The neurobiology of skeletal pain.
The neurobiology of skeletal pain.
复制标题
DOI：
10.1111/ejn.12462
复制
发表时间：
2014-02
期刊：
影响因子：
--
通讯作者：
Mantyh PW
中科院分区：
文献类型：
--
作者：
Mantyh PW
骨骼疾病是世界上慢性疼痛和长期身体残疾的最常见原因之一。慢性骨骼疼痛是由多种疾病引起的，包括创伤性骨折、骨关节炎、骨质疏松症、腰痛、骨科手术、乳糜泻、镰状细胞病和骨癌。虽然这些疾病是多种多样的，但它们的共同点是，当这些疾病发生慢性骨骼疼痛时，目前很少有治疗方法可以完全控制疼痛而不会产生显著的不良副作用。在这篇综述中，我们专注于我们的知识的最新进展，关于独特的人口的初级传入感觉神经纤维支配骨骼，伤害性和神经病理机制，参与驱动骨骼疼痛，和神经化学和结构的变化，可以发生在感觉和交感神经纤维和中枢神经系统在慢性骨骼疼痛。我们还讨论了针对神经生长因子或硬化素治疗骨骼疼痛的疗法。这些疗法提供了独特的见解，驱动骨骼疼痛的因素和发生在老化骨骼的结构衰退。最后，我们讨论了这些进展如何改变了我们的理解，并可能治疗和/或预防慢性疼痛的受伤，患病和老年骨骼的治疗选择。图形摘要：骨骼疼痛是常见的，往往难以完全控制。最近的数据表明，骨骼受一组有限的伤害感受器的支配，许多骨骼疼痛具有伤害性和神经性成分。在确定驱动骨骼疼痛的机制和控制骨骼重塑的因素方面已经取得了重大进展。这些见解有可能从根本上改变我们的理解和能力，以预防和/或治疗由于损伤，疾病和衰老引起的骨骼疼痛。
Disorders of the skeleton are one of the most common causes of chronic pain and long-term physical disability in the world. Chronic skeletal pain is caused by a remarkably diverse group of conditions including trauma-induced fracture, osteoarthritis, osteoporosis, low back pain, orthopedic procedures, celiac disease, sickle cell disease and bone cancer. While these disorders are diverse, what they share in common is that when chronic skeletal pain occurs in these disorders, there are currently few therapies that can fully control the pain without significant unwanted side effects. In this review we focus on recent advances in our knowledge concerning the unique population of primary afferent sensory nerve fibers that innervate the skeleton, the nociceptive and neuropathic mechanisms that are involved in driving skeletal pain, and the neurochemical and structural changes that can occur in sensory and sympathetic nerve fibers and the CNS in chronic skeletal pain. We also discuss therapies targeting nerve growth factor or sclerostin for treating skeletal pain. These therapies have provided unique insight into the factors that drive skeletal pain and the structural decline that occurs in the aging skeleton. We conclude by discussing how these advances have changed our understanding and potentially the therapeutic options for treating and/or preventing chronic pain in the injured, diseased and aged skeleton. GRAPHICAL ABSTRACT: Skeletal pain is common and frequently difficult to fully control. Recent data suggests that the skeleton is innervated by a restricted set of nociceptors and that many skeletal pains have both a nociceptive and a neuropathic component. Significant progress has been made in defining the mechanisms that drive skeletal pain and the factors that control skeletal remodeling. These insights have the potential to fundamentally transform our understanding and ability to prevent and/or treat skeletal pain due to injury, disease, and aging.
登录
查看更多内容
影响因子：
3.3
作者：
Castañeda-Corral G;Jimenez-Andrade JM;Bloom AP;Taylor RN;Mantyh WG;Kaczmarska MJ;Ghilardi JR;Mantyh PW
通讯作者：
Mantyh PW
影响因子：
2.3
作者：
Bedson, John;Croft, Peter R.
通讯作者：
Croft, Peter R.
影响因子：
20.3
作者：
Ballas, Samir K.;Gupta, Kalpna;Adams-Graves, Patricia
通讯作者：
Adams-Graves, Patricia
影响因子：
8.8
作者：
Donovan-Rodriguez, T;Dickenson, AH;Urch, CE
通讯作者：
Urch, CE
影响因子：
4.1
作者：
Burgers, Travis A.;Williams, Bart O.
通讯作者：
Williams, Bart O.