Visceral Pain in Preterm Infants with Necrotizing Enterocolitis: Underlying Mechanisms and Implications for Treatment.

IF 3.4 3区 医学 Q1 PEDIATRICS Pediatric Drugs Pub Date : 2025-01-03 DOI:10.1007/s40272-024-00676-0
Judith A Ten Barge, Gerbrich E van den Bosch, Rebeccah Slater, Nynke J van den Hoogen, Irwin K M Reiss, Sinno H P Simons
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Abstract

Necrotizing enterocolitis (NEC) is a relatively rare but very severe gastrointestinal disease primarily affecting very preterm infants. NEC is characterized by excessive inflammation and ischemia in the intestines, and is associated with prolonged, severe visceral pain. Despite its recognition as a highly painful disease, current pain management for NEC is often inadequate, and research on optimal analgesic therapy for these patients is lacking. Insight into the mechanisms underlying intestinal pain in infants with NEC-visceral pain-could help identify the most effective analgesics for these vulnerable patients. Therefore, this comprehensive review aims to provide an overview of visceral nociception, including transduction, transmission, modulation, and experience, and discuss the implications for analgesic therapy in preterm infants with NEC. The transmission of visceral pain differs from that of somatic pain, contributing to the diffuse nature of visceral pain. Studies evaluating the effectiveness of analgesics for treating visceral pain in infants are scarce. However, research in visceral pain models highlights agents that may be particularly effective for treating visceral pain based on their mechanisms of action. Further research is necessary to determine whether agents that have shown promise for treating visceral pain in preclinical studies and adults are effective in infants with NEC as well.

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坏死性小肠结肠炎早产儿的内脏疼痛:潜在的机制和治疗意义。
坏死性小肠结肠炎(NEC)是一种相对罕见但非常严重的胃肠道疾病,主要影响极早产儿。NEC的特点是肠道过度炎症和缺血,并伴有长期严重的内脏疼痛。尽管NEC被认为是一种非常痛苦的疾病,但目前对NEC的疼痛管理往往不足,并且缺乏对这些患者的最佳镇痛治疗的研究。深入了解nec婴儿肠道疼痛(内脏疼痛)的潜在机制,可以帮助确定对这些易感患者最有效的镇痛药。因此,本综述旨在提供内脏痛觉的概述,包括传导、传递、调节和经验,并讨论对NEC早产儿镇痛治疗的影响。内脏疼痛的传递不同于躯体疼痛,这有助于内脏疼痛的弥漫性。评估镇痛药治疗婴儿内脏疼痛的有效性的研究很少。然而,内脏疼痛模型的研究强调了基于其作用机制的药物可能对治疗内脏疼痛特别有效。需要进一步的研究来确定在临床前研究和成人中显示出治疗内脏疼痛的药物是否对NEC婴儿有效。
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来源期刊
Pediatric Drugs
Pediatric Drugs PEDIATRICS-PHARMACOLOGY & PHARMACY
CiteScore
7.20
自引率
0.00%
发文量
54
审稿时长
>12 weeks
期刊介绍: Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes: -overviews of contentious or emerging issues. -comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development. -practical reviews covering optimum drug management of specific clinical situations. -systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. -Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population. -original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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