揭开子宫内膜异位症的痛苦:从神经系统的角度。

IF 4.5 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Expert Reviews in Molecular Medicine Pub Date : 2022-09-05 DOI:10.1017/erm.2022.26
Peiya Fan, Tian Li
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引用次数: 1

摘要

子宫内膜异位症是一种慢性炎症性疾病,伴有骨盆疼痛和非特征性的伴随症状。子宫内膜异位症相关的疼痛通常持续存在,尽管该疾病的治疗,因此它带来了有害的影响,对他们的个人生活以及施加了巨大的经济负担。目前,子宫内膜异位症相关疼痛的机制包括炎症反应、损伤、血管异常以及外周和中枢神经系统的形态和功能异常。神经末梢受病变周围的物理和化学因素影响,经传入神经到脊神经后根,再到参与伤害感觉的特定大脑皮层。然而,我们对这种由子宫内膜异位症引起的复杂疼痛过程的病因和机制的理解仍然不完整。确定子宫内膜异位症的发病机制对疾病管理、提供适当的治疗以及帮助患者寻找维持慢性疼痛的新靶点至关重要。本文主要从外周神经系统和中枢神经系统两方面对子宫内膜异位症相关疼痛的可能机制进行综述,并从外周病变与神经的相互作用到疼痛传递的改变,从而导致痛觉过敏以及相应的大脑皮层和脑代谢的改变,提出相关的作用机制。
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Unveil the pain of endometriosis: from the perspective of the nervous system.

Endometriosis is a chronic inflammatory disease with pelvic pain and uncharacteristic accompanying symptoms. Endometriosis-associated pain often persists despite treatment of the disease, thus it brings a deleterious impact on their personal lives as well as imposing a substantial economic burden on them. At present, mechanisms underlie endometriosis-associated pain including inflammatory reaction, injury, aberrant blood vessels and the morphological and functional anomaly of the peripheral and central nervous systems. The nerve endings are influenced by the physical and chemical factors surrounding the lesion, via afferent nerve to the posterior root of the spinal nerve, then to the specific cerebral cortex involved in nociception. However, our understanding of the aetiology and mechanism of this complex pain process caused by endometriosis remains incomplete. Identifying the pathogenesis of endometriosis is crucial to disease management, offering proper treatment, and helping patients to seek novel targets for the maintenance and contributors of chronic pain. The main aim of this review is to focus on every possible mechanism of pain related to endometriosis in both peripheral and central nervous systems, and to present related mechanisms of action from the interaction between peripheral lesions and nerves to the changes in transmission of pain, resulting in hyperalgesia and the corresponding alterations in cerebral cortex and brain metabolism.

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来源期刊
Expert Reviews in Molecular Medicine
Expert Reviews in Molecular Medicine BIOCHEMISTRY & MOLECULAR BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
7.40
自引率
1.60%
发文量
45
期刊介绍: Expert Reviews in Molecular Medicine is an innovative online journal featuring authoritative and timely Reviews covering gene therapy, immunotherapeutics, drug design, vaccines, genetic testing, pathogenesis, microbiology, genomics, molecular epidemiology and diagnostic techniques. We especially welcome reviews on translational aspects of molecular medicine, particularly those related to the application of new understanding of the molecular basis of disease to experimental medicine and clinical practice.
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