The neuroanatomy of sexual dimorphism in opioid analgesia.

The neuroanatomy of sexual dimorphism in opioid analgesia.
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DOI:
10.1016/j.expneurol.2014.04.004
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发表时间:
2014-09
影响因子:
5.3
通讯作者:
Murphy, Anne Z.
Murphy, Anne Z.
中科院分区:
医学2区
文献类型:
--
作者:
Loyd, Dayna R.;Murphy, Anne Z.

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在疼痛与镇痛的临床研究中,性别因素的影响一直被忽视,绝大多数研究仅以男性为对象。然而,临床前研究和临床研究均表明,在参与疼痛处理与镇痛的中枢神经系统回路的解剖结构和生理构成方面,男性和女性存在差异。这些差异不仅影响对伤害性刺激的反应,还影响药物改变这种反应的能力。吗啡是临床上用于缓解持续性疼痛最常用的阿片类药物;然而,越来越明显的是,与男性相比,吗啡对女性的药效较弱。本综述重点介绍了近期有关确定疼痛和阿片类镇痛中性别差异背后的神经解剖学和生理学二态性的研究,聚焦于内源性下行疼痛调节回路。
The influence of sex has been neglected in clinical studies on pain and analgesia, with the vast majority of research conducted exclusively in males. However, both preclinical and clinical studies indicate that males and females differ in both the anatomical and physiological composition of central nervous system circuits that are involved in pain processing and analgesia. These differences influence not only the response to noxious stimuli, but also the ability of pharmacological agents to modify this response. Morphine is the most widely prescribed opiate for the alleviation of persistent pain in the clinic; however, it is becoming increasingly clear that morphine is less potent in women compared to men. This review highlights recent research identifying neuroanatomical and physiological dimorphisms underlying sex differences in pain and opioid analgesia, focusing on the endogenous descending pain modulatory circuit.
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