神經(jīng)病理性疼痛發(fā)生機(jī)制的研究進(jìn)展(3)
慢性疼痛是最常見的神經(jīng)病理性疼痛的表現(xiàn)，極大地影響患者的生活質(zhì)量，因此，對(duì)神經(jīng)病理性疼痛的發(fā)生、發(fā)展與維持機(jī)制進(jìn)行研究，可有針對(duì)性地緩解疼痛，更有效地控制疼痛，故有大量神經(jīng)病理性疼痛動(dòng)物實(shí)驗(yàn)?zāi)Ｐ偷慕�，其主要目的為尋找疼痛發(fā)生機(jī)制。星形膠質(zhì)細(xì)胞抑制劑氟代枸櫞酸可降低星形膠質(zhì)細(xì)胞在發(fā)生神經(jīng)病理性疼痛后的表達(dá)水平從而達(dá)到鎮(zhèn)痛目的；氯胺酮可通過抑制星形膠質(zhì)細(xì)胞的活化從而達(dá)到鎮(zhèn)痛目的。低濃度河豚毒素(TTX)可抑制糖尿病動(dòng)物C-纖維的機(jī)械痛敏[25]。鞘內(nèi)注射TNF-α抑制劑可以緩解相應(yīng)類型的疼痛。從基因表達(dá)方面入手，通過敲除P2X4受體、TNFR1、TNFR2基因，使其不能轉(zhuǎn)錄、翻譯、在體內(nèi)合成相應(yīng)蛋白質(zhì)，阻斷疼痛信號(hào)傳導(dǎo)，或是干擾其在者體內(nèi)的過度表達(dá)，以起到緩解疼痛目的的作用。目前已明確的研究成果中通過基因、細(xì)胞信息傳導(dǎo)、受體介導(dǎo)導(dǎo)致神經(jīng)病理性疼痛的研究略顯不夠。需要積極地探索并研究相關(guān)機(jī)制，以尋找臨床更有效的治療方法。
[參考文獻(xiàn)]
[1] Haan M，Attal N，Backonja M，et al.NeuPSIG guidelines on neuropathic pain assessment[J].Pain，2011，152(1)：14-27.
[2] Pizzo PA，Clark NM.Alleviating suffering 101—pain relief in the United States[J].N Engl J Med，2012，366(3)：197-199.
[3] Abougalambou SS，Abougalambou AS.Explorative study on diabetes neuropathy among type Ⅱdiabetic patients in Universiti Sains Malaysia Hospital[J].Diabetes Metab Syndr，2012，6(3)：167-172.
[4] Singh R，Kishore N，Kaur N.Diabetic peripheral neuropathy：current perspective and future directions[J].Pharmacol Res，2014，80：21-35.
[5] Cheng CF，Cheng JK，Chen CY，et al.Mirror-image pain is mediated by nerve growth factor produced from tumor necrosis factor alpha-activated satellite glia after peripheral nerve injury[J].Pain，2014，155(5)：906-920.
[6] 邵林華，陳亦華，鄭龍，等.顱腦損傷患者血清GFAP含量變化及其臨床意義[J].全科醫(yī)學(xué)臨床與教育，2011，9(3)：255-257.
[7] Carrison CJ，Dougherty PM，Kajarkler KC，et al.Staining of glial fibrillary acidic protein (GFAP) in lumber spinal cord increases following a sciatic nerve constriction injury[J].Brain Res，1991，565(1)：1-7.
[8] Zhang H，Yoon SY，Zhang H，et al.Evidence that spinal astrocytes but not microglia contribute to the pathogenesis of Paclitaxel-induced painful neuropathy[J].J Pain，2012：13(3)：293-303.
[9] Liu T，Gao YJ，Ji RR.Emerging role of Toll-like receptors in the control of pain and itch[J].Neurosci Bull，2012，28(2)：131-144.
[10] Siniscalco D，Giordano C，Risso F，et al.Role of neurotrophins in neuropathic pain[J].Current Neuropharmacology，2011，9(4)：523-529.
[11] Cao Y，Wang H，Chiang CY，et al.Pregabalin suppresses nociceptive behavior and central sensitization in a rat trigeminal neuropathic pain model[J]. J Pain，2013，14(2)：193-204.
[12] Kuner R.Central mechanisms of pathological pain[J].Nat Med，2010， 16(11)：1258-1266.
[13] Peters CM，Ghilari JR，Keyser CP，et al.Tumor-induced in jury of primary afferent sensory nerve fibers in bone cancer pain[J].Exp Neurol，2005，193(1)：85-100.
[14] Hulse R，Wynick D，Donaldson LF.Intact cutaneous C fiber afferent properties in mechanical and cold neuropathic allodynia[J].Eur J Pain，2010，14(6)：565. (范順意 李亦梅)
[參考文獻(xiàn)]
[1] Haan M，Attal N，Backonja M，et al.NeuPSIG guidelines on neuropathic pain assessment[J].Pain，2011，152(1)：14-27.
[2] Pizzo PA，Clark NM.Alleviating suffering 101—pain relief in the United States[J].N Engl J Med，2012，366(3)：197-199.
[3] Abougalambou SS，Abougalambou AS.Explorative study on diabetes neuropathy among type Ⅱdiabetic patients in Universiti Sains Malaysia Hospital[J].Diabetes Metab Syndr，2012，6(3)：167-172.
[4] Singh R，Kishore N，Kaur N.Diabetic peripheral neuropathy：current perspective and future directions[J].Pharmacol Res，2014，80：21-35.
[5] Cheng CF，Cheng JK，Chen CY，et al.Mirror-image pain is mediated by nerve growth factor produced from tumor necrosis factor alpha-activated satellite glia after peripheral nerve injury[J].Pain，2014，155(5)：906-920.
[6] 邵林華，陳亦華，鄭龍，等.顱腦損傷患者血清GFAP含量變化及其臨床意義[J].全科醫(yī)學(xué)臨床與教育，2011，9(3)：255-257.
[7] Carrison CJ，Dougherty PM，Kajarkler KC，et al.Staining of glial fibrillary acidic protein (GFAP) in lumber spinal cord increases following a sciatic nerve constriction injury[J].Brain Res，1991，565(1)：1-7.
[8] Zhang H，Yoon SY，Zhang H，et al.Evidence that spinal astrocytes but not microglia contribute to the pathogenesis of Paclitaxel-induced painful neuropathy[J].J Pain，2012：13(3)：293-303.
[9] Liu T，Gao YJ，Ji RR.Emerging role of Toll-like receptors in the control of pain and itch[J].Neurosci Bull，2012，28(2)：131-144.
[10] Siniscalco D，Giordano C，Risso F，et al.Role of neurotrophins in neuropathic pain[J].Current Neuropharmacology，2011，9(4)：523-529.
[11] Cao Y，Wang H，Chiang CY，et al.Pregabalin suppresses nociceptive behavior and central sensitization in a rat trigeminal neuropathic pain model[J]. J Pain，2013，14(2)：193-204.
[12] Kuner R.Central mechanisms of pathological pain[J].Nat Med，2010， 16(11)：1258-1266.
[13] Peters CM，Ghilari JR，Keyser CP，et al.Tumor-induced in jury of primary afferent sensory nerve fibers in bone cancer pain[J].Exp Neurol，2005，193(1)：85-100.
[14] Hulse R，Wynick D，Donaldson LF.Intact cutaneous C fiber afferent properties in mechanical and cold neuropathic allodynia[J].Eur J Pain，2010，14(6)：565. (范順意 李亦梅)