Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran.
Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran.
Mol Pain. 2024 Jan-Dec;20:17448069241275097. doi: 10.1177/17448069241275097.
Chronic pain is a debilitating symptom with a significant negative impact on the quality of life and socioeconomic status, particularly among adults and the elderly. Major Depressive Disorder (MDD) stands out as one of the most important comorbid disorders accompanying chronic pain. The kynurenine pathway serves as the primary route for tryptophan degradation and holds critical significance in various biological processes, including the regulation of neurotransmitters, immune responses, cancer development, metabolism, and inflammation. This review encompasses key research studies related to the kynurenine pathway in the context of headache, neuropathic pain, gastrointestinal disorders, fibromyalgia, chronic fatigue syndrome, and MDD. Various metabolites produced in the kynurenine pathway, such as kynurenic acid and quinolinic acid, exhibit neuroprotective and neurotoxic effects, respectively. Recent studies have highlighted the significant involvement of kynurenine and its metabolites in the pathophysiology of pain. Moreover, pharmacological interventions targeting the regulation of the kynurenine pathway have shown therapeutic promise in pain management. Understanding the underlying mechanisms of this pathway presents an opportunity for developing personalized, innovative, and non-opioid approaches to pain treatment. Therefore, this narrative review explores the role of the kynurenine pathway in various chronic pain disorders and its association with depression and chronic pain.
慢性疼痛是一种使人虚弱的症状，对生活质量和社会经济状况有重大负面影响，尤其是在成年人和老年人中。重度抑郁症（MDD）是伴随慢性疼痛的最重要的共病障碍之一。犬尿氨酸途径是色氨酸降解的主要途径，在各种生物过程中具有重要意义，包括神经递质的调节、免疫反应、癌症发展、代谢和炎症。这篇综述包括了与头痛、神经病理性疼痛、胃肠道疾病、纤维肌痛、慢性疲劳综合征和 MDD 相关的犬尿氨酸途径的关键研究。犬尿氨酸途径中产生的各种代谢物，如犬尿氨酸和喹啉酸，分别具有神经保护和神经毒性作用。最近的研究强调了犬尿氨酸及其代谢物在疼痛病理生理学中的重要作用。此外，针对犬尿氨酸途径调节的药理学干预在疼痛管理中显示出了治疗潜力。了解该途径的潜在机制为开发针对疼痛治疗的个性化、创新和非阿片类方法提供了机会。因此，本叙述性综述探讨了犬尿氨酸途径在各种慢性疼痛障碍中的作用及其与抑郁和慢性疼痛的关联。
