Acute and Chronic Pain from Facial Skin and Oral Mucosa: Unique Neurobiology and Challenging Treatment.
Acute and Chronic Pain from Facial Skin and Oral Mucosa: Unique Neurobiology and Challenging Treatment.
复制标题
DOI：
10.3390/ijms22115810
复制
发表时间：
2021-05-28
影响因子：
5.6
通讯作者：
Kim YS
中科院分区：
文献类型：
--
作者：
Chung MK;Wang S;Oh SL;Kim YS
口腔是进入消化系统的门户，具有独特的感官特性。与面部皮肤一样，口腔粘膜需要非常敏感和选择性，以便检测有害毒素和可食用食物。通过多种受体（包括瞬时受体电位通道）的化学感觉和躯体感觉已充分发展以满足这些需求。然而，与面部皮肤相反，口腔粘膜很少表现出瘙痒反应。与肠道一样，口腔也进行机械和化学消化。因此，口腔粘膜需要在一定程度上不敏感，以耐受有害刺激。口腔粘膜的持续性疼痛通常是由于溃疡，涉及组织损伤和感染。三叉神经损伤和三叉神经痛产生顽固性疼痛的口面皮肤和口腔粘膜，通过不同的机制，在脊柱区域，这是特别难以预测或治疗的特发性慢性疼痛，如非典型牙痛（特发性疼痛性三叉神经病变或创伤后三叉神经病变）和灼口综合征的诊断和治疗，仍然特别具有挑战性。味觉输入的中枢整合可能调节慢性口腔和面部疼痛。口腔内慢性炎症（如慢性牙周炎）的疼痛缺乏涉及口腔细菌的专门功能。更详细地了解独特的神经生物学疼痛的口面部皮肤和口腔粘膜应该帮助我们开发新的方法，更好地治疗持续性口面部疼痛。
The oral cavity is a portal into the digestive system, which exhibits unique sensory properties. Like facial skin, the oral mucosa needs to be exquisitely sensitive and selective, in order to detect harmful toxins versus edible food. Chemosensation and somatosensation by multiple receptors, including transient receptor potential channels, are well-developed to meet these needs. In contrast to facial skin, however, the oral mucosa rarely exhibits itch responses. Like the gut, the oral cavity performs mechanical and chemical digestion. Therefore, the oral mucosa needs to be insensitive, to some degree, in order to endure noxious irritation. Persistent pain from the oral mucosa is often due to ulcers, involving both tissue injury and infection. Trigeminal nerve injury and trigeminal neuralgia produce intractable pain in the orofacial skin and the oral mucosa, through mechanisms distinct from those seen in the spinal area, which is particularly difficult to predict or treat. The diagnosis and treatment of idiopathic chronic pain, such as atypical odontalgia (idiopathic painful trigeminal neuropathy or post-traumatic trigeminal neuropathy) and burning mouth syndrome, remain especially challenging. The central integration of gustatory inputs might modulate chronic oral and facial pain. A lack of pain in chronic inflammation inside the oral cavity, such as chronic periodontitis, involves the specialized functioning of oral bacteria. A more detailed understanding of the unique neurobiology of pain from the orofacial skin and the oral mucosa should help us develop novel methods for better treating persistent orofacial pain.