Neurosteroids in Pain Management: A New Perspective on an Old Player.

Neurosteroids in Pain Management: A New Perspective on an Old Player.
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DOI:
10.3389/fphar.2018.01127
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发表时间:
2018
影响因子:
5.6
通讯作者:
Todorovic SM
Todorovic SM
中科院分区:
医学2区
文献类型:
--
作者:
Joksimovic SL;Covey DF;Jevtovic-Todorovic V;Todorovic SM

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自从发现神经系统产生类固醇激素的能力以来,大量研究证明了它们在调节神经元兴奋性方面的重要性。这些中枢效应主要是通过不同的配体门控受体系统(例如 GABAA 和 NMDA)以及电压依赖性 Ca2+ 或 K+ 通道介导的。由于这些目标也与感觉信息的传递有关,因此大量研究表明神经类固醇在各种疼痛模型中的镇痛特性也就不足为奇了。生理性(伤害性)疼痛通过促进危及生命的条件下的生存而对有机体具有保护价值。然而,由神经功能障碍(神经性疼痛)引起的更长时间的疼痛,甚至在组织损伤消退后仍然持续,是患者就医的主要原因之一。本综述将主要关注神经类固醇及其合成 5α 和 5β 类似物在伤害性疼痛和神经病理性疼痛中的镇痛作用。
Since the discovery of the nervous system’s ability to produce steroid hormones, numerous studies have demonstrated their importance in modulating neuronal excitability. These central effects are mostly mediated through different ligand-gated receptor systems such as GABAA and NMDA, as well as voltage-dependent Ca2+ or K+ channels. Because these targets are also implicated in transmission of sensory information, it is not surprising that numerous studies have shown the analgesic properties of neurosteroids in various pain models. Physiological (nociceptive) pain has protective value for an organism by promoting survival in life-threatening conditions. However, more prolonged pain that results from dysfunction of nerves (neuropathic pain), and persists even after tissue injury has resolved, is one of the main reasons that patients seek medical attention. This review will focus mostly on the analgesic perspective of neurosteroids and their synthetic 5α and 5β analogs in nociceptive and neuropathic pain conditions.
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