女性慢性盆腔痛的神经生物学研究进展
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摘要
盆腔痛是女性常见妇科疾病之一,以慢性盆腔痛为主,对女性的姿势、平衡能力等都有着较大的影响,严重威胁着女性患者的生活质量和生命健康。但是目前关于女性慢性盆腔痛发生的生物学基础尚不清楚,病因也尚不明确,且对慢性盆腔痛的评估和治疗也比较复杂,给女性慢性盆腔痛的治疗和康复带来了较大的困难。为了给女性盆腔痛预防和治疗提供进一步的理论基础,拟对女性内生殖系统和外生殖系统的神经支配、中枢神经系统影像改变和疼痛易感性、细胞因子和外周神经纤维的相互作用、炎症因子在降低外周神经敏感性中的作用、钠离子通道介导神经元疼痛信号的传导、神经元的激酶信号传导通路激活进行综述,重点探讨信号通路和细胞因子等因素在疼痛发生中的作用。
Pelvic pain is one of the common gynecological diseases in women, which mainly presents as chronic pelvic pain. It has not only a great impact on women′s posture and balance ability, but also severe influence on the quality of life and health. However, the biological basis and etiology of chronic pelvic pain are still unclear. Its evaluation and treatment are complicated, which brings great difficulties to the treatment and rehabilitation. We aim to review the innervation of internal and external reproductive systems, the imaging changes and pain susceptibility of central nervous, the interaction between cytokines and peripheral nerve fibers, the role of inflammation factor in reducing peripheral nerve sensitivity, the pain signals transmission and neurons kinase signaling pathways activation mediated by sodium channel to further provide a theoretical basis for the prevention and treatment of female pelvic pain. We focus on the role of signaling pathways and cytokines in the pathogenesis of pain.
Pelvic pain is one of the common gynecological diseases in women, which mainly presents as chronic pelvic pain. It has not only a great impact on women′s posture and balance ability, but also severe influence on the quality of life and health. However, the biological basis and etiology of chronic pelvic pain are still unclear. Its evaluation and treatment are complicated, which brings great difficulties to the treatment and rehabilitation. We aim to review the innervation of internal and external reproductive systems, the imaging changes and pain susceptibility of central nervous, the interaction between cytokines and peripheral nerve fibers, the role of inflammation factor in reducing peripheral nerve sensitivity, the pain signals transmission and neurons kinase signaling pathways activation mediated by sodium channel to further provide a theoretical basis for the prevention and treatment of female pelvic pain. We focus on the role of signaling pathways and cytokines in the pathogenesis of pain.
引文
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[13]李书景,彭艳品,姬聪钗,等.腹部外阴盆底肌群双侧附件子宫骶骨韧带压力性疼痛阈值对于慢性盆腔痛患者的临床意义[J].山西医药杂志,2018,47(5):537-539.
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[15]As-Sanie S,Harris RE,Napadow V,et al.Changes in regional gray matter volume in women with chronic pelvic pain:a voxel-based morphometry study[J].Pain,2012,153(5):1006-1014.
[16]Mckinnon BD,Bertschi D,Bersinger NA,et al.Inflammation and nerve fiber interaction in endometriotic pain[J].Trends Endocrin Met,2015,26(1):1-10.
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[21]Trutnovsky G,Plieseis C,Bjelic-Radisic V,et al.Vulvodynia and chronic pelvic pain in a gynecologic outpatient clinic[J].J Psychosom Obstet Gynaecol,2018:1-5.
[22]黄艳辉,丑丹,冯丹,等.温经止痛方对子宫内膜异位症模型大鼠自嗜基因Beclin-1、LC3表达的影响[J].广州中医药大学学报,2018,35(5):848-854.
[23]Zhang F,Liu XL,Wang W,et al.Expression of MMIF,HIF-1αand VEGF in Serum and Endometrial Tissues of Patients with Endometriosis[J].Curr Med Sci,2018,38(3):499-504.
[24]Plaschke K,Schulz S,Rullof R,et al.In-depth characterization of the neuroinflammatory reaction induced by peripheral surgery in an animal model[J].J Neural Transm(Vienna),2018,125(10):1487-1494.
[25]Mitsiadis TA,Pagella P.Expression of Nerve Growth Factor(NGF),TrkA,and p75(NTR)in Developing Human Fetal Teeth[J].Front Physiol,2016,7:338.
[26]Chmaj-Wierzchowska K,Kampioni M,Wilczak M,et al.The role of chemokine and non-chemokine factors in pain-related complaints in patients with endometrial cysts[J].Ginekol Pol,2015,86(2):94-99.
[27]Patel F,Brackenbury WJ.Dual roles of voltage-gated sodium channels in development and cancer[J].Int J Dev Biol,2015,59(7/8/9):357-366.
[28]Chen KH,Yang CH,Wallace CG,et al.Combination therapy with extracorporeal shock wave and melatonin markedly attenuated neuropathic pain in rat[J].Am J Transl Res,2017,9(10):4593-4606.
[29]Popiolek-Barczyk K,Lazewska D,Latacz G,et al.Antinociceptive effects of novel histamine H3 and H4 receptor antagonists and their influence on morphine analgesia of neuropathic pain in the mouse[J].Br J Pharmacol,2018,175(14):2897-2910.
[30]Hao Y,Feng Y,Li J,et al.Role of MAPKs in HSP70′s Protection against Heat Stress-Induced Injury in Rat Small Intestine[J].Biomed Res Int,2018,2018:1571406.
[31]尹艺儒,米鹏霞,张宇,等.P物质通过p38MAPK途径激活小胶质细胞参与大鼠热痛敏感的形成[J].山西医科大学学报,2018,49(7):785-789.
[32]杜艳,王浩江,苏红亮,等.l-四氢巴马汀对氯胺酮依赖大鼠海马GFAP及伏隔核ERK磷酸化蛋白表达的影响[J].中国法医学杂志,2018,33(3):258-262.
[2]Dybowski C,Lwe B,Brünahl C.Predictors of pain,urinary symptoms and quality of life in patients with chronic pelvic pain syndrome(CPPS):A prospective 12-month follow-up study[J].JPsychosom Res,2018,112:99-106.
[3]Sewell M,Churilov L,Mooney S,et al.Chronic pelvic pain-pain catastrophizing,pelvic pain and quality of life[J].Scand J Pain,2018,18(3):441-448.
[4]Fuentes-Márquez P,Rodríguez-Torres JR,Valenza MC,et al.Balance ability and posture in postmenopausal women with chronic pelvic pain[J].Menopause,2018,25(7):783-788.
[5]Hunter CW,Yang A.Dorsal Root Ganglion Stimulation for Chronic Pelvic Pain:A Case Series and Technical Report on a Novel Lead Configuration[J].Neuromodulation,2018.[Epub ahead of print]
[6]孟杰,洪莉,刘成,等.生物反馈电刺激联合腹下丛连续阻滞治疗女性慢性盆腔痛的疗效观察[J].实用医学杂志,2018,34(4):579-582.
[7]Allaire C,Williams C,Bodmer-Roy S,et al.Chronic pelvic pain in an interdisciplinary setting:1-year prospective cohort[J].Am JObstet Gynecol,2018,218(1):114.e1-114.e12.
[8]陈丽萍,袁君梅,谭华蒂.中医联合电刺激治疗女性炎性慢性盆腔痛的临床研究[J].现代中西医结合杂志,2016,25(14):1521-1523.
[9]Duh K,Funaro MG,DeGouveia W,et al.Crosstalk between the immune system and neural pathways in interstitial cystitis/bladder pain syndrome[J].Discov Med,2018,25(139):243-250.
[10]付晓雯,姚丽艳,王虎.子宫内膜异位症病灶与盆腔疼痛的相关性研究[J].新疆医学,2018,48(3):291-294.
[11]Grinberg K,Granot M,Lowenstein L,et al.A common pronociceptive pain modulation profile typifying subgroups of chronic pelvic pain syndromes is interrelated with enhanced clinical pain[J].Pain,2017,158(6):1021-1029.
[12]黄月娇,陈友国,侯文杰.腹腔镜联合康妇炎胶囊治疗输卵管卵巢囊肿合并慢性盆腔痛的临床观察[J].世界中西医结合杂志,2018,13(5):666-669.
[13]李书景,彭艳品,姬聪钗,等.腹部外阴盆底肌群双侧附件子宫骶骨韧带压力性疼痛阈值对于慢性盆腔痛患者的临床意义[J].山西医药杂志,2018,47(5):537-539.
[14]Woolf CJ,Salter MW.Neuronal plasticity:increasingthe gain in pain[J].Science,2000,288:1765-1769.
[15]As-Sanie S,Harris RE,Napadow V,et al.Changes in regional gray matter volume in women with chronic pelvic pain:a voxel-based morphometry study[J].Pain,2012,153(5):1006-1014.
[16]Mckinnon BD,Bertschi D,Bersinger NA,et al.Inflammation and nerve fiber interaction in endometriotic pain[J].Trends Endocrin Met,2015,26(1):1-10.
[17]Pierce AN,Christianson JA.Stress and chronic pelvic pain[J].Prog Mol Biol Transl Sci,2015,131:509-535.
[18]Eller-Smith OC,Nicol AL,Christianson JA.Potential Mechanisms Underlying Centralized Pain and Emerging Therapeutic Interventions[J].Front Cell Neurosci,2018,12:35.
[19]Vincent K,Warnaby C,Stagg CJ,et al.Dysmenorrhoea is associated with central changes in otherwise healthy women[J].Pain,2011,152(9):1966-1975.
[20]Beazley-Long N,Durrant AM,Swift MN,et al.The physiological functions of central nervous system pericytes and a potential role in pain[J].F1000Res,2018,7:341.
[21]Trutnovsky G,Plieseis C,Bjelic-Radisic V,et al.Vulvodynia and chronic pelvic pain in a gynecologic outpatient clinic[J].J Psychosom Obstet Gynaecol,2018:1-5.
[22]黄艳辉,丑丹,冯丹,等.温经止痛方对子宫内膜异位症模型大鼠自嗜基因Beclin-1、LC3表达的影响[J].广州中医药大学学报,2018,35(5):848-854.
[23]Zhang F,Liu XL,Wang W,et al.Expression of MMIF,HIF-1αand VEGF in Serum and Endometrial Tissues of Patients with Endometriosis[J].Curr Med Sci,2018,38(3):499-504.
[24]Plaschke K,Schulz S,Rullof R,et al.In-depth characterization of the neuroinflammatory reaction induced by peripheral surgery in an animal model[J].J Neural Transm(Vienna),2018,125(10):1487-1494.
[25]Mitsiadis TA,Pagella P.Expression of Nerve Growth Factor(NGF),TrkA,and p75(NTR)in Developing Human Fetal Teeth[J].Front Physiol,2016,7:338.
[26]Chmaj-Wierzchowska K,Kampioni M,Wilczak M,et al.The role of chemokine and non-chemokine factors in pain-related complaints in patients with endometrial cysts[J].Ginekol Pol,2015,86(2):94-99.
[27]Patel F,Brackenbury WJ.Dual roles of voltage-gated sodium channels in development and cancer[J].Int J Dev Biol,2015,59(7/8/9):357-366.
[28]Chen KH,Yang CH,Wallace CG,et al.Combination therapy with extracorporeal shock wave and melatonin markedly attenuated neuropathic pain in rat[J].Am J Transl Res,2017,9(10):4593-4606.
[29]Popiolek-Barczyk K,Lazewska D,Latacz G,et al.Antinociceptive effects of novel histamine H3 and H4 receptor antagonists and their influence on morphine analgesia of neuropathic pain in the mouse[J].Br J Pharmacol,2018,175(14):2897-2910.
[30]Hao Y,Feng Y,Li J,et al.Role of MAPKs in HSP70′s Protection against Heat Stress-Induced Injury in Rat Small Intestine[J].Biomed Res Int,2018,2018:1571406.
[31]尹艺儒,米鹏霞,张宇,等.P物质通过p38MAPK途径激活小胶质细胞参与大鼠热痛敏感的形成[J].山西医科大学学报,2018,49(7):785-789.
[32]杜艳,王浩江,苏红亮,等.l-四氢巴马汀对氯胺酮依赖大鼠海马GFAP及伏隔核ERK磷酸化蛋白表达的影响[J].中国法医学杂志,2018,33(3):258-262.