The Pharmacology of Visceral Pain
The Pharmacology of Visceral Pain
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DOI：
10.1016/bs.apha.2015.11.002
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发表时间：
2016-01-01
期刊：
影响因子：
--
通讯作者：
Greenwood-Van Meerveld, Beverley
中科院分区：
文献类型：
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作者：
Johnson, Anthony C.;Greenwood-Van Meerveld, Beverley
内脏痛指的是来自胸腔、盆腔或腹部内部器官的疼痛。与躯体疼痛不同，内脏疼痛通常是模糊的，局部性不佳，其特征是对刺激(如器官扩张)高度敏感。虽然目前的治疗方法在一定程度上缓解了躯体疼痛，但用于治疗慢性内脏疼痛的药物通常效果较差，并受到多种不良副作用的限制。因此，内脏疼痛的治疗代表着一个主要的未得到满足的医疗需求。此外，需要对内脏疼痛的生理学和病理生理学进行更多的基础研究，为未来的药物开发提供新的靶点。在慢性内脏疼痛的同时，与压力相关的精神疾病，包括焦虑和抑郁，有很高的共患率。内脏疼痛与这些重叠的并存疾病之间的联系机制仍有待阐明。然而，持续的压力促进了疼痛的感知并敏化了疼痛通路，导致了一个促进慢性内脏疼痛障碍的前馈循环。我们将重点关注应激诱导的慢性内脏疼痛加剧，并提供支持证据，证明针对疼痛和应激反应脑区的中枢作用药物可能是开发新的有效疗法的有效靶点。
Visceral pain describes pain emanating from the internal thoracic, pelvic, or abdominal organs. Unlike somatic pain, visceral pain is generally vague, poorly localized, and characterized by hypersensitivity to a stimulus such as organ distension. While current therapeutics provides some relief from somatic pain, drugs used for treatment of chronic visceral pain are typically less efficacious and limited by multiple adverse side effects. Thus, the treatment of visceral pain represents a major unmet medical need. Further, more basic research into the physiology and pathophysiology of visceral pain is needed to provide novel targets for future drug development. In concert with chronic visceral pain, there is a high comorbidity with stress-related psychiatric disorders including anxiety and depression. The mechanisms linking visceral pain with these overlapping comorbidities remain to be elucidated. However, persistent stress facilitates pain perception and sensitizes pain pathways, leading to a feed-forward cycle promoting chronic visceral pain disorders. We will focus on stress-induced exacerbation of chronic visceral pain and provide supporting evidence that centrally acting drugs targeting the pain and stress-responsive brain regions may represent a valid target for the development of novel and effective therapeutics.