基于5-HT/5-HT2A受体/PLC/TRPV1信号通路探讨银质针治疗肌筋膜疼痛综合征的机制研究

肌筋膜疼痛综合征（MPS）是临床常见而难治性痛疾，发病机制仍不清晰。临床证实银质针导热治疗MPS具有较好的长期缓解疼痛疗效，但机制不明。研究表明5-HT作用于5-HT2A受体（5-HT2AR）后可通过PLC介导TRPV1脱敏；另TRPV1可被热效应激活，TRPV1持续激活后可脱敏而降低脊髓SP、CGRP等表达发挥镇痛效应。我们前期研究发现银质针导热可增加MPS大鼠脊髓5-HT和5-HT2AR的表达，据此推测银质针导热可能是通过5-HT/5-HT2AR/PLC/TRPV1信号通路发挥镇痛作用。因此本项目拟以MPS大鼠和原代培养的脊髓神经细胞为研究对象，采用行为学、电生理学、组织形态学和分子生物学等手段，探讨5-HT/5-HT2AR/PLC/TRPV1通路在MPS病理过程中的机制，明确银质针导热治疗MPS是否通过该通路发挥针刺与热效应双重镇痛效应，为临床采用银质针导热治疗MPS提供理论依据。

MPS myofascial pain syndrome (MPS) is a common and refractory pain disease in clinic. The pathogenesis of MPS is still unclear. Clinical studies have confirmed that silver needle heat conduction therapy for MPS has a prefect long-term pain relief effect, but the mechanism is unknown. Studies have shown that 5-HT acting on the 5-HT2A receptor can desensitize TRPV1 through PLC-mediated. In addition, TRPV1 can be activated by thermal effects. TRPV1 can be desensitized after sustain activation. The desensitization of TRPV1 can reduce the expression of SP and CGRP in spinal cord to exert an analgesic effect. Our previous research found that silver needle heat conduction can increase the expression of 5-HT and 5-HT2AR in the spinal cord of MPS rats. It is speculated that silver needle heat conduction may play analgesic effect through the 5-HT/ 5-HT2AR/PLC/TRPV1 signaling pathway. Therefore, our study intends to use MPS rats and primary cultured spinal nerve cells as the research object, applying behavioral, electrophysiology, histomorphology and molecular biology to explore the pathological mechanism of 5-HT/5-HT2AR/ PLC/TRPV1 pathway in MPS and whether the silver needle heat conduction therapy for MPS can exert the dual analgesic effect with combined acupuncture and heat action through this pathway, which might provide a theoretical basis on the clinical use of silver needle thermal conduction therapy for MPS.