细胞焦亡在阿片类药物所致痛觉过敏中的作用

The role of pyroptosis in opioidinduced postoperative hyperalgesia

阿片类药物通常为手术镇痛的首选用药,但其使用往往会引发阿片类药物所致痛觉过敏(opioidinduced hyperalgesia,OIH)等不良反应。以往研究证实,OIH的发生可能与大脑中枢激活相关。研究发现,脊髓胶质细胞活化后炎性介质释放可介导OIH发生,而含半胱氨酸的天冬氨酸蛋白水解酶1(cysteinyl aspartate specific proteinase1,caspase1)介导的细胞焦亡通路作为释放炎性介质的重要途径之一,可能参与了小胶质细胞的炎性反应。文章基于目前研究成果,对细胞焦亡通路特性、OIH的发生机制等方面进行综述,从脊髓胶质细胞活化、细胞焦亡通路介导其他类型OIH和炎性介质释放等方面来探讨细胞焦亡通路和OIH之间的可能关系,为OIH的治疗提供新思路。

As the first choice for surgical analgesia,opioids often cause adverse reactions such as opioidinduced hyperalgesia(OIH).Previous studies have confirmed that the occurrence of OIH may be related to the activation of the action center in the brain.In recent years,studies have found that the release of inflammatory mediators after activation of spinal cord glial cells can mediate the occurrence of OIH.Cysteinyl aspartate specific proteinase1(caspase1)mediated pyrolysis pathway is one of the important ways to release inflammatory mediators,which may be involved in the small glue inflammation of plasmocytes.Based on the current researches,this review summarizes the characteristics of the cell pyrolysis pathway and the mechanism of OIH occurrence.From the three aspects of spinal cord glial cell activation,the pyrolysis pathway mediated other types of hyperalgesia and the release of inflammatory mediators,the possible relationship between the pyrolysis pathway and OIH is explored,which provides new ideas for the treatment of OIH.