Pancreatic pain
Pancreatic pain
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DOI：
10.1016/j.bpg.2007.10.016
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发表时间：
2008-01-01
影响因子：
3.2
通讯作者：
Friess, Helmut
中科院分区：
文献类型：
--
作者：
Ceyhan, Guralp O.;Michalski, Christoph W.;Friess, Helmut
腹痛是胰腺疾病的重要临床症状。越来越多的证据表明，慢性胰腺炎和胰腺癌的疼痛是由胰腺神经病变引发的。胰腺内神经的损伤似乎支持神经病理性疼痛的维持和加重。在慢性胰腺炎中，胰腺内神经受到免疫细胞的侵袭。这一观察结果导致了一种假设，即神经免疫相互作用在慢性胰腺炎和伴随的腹痛综合征的发病机制中发挥作用。同样，胰腺癌细胞渗入局部神经的神经膜，这可能在一定程度上解释了患者经历的剧烈疼痛。此外，神经周围侵犯胰腺外神经可能妨碍根治性切除，因此常常导致局部复发。近年来，发现多种神经营养因子和神经肽参与了胰源性疼痛的发病机制。本文综述了有关胰腺疾病中神经病变和疼痛产生机制的最新数据。
Abdominal pain is an important clinical symptom in pancreatic diseases. There is increasing evidence that pain in chronic pancreatitis and pancreatic cancer is triggered by pancreatic neuropathy. Damage to intrapancreatic nerves seems to support the maintenance and exacerbation of neuropathic pain. In chronic pancreatitis, intrapancreatic nerves are invaded by immune cells. This observation led to the hypothesis that neuro-immune interactions play a role in the pathogenesis of chronic pancreatitis and the accompanying abdominal pain syndrome. Similarly, pancreatic cancer cells infiltrate the perineurium of local nerves, which may in part explain the severe pain experienced by the patients. Furthermore, perineural invasion extending into extrapancreatic nerves may preclude curative resection and thus often leads to local recurrence. In recent years, the involvement of a variety of neurotrophins and neuropeptides in the pathogenesis of pancreatic pain was discovered. This review summarises recent data on the mechanisms of neuropathy and pain generation in pancreatic disorders.