基于“干扰素-胶质细胞-中枢敏化”途径探析针刺治疗神经病理性疼痛的潜在机制

Exploration on the potential mechanism of acupuncture in the treatment of neuropathic pain based on the‘interferon-gliacyte-central sensitization'pathway

神经病理性疼痛(NP)是由躯体感觉神经系统病变或疾病引起的疼痛,以自发性疼痛、痛觉过敏、异常疼痛为表现,使用常规镇痛药治疗效果不佳。针刺能够显著缓解NP症状并改善患者情绪及生活质量,且不良反应较少,但其具体机制尚不明确。中枢敏化是NP发生和维持的重要环节,胶质细胞激活后诱发“胶质细胞增生”同时释放相关介质诱发疼痛,参与了中枢敏化过程。干扰素是一类具有抗病毒、抗增殖、免疫调节等特性的内源性细胞因子的总称,能通过介导胶质细胞激活促进中枢敏化诱发疼痛。文章从“干扰素-胶质细胞-中枢敏化”途径出发,阐释NP的发病机制,并从针刺或能对干扰素进行调控的角度,探析针刺治疗NP的潜在生物学机制。

Neuropathic pain(NP)is pain caused by somatosensory neurological lesions or diseases,which is characterized by spontaneous pain,nociceptive hypersensitivity and abnormal pain,and is poorly treated with conventional analgesics.Acupuncture can significantly relieve NP symptoms and improve patients'mood and quality of life with fewer side effects,but its specific mechanism is not clear.Central sensitization is an important part in the development and maintenance of NP,and the activation of glial cells induces'glial cell hyperplasia'and the release of related mediators to induce pain,which is involved in the central sensitization process.Interferon is a class of endogenous cytokines with antiviral,antiproliferative and immunomodulatory properties,which can promote central sensitization and induce pain through glial cell activation.In this paper,we explain the pathogenesis of NP from the interferon-glia-central sensitization'pathway,and explore the potential biological mechanism of acupuncture in treating NP from the point of view that acupuncture may regulate interferon.