The role of cytokines in the initiation and maintenance of chronic pain
The role of cytokines in the initiation and maintenance of chronic pain
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DOI：
10.1358/dnp.2002.15.10.740239
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发表时间：
2002-12-01
影响因子：
--
通讯作者：
DeLeo, JA
中科院分区：
文献类型：
--
作者：
Rutkowski, MA;DeLeo, JA
最近在疼痛领域的进展已经确定了中枢神经系统（CNS）的神经免疫反应，它可能是神经过敏的驱动力，这是周围神经损伤后慢性疼痛的病理相关。神经免疫激活涉及非神经元细胞（如内皮细胞和神经胶质细胞）的激活，当这些细胞受到刺激时，会导致大量炎症介质（如细胞因子）的产生增强。促炎细胞因子的中枢产生，如白细胞介素-1 β (il -1 β)、IL-6和肿瘤坏死因子，已被发现在持续疼痛状态的传播中发挥关键作用。此外，趋化细胞因子，趋化因子，最近也在周围神经损伤后发生的中枢神经免疫级联反应中被发现。白细胞从血液外渗到感知损伤的部位被定义为这个级联的神经炎症方面。趋化因子直接控制这种白细胞迁移过程。它们在损伤部位合成，并建立免疫细胞迁移的浓度梯度。最近的研究表明，白细胞在周围神经或腰神经根损伤后进入中枢神经系统。使用选择性细胞因子抑制剂和中和抗体。在神经病变动物模型中，触觉和热超敏反应减弱。进一步了解非神经元细胞的作用，中枢神经系统细胞因子和趋化因子的生理机制，以及它们与神经免疫激活和神经炎症过程的相关性，可能会导致开发用于治疗和预防慢性疼痛的新型药物。(C) 2002年科学研究。版权所有。
Recent advancements in the pain field have identified a central nervous system (CNS) neuroimmune response that may act as the driving force for neuronal hypersensitivity, the pathological correlate to chronic pain following peripheral nerve injury. Neuroimmune activation involves the activation of nonneuronal cells such as endothelial and glial cells, which when stimulated leads to enhanced production of a host of inflammatory mediators, such as cytokines. The central production of proinflammatory cytokines, such as interleukin-1beta(IL-1beta), IL-6 and tumor necrosis factor have been found to play a key role in the propagation of persistent pain states. In addition, chemotactic cytokines, chemokines, have also been recently identified in the CNS neuroimmune cascade that ensues after injury to a peripheral nerve. The extravasation of leukocytes from the blood to the site of perceived injury is defined as the neuroinflammatory aspect of this cascade. Chemokines directly control this leukocyte transmigration process. They are synthesized at the site of injury and establish a concentration gradient through which immune cells migrate. Recent studies have demonstrated leukocyte trafficking into the CNS following peripheral nerve or lumbar nerve root injury. With the use of selective cytokine inhibitors and neutralizing antibodies. tactile and thermal hypersensitivity is attenuated in animal models of neuropathy. A further understanding of the role of nonneuronal cells, the physiological mechanisms of CNS cytokines and chemokines, and their relevance to neuroimmune activation and neuroinflammatory processes may lead to the development of novel pharmacological agents for the treatment and prevention of chronic pain. (C) 2002 Prous Science. All rights reserved.