略变得复杂,并限制了吗啡在长期疼痛治疗中的有效性。P38丝裂原活化蛋白激酶(P38MAPK)是丝裂原活化蛋白激酶(MAPK)家族的关键成员。近年来发现,在多种吗啡耐受动物模型中,P38MAPK显著升高。抑制P38MAPK可降低或逆转吗啡耐受性。然而,P38MAPK的作用及具体机制尚不清楚。在本综述中,我们综合了相关研究结果,着重阐述了P38MAPK在吗啡耐受中的作用和潜在机制,以及吗啡耐受治疗的现状和疗效,并强调了以P38MAPK为靶点治疗吗啡耐受的前景。

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