The Endogenous Opioid System and Clinical Pain Management
The Endogenous Opioid System and Clinical Pain Management
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DOI：
10.1097/00044067-200507000-00003
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发表时间：
2005-07-01
影响因子：
2.2
通讯作者：
Forrest, Jeannine M.
中科院分区：
文献类型：
--
作者：
Holden, Janean E.;Jeong, Younhee;Forrest, Jeannine M.
内源性阿片系统是研究最多的先天性镇痛系统之一。这个系统由广泛分布的神经元组成，它们产生三种阿片类物质：β-内啡肽、甲硫氨酸脑啡肽和亮脑啡肽以及强啡肽。这些阿片类药物作为神经递质和神经调质在三个主要类别的受体，称为μ，δ和κ，并产生镇痛。像它们的内源性对应物一样，阿片类药物或阿片类药物作用于这些相同的受体，产生镇痛和不良副作用。本文探讨了一些关于阿片系统的最新发现，包括与其他神经递质的相互作用，受体亚型的位置和存在，以及这些信息如何推动寻找更好的镇痛药。我们还考虑了阿片系统的理解如何影响阿片类药物管理的临床反应，以及未来可能会改善疼痛缓解。这篇文章的目的是帮助临床医生制定更好地满足患者镇痛需求的药物干预措施。
The endogenous opioid system is one of the most studied innate pain-relieving systems. This system consists of widely scattered neurons that produce three opioids: ss-endorphin, the met-and leu-enkephalins, and the dynorphins. These opioids act as neurotransmitters and neuromodulators at three major classes of receptors, termed mu, delta, and kappa, and produce analgesia. Like their endogenous counterparts, the opioid drugs, or opiates, act at these same receptors to produce both analgesia and undesirable side effects. This article examines some of the recent findings about the opioid system, including interactions with other neurotransmitters, the location and existence of receptor subtypes, and how this information drives the search for better analgesics. We also consider how an understanding of the opioid system affects clinical responses to opiate administration and what the future may hold for improved pain relief. The goal of this article is to assist clinicians to develop pharmacological interventions that better meet their patient's analgesic needs.