Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA.
Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA.
Pharmacol Ther. 2023 Jul;247:108435. doi: 10.1016/j.pharmthera.2023.108435. Epub 2023 May 9.
Women experience chronic pain more often than men with some pain conditions being specific to women while others are more prevalent in women. Prolactin, a neuropeptide hormone with higher serum levels in women, has recently been demonstrated in preclinical studies to sensitize nociceptive sensory neurons in a sexually dimorphic manner. Dysregulation of prolactin and prolactin receptors may be responsible for increased pain especially in female predominant conditions such as migraine, fibromyalgia, and pelvic pain. In this review, we focus on the role of prolactin in endometriosis, a condition characterized by pelvic pain and infertility that affects a large proportion of women during their reproductive age. We discuss the symptoms and pathology of endometriosis and discuss how different sources of prolactin secretion may contribute to this disease. We highlight our current understanding of prolactin-mediated mechanisms of nociceptor sensitization in females and how this mechanism may apply to endometriosis. Lastly, we report the results of a systematic review of clinical studies conducted by searching the PubMed and EMBASE databases to identify association between endometriosis and blood levels of prolactin. The results of this search strongly indicate that serum prolactin levels are increased in patients with endometriosis and support the possibility that high levels of prolactin may promote pelvic pain in these patients and increase vulnerability to other comorbid pain conditions likely by dysregulating prolactin receptor expression. Targeting of prolactin and prolactin receptors may improve management of pain associated with endometriosis.
女性比男性更常经历慢性疼痛，有些疼痛状况是女性特有的，而有些则更常见于女性。催乳素是一种神经肽激素，女性血清水平较高，最近的临床前研究表明，它以性别二态的方式使伤害感受感觉神经元敏感。催乳素和催乳素受体的失调可能是导致疼痛增加的原因，尤其是在偏头痛、纤维肌痛和盆腔疼痛等以女性为主的疾病中。在这篇综述中，我们专注于催乳素在子宫内膜异位症中的作用，这是一种以盆腔疼痛和不孕为特征的疾病，在女性生育年龄中影响很大一部分女性。我们讨论了子宫内膜异位症的症状和病理学，并讨论了不同来源的催乳素分泌如何导致这种疾病。我们强调了我们对女性伤害感受器敏化的催乳素介导机制的现有理解，以及这种机制如何适用于子宫内膜异位症。最后，我们报告了通过搜索 PubMed 和 EMBASE 数据库进行的临床研究的系统评价结果，以确定子宫内膜异位症与催乳素血液水平之间的关联。该搜索的结果强烈表明，子宫内膜异位症患者的血清催乳素水平升高，并支持高水平的催乳素可能通过调节催乳素受体表达来促进这些患者的盆腔疼痛，并增加对其他合并疼痛状况的易感性的可能性。靶向催乳素和催乳素受体可能会改善与子宫内膜异位症相关的疼痛管理。
