Persistent changes in peripheral and spinal nociceptive processing after early tissue injury.
Persistent changes in peripheral and spinal nociceptive processing after early tissue injury.
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DOI：
10.1016/j.expneurol.2015.06.020
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发表时间：
2016-01
影响因子：
5.3
通讯作者：
Baccei ML
中科院分区：
文献类型：
--
作者：
Walker SM;Beggs S;Baccei ML
很明显，生命早期关键时期的组织损伤可能会导致疼痛敏感性的长期变化，但其潜在机制仍有待充分阐明。在这里，我们回顾了新生儿组织损伤后伤害感受处理持续改变的临床和临床前证据，这些证据共同表明基线时存在广泛的痛觉减退，以及随后对同一躯体区域的损伤后痛觉过敏程度加剧。我们还强调了最近在细胞和分子水平上研究早期创伤对上行疼痛通路的组织和功能的影响的工作。新生儿损伤的这些影响包括初级传入神经元和脊髓神经元中离子通道表达的改变、浅表背角 (SDH) 网络内突触兴奋和抑制之间平衡的变化，以及成人 SDH 中小胶质细胞反应的“启动”。更好地了解早期组织损伤如何影响伤害感受回路的成熟，可以对策略产生新的见解，以最大限度地减少必要但侵入性的医疗程序对发育中的体感系统的长期影响。
It has become clear that tissue damage during a critical period of early life can result in long-term changes in pain sensitivity, but the underlying mechanisms remain to be fully elucidated. Here we review the clinical and preclinical evidence for persistent alterations in nociceptive processing following neonatal tissue injury, which collectively point to the existence of both a widespread hypoalgesia at baseline as well as an exacerbated degree of hyperalgesia following a subsequent insult to the same somatotopic region. We also highlight recent work investigating the effects of early trauma on the organization and function of ascending pain pathways at a cellular and molecular level. These effects of neonatal injury include altered ion channel expression in both primary afferent and spinal cord neurons, shifts in the balance between synaptic excitation and inhibition within the superficial dorsal horn (SDH) network, and a ‘priming’ of microglial responses in the adult SDH. A better understanding of how early tissue damage influences the maturation of nociceptive circuits could yield new insight into strategies to minimize the long-term consequences of essential, but invasive, medical procedures on the developing somatosensory system.