Mechanisms of non-opioid analgesics beyond cyclooxygenase enzyme inhibition.
Mechanisms of non-opioid analgesics beyond cyclooxygenase enzyme inhibition.
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DOI：
10.2174/1874467210902010001
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发表时间：
2009-01
影响因子：
2.7
通讯作者：
Dionne RA
中科院分区：
文献类型：
--
作者：
Hamza M;Dionne RA
非阿片类镇痛药，包括选择性和非选择性环氧合酶 (COX) 抑制剂和对乙酰氨基酚，是最广泛使用的疼痛治疗方法。 COX 的抑制被认为是此类药物的治疗作用和不良反应的主要原因。过去二十年积累的证据表明，非阿片类药物的作用超出了抑制 COX 和前列腺素合成的范围，这也可能解释其治疗和不良反应。这些包括它们与内源性大麻素、一氧化氮、单胺能和胆碱能系统的相互作用。此外，最近发展的微阵列技术可以研究人类基因表达，这表明多种途径可能与非阿片类药物的镇痛和抗炎作用有关。本综述将讨论非阿片类药物的多种作用及其在炎症和疼痛期间与这些系统的相互作用，表明 COX 抑制是对非阿片类药物作用的不完整解释，并提出其镇痛及其不良反应涉及多个选择性靶点。
Non-opioid analgesics including both selective and non-selective cyclooxygenase (COX) inhibitors and acetaminophen are the most widely used treatments for pain. Inhibition of COX is thought to be largely responsible for both the therapeutic and adverse effects of this class of drugs. Accumulating evidence over the past two decades has demonstrated effects of non-opioids beyond the inhibition of COX and prostaglandin synthesis that might also explain their therapeutic and adverse effects. These include their interaction with endocannabinoids, nitric oxide, monoaminergic, and cholinergic systems. Moreover, the recent development of microarray technology that allows the study of human gene expression suggests multiple pathways that may be related to the analgesic and anti-inflammatory effects of non-opioids. The present review will discuss the multiple actions of non-opioids and their interactions with these systems during inflammation and pain, suggesting that COX inhibition is an incomplete explanation for the actions of non-opioids and proposes the involvement of multiple selective targets for their analgesic, as well as, their adverse effects.