NEW CULPRITS IN CHRONIC PAIN
NEW CULPRITS IN CHRONIC PAIN
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DOI：
10.1038/scientificamerican1109-50
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发表时间：
2009-11-01
影响因子：
3
通讯作者：
Fields, R. Douglas
中科院分区：
文献类型：
--
作者：
Fields, R. Douglas
身体受伤部位的感觉在被大脑感知为疼痛之前会经过三个阶段的神经回路。在脊柱中信息从第一阶段传递到下一阶段的中继点，称为神经胶质细胞的支持细胞监视并调节神经元的行为，以缓解信号的传输。这是一种虚假警报，被称为神经性警报，因为它是由神经本身的不当行为引起的。当错误信号到达大脑时，它们造成的痛苦就像任何危及生命的疼痛一样真实，但它永远不会消失，医生往往无力平息它。最近的研究终于阐明了为什么传统止痛药常常无法平息神经性疼痛：当疼痛的根本原因可能是存在于大脑和脊髓中的神经胶质细胞的功能障碍时，这些药物仅针对神经元。这些细胞的作用是培养神经元的活动，但它们本身如何变得不平衡并破坏神经元功能，这些新见解正在激发治疗慢性疼痛的新想法。这项工作还为某些人目前疼痛治疗的一个不幸的必然结果提供了令人惊讶的视角：麻醉成瘾。
Sensations from an injured part of the body travel through three stages of neural circuitry before being perceived as pain by the brain. At the relay point in the spine where messages are passed from the first stage to the next, support cells called glia monitor and regulate the behavior of neurons to ease the transmission of signals. ger a false alarm, one that is termed neuropathic because it arises from the misbehavior of the nerves themselves. When the false signals reach the brain, the agony they inflict is as real as any life-threatening pain, yet it never goes away and doctors are often powerless to quiet it. Recent research is finally elucidating why traditional pain drugs often fail to quell neuropathic pain: the drugs target only neurons when the underlying source of the pain can be the dysfunction of nonneuronal cells called glia that reside in the brain and spinal cord. New insights into how these cells, whose job is to nurture the activity of neurons, can themselves become unbalanced and disrupt neuronal function are sparking new ideas for treating chronic pain. The work is also providing a surprising perspective on an unfortunate corollary of current pain treatment in some people: narcotic addiction.