Attenuation of Pain in Men and Women: Mechanisms of Exercise-Induced Analgesia

男性和女性疼痛的减轻：运动诱发镇痛的机制

• 批准号: 7789289
• 负责人: KELLI F KOLTYN
• 金额: $ 16.36万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-02-01 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7789289
• 关键词: Absence of pain sensation; Age; Analgesics; Animal Experimentation; Arthritis; Blood; Clinical; Consensus; Country; Crossover Design; Double-Blind Method; Endocannabinoids; Etiology; Exercise; Female; Fibromyalgia; Headache; Health; Health Care Costs; Human; Indium; Individual; Institute of Medicine (U.S.); International; Irritable Bowel Syndrome; Knowledge; Mediating; Mediation; Methodology; Naltrexone; Narcotic Antagonists; Operating System; Opioid; Pain; Pain management; Participant; Perception; Placebo Control; Placebos; Prevalence; Prevention; Productivity; Randomized; Recruitment Activity; Reporting; Research; Research Personnel; Safe Sex; Sex Characteristics; Stimulus; Syndrome; System; Temporomandibular Joint Disorders; Terminology; Testing; Therapeutic; United States National Institutes of Health; Well in self; Woman; attenuation; base; chronic pain; cost; endogenous opioids; male; men; neurochemistry; novel strategies; preclinical study; pressure; programs; public health relevance; response; sex; social

DESCRIPTION (provided by applicant): Pain is considered to be a critical national health problem that costs this country over $100 billion each year in health costs and lost productivity (NIH, 2006). In addition, it has been reported that women are over-represented for a number of chronic pain conditions (e.g., temporomandibular disorders, arthritis, fibromyalgia) compared to men. The mechanisms responsible for these sex differences, however, have yet to be fully determined, thus, the overall objective of the proposed research is to examine whether men and women differ in selected mechanisms of endogenous pain modulation. One form of endogenous pain modulation is exercise-induced analgesia (EIA). Numerous studies have indicated an attenuation of pain following exercise, and therapeutic exercise programs are an important element in the treatment of many chronic pain syndromes. Thus, it is surprising how little is known regarding this form of endogenous pain modulation in men and women. Currently, the mechanisms responsible for EIA are poorly understood but results from the animal research indicate that multiple analgesic systems exist, and there are sex differences in the underlying neurochemical mediation of analgesia. The primary purpose of the proposed research is to examine opioid and endocannabinoid mechanisms of EIA in men and women. A double-blind placebo- controlled crossover design employing an opioid blockade methodology will be utilized in the proposed research. A total of 60 men and women between the ages of 18-40 yrs will be recruited to participate in a familiarization session and two randomly assigned experimental sessions. Participants will undergo pain testing (i.e., noxious thermal and pressure stimuli) before and after exercise following double-blind administration of an opioid antagonist and a placebo. Blood will be drawn before and following exercise to examine endocannabinoid responses to exercise. Understanding why men and women differ in pain sensitivity has important implications for furthering our knowledge of the etiology, mechanisms and treatment of pain PUBLIC HEALTH RELEVANCE: The perception of pain is modulated by multiple endogenous analgesic systems, and there is evidence that these systems operate differently in men and women. Given the substantially greater prevalence of many clinical pain conditions in women vs men, it is essential to gain a better understanding of sex differences in endogenous pain inhibitory mechanisms which will ultimately permit the tailoring of better treatments to enhance pain control in both men and women.

描述（由申请人提供）：疼痛被认为是一个关键的国家健康问题，每年花费这个国家超过1000亿美元的健康成本和生产力损失（NIH，2006）。此外，据报道，女性在许多慢性疼痛病症中的比例过高（例如，颞下颌关节紊乱病、关节炎、纤维肌痛）。然而，导致这些性别差异的机制尚未完全确定，因此，拟议研究的总体目标是检查男性和女性在内源性疼痛调制的选定机制中是否存在差异。内源性疼痛调节的一种形式是运动诱导的镇痛（EIA）。许多研究表明运动后疼痛减轻，治疗性运动计划是治疗许多慢性疼痛综合征的重要因素。因此，令人惊讶的是，关于男性和女性中这种形式的内源性疼痛调节知之甚少。目前，负责EIA的机制知之甚少，但动物研究的结果表明，存在多个镇痛系统，并且在潜在的镇痛神经化学介导中存在性别差异。拟议研究的主要目的是检查男性和女性EIA的阿片类和内源性大麻素机制。在拟定的研究中将使用采用阿片类药物阻滞方法的双盲安慰剂对照交叉设计。将招募60名年龄在18-40岁之间的男性和女性参加熟悉课程和两个随机分配的实验课程。参与者将接受疼痛测试（即，有害的热和压力刺激）。在运动之前和之后抽血，以检查内源性大麻素对运动的反应。了解为什么男性和女性在疼痛敏感性方面存在差异，对于进一步了解疼痛的病因、机制和治疗具有重要意义 公共卫生相关性：疼痛的感觉是由多种内源性镇痛系统调节的，有证据表明这些系统在男性和女性中的运作方式不同。鉴于女性与男性相比，许多临床疼痛状况的患病率更高，因此必须更好地了解内源性疼痛抑制机制的性别差异，这将最终允许定制更好的治疗方法，以增强男性和女性的疼痛控制。