下行疼痛易化系统在吗啡耐受机制中的作用

吗啡是临床上常用的一种阿片类镇痛药物,广泛用于治疗各种类型疼痛,但是长期应用吗啡会造成吗啡耐受,从而限制了吗啡的临床应用。吗啡耐受的机制十分复杂,近年来的研究表明下行疼痛易化系统参与了吗啡耐受,本文拟对近年来此方面的研究进行综述。     

下行疼痛易化系统在吗啡耐受机制中的作用

吗啡是临床上常用的一种阿片类镇痛药物,广泛用于治疗各种类型疼痛,但是长期应用吗啡会造成吗啡耐受,从而限制了吗啡的临床应用。吗啡耐受的机制十分复杂,近年来的研究表明下行疼痛易化系统参与了吗啡耐受,本文拟对近年来此方面的研究进行综述。     

下行易化系统及其参与神经病理痛的机制

神经病理痛是指由中枢或外周神经系统损伤或疾病引起的疼痛综合征.神经病理痛是临床上常见的一种疾病,但是其发病机制不甚清楚,临床上也缺乏有效的治疗手段.近年来的研究除了集中于痛觉的上行传导及中枢机制,以及痛觉的下行抑制之外,也证明下行易化系统激活参与神经病理痛的发病机制.本文拟对此进行综述,希望为治疗神经病理痛提供新思路.     

内源性下行抑制/易化系统与5-羟色胺对脊髓伤害感受性信息的调制

内源性下行抑制系统在痛传递与调制中具有重要作用。近年来,与这一系统相对的下行易化系统开始引起人们的关注。中枢神经系统通过下行抑制易化系统对外周伤害性信息进行双向调制。５－羟色胺（５－ＨＴ）是痛上行调制系统的主要神经递质,电刺激或微量注射兴奋性氨基酸于中缝大核（ＮＭＲ）或巨细胞网状核（ＮＧＣ）内,既可兴奋也可抑制脊髓伤害性反应。这种相互矛盾遥效应可能与脊髓内的多种５－ＨＴ受体亚型有关。     

棕色脂肪组织与交感神经系统之间双向调节的机制

神经与脂肪组织的交互作用一直是十分热门的研究课题.棕色脂肪组织(brown adipose tissue,BAT)内部有丰富的交感神经纤维浸润,这些纤维在BAT局部构成交感神经系统(sympathetic nervous system,SNS)传出支.近几年的研究发现,SNS在BAT生理功能的调节中发挥主导作用,而BA...     

Central nervous system mechanisms for pain modulation

Although a great deal has been learned about the neural basis for stimulation-produced analgesia, it is evident that the 'analgesia systems' are much more complex than was initially thought. Part of the complexity derives from the fact that a number of different pathways, using several different neurotransmitters, can affect nociceptive transmission. Further complexity stems from evidence that nociceptive transmission can be modulated both at a spinal cord level and at higher levels of the nociceptive projection system, such as the thalamus. Hopefully, a greater understanding of the 'analgesia systems' will lead to explanations for a number of puzzling aspects of pain and perhaps to improved therapy.     

Effects of modulation of the redox system on endogenous lipoperoxidation in the rat central nervous system

In this study we have measured malonaldehyde (MDA) as an index of endogenous lipoperoxidation, the latter being a relevant aspect of oxidative stress that occurs in different neuronal systems. Our results clearly demonstrate that in physiological conditions specific neuronal systems exhibit a different rate of MDA formation among which substantia nigra neurons show a particular vulnerability to oxidative stress. Chronic ethanol treatment significantly enhances MDA production, particularly at the level of cholinergic structures (septum) as well as in the dopaminergic system (substantia nigra) and cortex. On the other hand, treatment with glutathione is able to decrease MDA formation, pointing out the possibility of an exogenous modulation of redox balance in brain cells.     

内源性阿片肽疼痛调节机制

内源性阿片肽(EOP)作为一类重要的神经递质发挥着许多生物学效应,而在痛觉信息的传递和调节过程中发挥的重要作用最为显著,这些结果将可能为疼痛治疗开辟新天地.本文就近年来EOP的研究进展,特别是关于它们在神经系统内的分布,组成,阿片受体的特点,疼痛调节的特点及其机制等方面作一综述.     

Neurotensin and pain modulation

Neurotensin (NT) can produce a profound analgesia or enhance pain responses, depending on the circumstances. Recent evidence suggests that this may be due to a dose-dependent recruitment of distinct populations of pain modulatory neurons. NT knockout mice display defects in both basal nociceptive responses and stress-induced analgesia. Stress-induced antinociception is absent in these mice and instead stress induces a hyperalgesic response, suggesting that NT plays a key role in the stress-induced suppression of pain. Cold water swim stress results in increased NT mRNA expression in hypothalamic regions known to project to periaqueductal gray, a key region involved in pain modulation. Thus, stress-induced increases in NT signaling in pain modulatory regions may be responsible for the transition from pain facilitation to analgesia. This review focuses on recent advances that have provided insights into the role of NT in pain modulation.     

Brain mechanisms of pain affect and pain modulation

Recent animal studies reveal ascending nociceptive and descending modulatory pathways that may contribute to the affective-motivational aspects of pain and play a critical role in the modulation of pain. In humans, a reliable pattern of cerebral activity occurs during the subjective experience of pain. Activity within the anterior cingulate cortex and possibly in other classical limbic structures, appears to be closely related to the subjective experience of pain unpleasantness and may reflect the regulation of endogenous mechanisms of pain modulation.     

Endocannabinoids in pain modulation

Five major approaches have been employed to determine the role of endocannabinoids in pain modulation: (1) studies of various markers of endocannabinoid action aimed at determining whether the necessary cannabinoid biochemical machinery is present in those brain areas that control pain sensitivity; (2) administration of exogenous cannabinoids to determine whether endocannabinoid action at appropriate sites would lead to a loss of pain sensitivity; (3) administration of compounds that would affect endocannabinoid action such as antagonists and transport inhibitors to determine whether drug-induced preterbation of cannabinoid action would alter pain sensitivity; (4) studies of genetically altered animals aimed at determining whether pain responses or responses to cannabinergic drugs are altered; and (5) studies that measure the release of endocannabinoids. Converging evidence from each of these research areas indicates that endocannabinods function to control pain in parallel with endogenous opioids but via different mechanisms.     

Oxytocin in the periaqueductal gray participates in pain modulation in the rat by influencing endogenous opiate peptides

Periaqueductal gray (PAG) plays a very important role in pain modulation through endogenous opiate peptides including leucine-enkephalin (L-Ek), methionine-enkephalin (M-Ek), β-endorphin (β-Ep) and dynorphin A_1-13 (DynA_1-13). Our pervious study has demonstrated that intra-PAG injection of oxytocin (OXT) increases the pain threshold, and local administration of OXT receptor antagonist decreases the pain threshold, in which the antinociceptive role of OXT can be reversed by pre-PAG administration of OXT receptor antagonist. The experiment was designed to investigate the effect of OXT on endogenous opiate peptides in the rat PAG during the pain process. The results showed that (1) the concentrations of OXT, L-Ek, M-Ek and β-Ep, not DynA_1-13 in the PAG perfusion liquid were increased after the pain stimulation; (2) the concentrations of L-Ek, M-Ek and β-Ep, not DynA_1-13 in the PAG perfusion liquid were decreased by the OXT receptor antagonist; (3) the increased pain threshold induced by the OXT was attenuated by naloxone, an opiate receptor antagonist; and (4) the concentrations of L-Ek, M-Ek and β-Ep, not DynA_1-13 in the PAG perfusion liquid were increased by exogenous OXT administration. The data suggested that OXT in the PAG could influence the L-Ek, M-Ek and β-Ep rather than DynA_1-13 to participate in pain modulation, i.e. OXT in the PAG participate in pain modulation by influencing the L-Ek, M-Ek and β-Ep rather than DynA_1-13.     

The cerebral signature for pain perception and its modulation

Our understanding of the neural correlates of pain perception in humans has increased significantly since the advent of neuroimaging. Relating neural activity changes to the varied pain experiences has led to an increased awareness of how factors (e.g., cognition, emotion, context, injury) can separately influence pain perception. Tying this body of knowledge in humans to work in animal models of pain provides an opportunity to determine common features that reliably contribute to pain perception and its modulation. One key system that underpins the ability to change pain intensity is the brainstem's descending modulatory network with its pro- and antinociceptive components. We discuss not only the latest data describing the cerebral signature of pain and its modulation in humans, but also suggest that the brainstem plays a pivotal role in gating the degree of nociceptive transmission so that the resultant pain experienced is appropriate for the particular situation of the individual.