Stress-induced visceral pain: toward animal models of irritable-bowel syndrome and associated comorbidities.
Stress-induced visceral pain: toward animal models of irritable-bowel syndrome and associated comorbidities.
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DOI：
10.3389/fpsyt.2015.00015
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发表时间：
2015
影响因子：
4.7
通讯作者：
Cryan JF
中科院分区：
文献类型：
--
作者：
Moloney RD;O'Mahony SM;Dinan TG;Cryan JF
内脏痛是一个通用术语，用于描述源自内脏器官的疼痛，与躯体疼痛不同。它是肠易激综合征（IBS）等功能性胃肠道疾病的一个标志。目前，针对内脏疼痛的治疗策略并不令人满意，由于缺乏对潜在机制的详细了解，新疗法的开发受到阻碍。在临床前和临床研究中，压力长期以来一直被认为与内脏疼痛的病理生理学有关。在这里，我们讨论内脏疼痛的复杂病因，回顾我们目前对压力、性别、肠道微生物群改变和免疫功能作用的理解。此外，我们回顾了谷氨酸、GABA 和表观遗传机制作为治疗内脏疼痛的可能治疗策略的作用，而内脏疼痛的医疗需求尚未得到满足。此外，我们还讨论了在临床前环境中用于模拟内脏疼痛的最广泛描述的啮齿动物模型。动物模型背后的理论和应用对于理解潜在机制和设计未来治疗干预措施至关重要。综上所述，很明显，压力引起的内脏疼痛及其以IBS为代表的精神合并症具有多方面的病因。此外，与其他疼痛方式相比，治疗策略仍然远远落后。开发治疗内脏疼痛的新颖、有效和特异的疗法从未如此重要。
Visceral pain is a global term used to describe pain originating from the internal organs, which is distinct from somatic pain. It is a hallmark of functional gastrointestinal disorders such as irritable-bowel syndrome (IBS). Currently, the treatment strategies targeting visceral pain are unsatisfactory, with development of novel therapeutics hindered by a lack of detailed knowledge of the underlying mechanisms. Stress has long been implicated in the pathophysiology of visceral pain in both preclinical and clinical studies. Here, we discuss the complex etiology of visceral pain reviewing our current understanding in the context of the role of stress, gender, gut microbiota alterations, and immune functioning. Furthermore, we review the role of glutamate, GABA, and epigenetic mechanisms as possible therapeutic strategies for the treatment of visceral pain for which there is an unmet medical need. Moreover, we discuss the most widely described rodent models used to model visceral pain in the preclinical setting. The theory behind, and application of, animal models is key for both the understanding of underlying mechanisms and design of future therapeutic interventions. Taken together, it is apparent that stress-induced visceral pain and its psychiatric comorbidities, as typified by IBS, has a multifaceted etiology. Moreover, treatment strategies still lag far behind when compared to other pain modalities. The development of novel, effective, and specific therapeutics for the treatment of visceral pain has never been more pertinent.
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