Kumazawa T
Research Institute of Environmental Medicine, Nagoya University, Japan.
Neurosci Res. 1998 Sep;32(1):9-31. doi: 10.1016/s0168-0102(98)00060-1.
Bio-warning and defense mechanisms play the most fundamental roles in living organisms. From an evolutionary point of view, nociceptive systems are very primitive and are richly provided with humoral signaling mechanisms of aboriginal humoral defense systems, as reflected in the primitive nature of the polymodal receptor, a poorly differentiated sensory receptor signaling nociceptive information. Recent advances in studies on pain have made it possible to explain neural mechanisms of pain systems under physiological conditions and reveal that there is a large gap between physiological and pathological pains. Protracted nociceptive inputs under pathological conditions induce plastic, either functional or structural, alterations in the nociceptive pathways. These plastic changes lead to crosstalk among the neural networks, including circuits related to motor, autonomic, or psychological functions. These plastic changes, once established, persist even after the original pain sources disappear in a memory-like fashion. Thus, it is revealed that chronic pain cannot be treated by blocking pain pathways, which is effective against acute pain, but require treatment from a multidisciplinary perspective.
生物预警和防御机制在生物体中发挥着最基本的作用。从进化的角度来看，伤害感受系统非常原始，并且富含原始体液防御系统的体液信号传导机制，这一点在多模式受体的原始性质中得到体现，多模式受体是一种分化程度较低的感觉受体，用于传递伤害性信息。疼痛研究的最新进展使得解释生理条件下疼痛系统的神经机制成为可能，并揭示出生理疼痛和病理疼痛之间存在很大差距。病理条件下长期的伤害性输入会在伤害感受通路中诱导可塑性改变，包括功能或结构上的改变。这些可塑性变化会导致神经网络之间的相互作用，包括与运动、自主或心理功能相关的回路。这些可塑性变化一旦形成，即使在原始疼痛源消失后也会以类似记忆的方式持续存在。因此，研究表明，慢性疼痛不能通过阻断对急性疼痛有效的疼痛通路来治疗，而需要从多学科角度进行治疗。
