Graduated Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria (UFSM), 97105-900, Santa Maria, RS, Brazil.
Graduated Program in Pharmacology, Federal University of Santa Maria (UFSM), 97105-900 Santa Maria, RS, Brazil.
Biochem Pharmacol. 2024 Nov;229:116506. doi: 10.1016/j.bcp.2024.116506. Epub 2024 Aug 23.
Complex regional pain syndrome (CRPS) presents as a persistent and distressing pain condition often stemming from limb trauma or ischemia, manifesting as either CRPS-I (without initial nerve injury) or CRPS-II (accompanied by nerve injury). Despite its prevalence and significant impact on functionality and emotional well-being, standard treatments for CRPS remain elusive. The multifaceted nature of CRPS complicates the identification of its underlying mechanisms. In efforts to elucidate these mechanisms, researchers have turned to animal models such as chronic post-ischemic pain (CPIP), which mirrors the symptoms of CRPS-I. Various mechanisms have been proposed to underlie the acute and chronic pain experienced in CRPS-I, including oxidative stress and inflammation. Traditional treatment approaches often involve antidepressants, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids. However, these methods frequently fall short of providing adequate relief. Accordingly, there is a growing interest in exploring alternative treatments, such as antioxidant supplementation, anti-inflammatory agents, and non-pharmacological interventions. Future research directions should focus on optimizing treatment strategies and addressing remaining gaps in knowledge to improve patient outcomes. This review aims to delve into the pathophysiological mechanisms implicated in the CPIP model, specifically focusing on oxidative stress and inflammation, with the ultimate goal of proposing innovative therapeutic strategies for alleviating the symptoms of CRPS-I.
复杂性区域疼痛综合征(CRPS)表现为一种持续且令人痛苦的疾病状态,通常源于肢体创伤或缺血,表现为 CRPS-I(无初始神经损伤)或 CRPS-II(伴有神经损伤)。尽管 CRPS 患病率高,且对功能和情绪健康有重大影响,但标准的治疗方法仍难以捉摸。CRPS 的多面性质使确定其潜在机制变得复杂。为了阐明这些机制,研究人员转向了慢性缺血后疼痛(CPIP)等动物模型,该模型反映了 CRPS-I 的症状。各种机制被提出以解释 CRPS-I 中急性和慢性疼痛的发生,包括氧化应激和炎症。传统的治疗方法通常涉及抗抑郁药、非甾体抗炎药(NSAIDs)和阿片类药物。然而,这些方法往往无法提供足够的缓解。因此,人们越来越关注探索替代治疗方法,如抗氧化剂补充、抗炎剂和非药物干预。未来的研究方向应侧重于优化治疗策略并解决知识上的剩余差距,以改善患者的治疗效果。本综述旨在深入探讨 CPIP 模型中涉及的病理生理机制,特别是关注氧化应激和炎症,最终提出缓解 CRPS-I 症状的创新治疗策略。