Department of Human Anatomy, School of Medicine, Nantong University, Nantong, China.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Mol Pain. 2023 Jan-Dec;19:17448069231178176. doi: 10.1177/17448069231178176.
Chronic pain is a refractory health disease worldwide causing an enormous economic burden on individuals and society. Accumulating evidence suggests that inflammation in the peripheral nervous system (PNS) and central nervous system (CNS) is the major factor in the pathogenesis of chronic pain. The inflammation in the early- and late phase may have distinctive effects on the initiation and resolution of pain, which can be viewed as friend or foe. On the one hand, painful injuries lead to the activation of glial cells and immune cells in the PNS, releasing pro-inflammatory mediators, which contribute to the sensitization of nociceptors, leading to chronic pain; neuroinflammation in the CNS drives central sensitization and promotes the development of chronic pain. On the other hand, macrophages and glial cells of PNS and CNS promote pain resolution via anti-inflammatory mediators and specialized pro-resolving mediators (SPMs). In this review, we provide an overview of the current understanding of inflammation in the deterioration and resolution of pain. Further, we summarize a number of novel strategies that can be used to prevent and treat chronic pain by controlling inflammation. This comprehensive view of the relationship between inflammation and chronic pain and its specific mechanism will provide novel targets for the treatment of chronic pain.
慢性疼痛是一种全球性的难治性健康疾病,给个人和社会带来了巨大的经济负担。越来越多的证据表明,周围神经系统 (PNS) 和中枢神经系统 (CNS) 的炎症是慢性疼痛发病机制的主要因素。早期和晚期的炎症可能对疼痛的发生和缓解有独特的影响,可以被视为朋友或敌人。一方面,疼痛损伤导致 PNS 中的神经胶质细胞和免疫细胞激活,释放促炎介质,导致伤害感受器敏化,进而引发慢性疼痛;CNS 中的神经炎症驱动中枢敏化并促进慢性疼痛的发展。另一方面,PNS 和 CNS 的巨噬细胞和神经胶质细胞通过抗炎介质和特殊的促解决介质 (SPM) 促进疼痛缓解。在这篇综述中,我们概述了目前对疼痛恶化和缓解过程中炎症的理解。此外,我们总结了一些新的策略,通过控制炎症来预防和治疗慢性疼痛。这种对炎症与慢性疼痛之间关系及其具体机制的全面了解将为慢性疼痛的治疗提供新的靶点。
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