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背根神经节(dorsal root ganglia,DRG)和脊髓背角中痛介质(pronociceptive mediator)的增加是炎性疼痛与阿片耐受发生的重要病理机制。肾上腺髓质素(adrenomedullin,AM)属于降钙素基因相关肽(calcitonin gene-related peptide,CGRP)家族,是新近证实的痛介质。研究表明,炎症和重复应用吗啡时,DRG和脊髓背角中AM含量和释放都增加。鞘内给予AM受体阻断剂AM22-52能抑制炎性疼痛与吗啡耐受,表明DRG和脊髓背角中AM受体活动的增加参与炎性疼痛和吗啡耐受发生的病理过程。本文综述了最近有关研究进展,讨论了AM参与这两类疾患发生的神经学机制。
Increased dorsal root ganglia (DRG) and pronociceptive mediators in spinal dorsal horn are important pathological mechanisms of inflammatory pain and opioid tolerance. Adrenomedullin (AM), a calcitonin gene-related peptide (CGRP) family, is a newly identified pain mediator. Studies have shown that both inflammation and repeated morphine administration increase AM content and release in DRG and spinal dorsal horn. Intrathecal administration of AM22-52, an AM receptor blocker, inhibited inflammatory pain and morphine tolerance, suggesting that increased AM receptor activity in the DRG and spinal dorsal horn is involved in the pathological processes leading to inflammatory pain and morphine tolerance. This review summarizes recent research progress and discusses the neurological mechanisms by which AM participates in these two disorders.