放化疗所致口腔黏膜炎疼痛电生理机制研究进展

Research Progress on the Electrophysiological Mechanism of Pain in Oral Mucositis Caused by Chemoradiotherapy

放化疗后普遍出现的口腔黏膜炎(oral mucositis,OM)是头颈癌患者治疗过程中出现的最常见的不良反应之一,表现为口腔黏膜充血、水肿以及溃疡等,其引发的疼痛会严重影响患者的生活质量,干扰治疗进程。放化疗所致OM的发病机制复杂,涉及多种炎症因子及多条信号通路,而有关其疼痛的电生理机制的研究相对较少。黏膜损伤处的急性疼痛和炎症环境下的持续性疼痛,导致离子通道重构,产生中枢及外周的敏化。本研究从离子通道角度对OM的致痛机制进行探讨,通过类比其他炎性疼痛的研究结果,重点关注瞬时受体电位通道、钠通道和钾通道在OM及其他疾病所致疼痛中的变化,推测OM致痛可能的电生理机制。离子通道作为重要的药物靶点,针对性的开放剂和拮抗剂可有效缓解疼痛,结合目前放化疗所致OM主要治的疗方式,以期为OM疼痛管理提供新的思路。

Oral mucositis(OM)after chemoradiotherapy is a prevalent adverse effect in patients with head and neck cancer.It pres⁃ents as congestion,edema,and ulceration of the oral mucosa,significantly impacting patients'quality of life and treatment progress due to the associated pain.The pathogenesis of OM induced by chemoradiotherapy is intricate,involving a multitude of inflammatory factors and multiple signaling pathways,while the study on electrophysiological mechanism of pain is relatively few.Acute pain resulting from mucosal injury and persistent pain in an inflammatory environment can lead to the remodeling of ion channels,as well as central and peripheral sensitization.The paper examines the pain mechanism of OM from the perspective of ion channels.Drawing on research find⁃ings in other inflammatory pain conditions,it specifically focuses on the alterations in transient receptor potential channels,sodium chan⁃nels and potassium channels associated with pain caused by OM and other diseases,while also speculating on the possible electrophysi⁃ological mechanism underlying OM-induced pain.The ion channel serves as a crucial target for drug intervention,and the use of targeted openers and antagonists has been shown to effectively alleviate pain associated.Combined with the current main treatment methods of OM caused by chemoradiotherapy,we hope to offer novel insights for the management of OM-related pain.