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中国医药导刊 ›› 2024, Vol. 26 ›› Issue (7): 691-698.

• 研究进展 • 上一篇    下一篇

放化疗所致口腔黏膜炎疼痛电生理机制研究进展

刘怡华, 毛芮, 汤依群*   

  1. 中国药科大学基础医学与临床药学院,江苏 南京 211198
  • 收稿日期:2023-11-15 修回日期:2024-04-12 出版日期:2024-07-28 发布日期:2024-07-28
  • 基金资助:

     “重大新药创制”科技重大专项(2017ZX09301066)

Research Progress on the Electrophysiological Mechanism of Pain in Oral Mucositis Caused by Chemoradiotherapy

  1. Department of Clinical Pharmacy School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University
    Jiangsu Nanjing 211198, China
  • Received:2023-11-15 Revised:2024-04-12 Online:2024-07-28 Published:2024-07-28

摘要:

放化疗后普遍出现的口腔黏膜炎(oral mucositis OM)是头颈癌患者治疗过程中出现的最常见的不良反应之一,表现为口腔黏膜充血、水肿以及溃疡等,其引发的疼痛会严重影响患者的生活质量,干扰治疗进程。放化疗所致OM的发病机制复杂,涉及多种炎症因子及多条信号通路,而有关其疼痛的电生理机制的研究相对较少。黏膜损伤处的急性疼痛和炎症环境下的持续性疼痛,导致离子通道重构,产生中枢及外周的敏化。本研究从离子通道角度对OM的致痛机制进行探讨,通过类比其他炎性疼痛的研究结果,重点关注瞬时受体电位通道、钠通道和钾通道在OM及其他疾病所致疼痛中的变化,推测OM致痛可能的电生理机制。离子通道作为重要的药物靶点,针对性的开放剂和拮抗剂可有效缓解疼痛,结合目前放化疗所致OM主要治的疗方式,以期为OM疼痛管理提供新的思路。

  

关键词: 口腔黏膜炎, 离子通道, 疼痛作用机制, 放化疗, 炎症

Abstract:

Oral mucositis OM after chemoradiotherapy is a prevalent adverse effect in patients with head and neck cancer. It presents as congestion edema and ulceration of the oral mucosa significantly impacting patients' quality of life and treatment progress due to the associated pain. The pathogenesis of OM induced by chemoradiotherapy is intricate involving a multitude of inflammatory factors and multiple signaling pathways while the study on electrophysiological mechanism of pain is relatively few. Acute pain resulting from mucosal injury and persistent pain in an inflammatory environment can lead to the remodeling of ion channels as well as central and peripheral sensitization. The paper examines the pain mechanism of OM from the perspective of ion channels. Drawing on research findings in other inflammatory pain conditions it specifically focuses on the alterations in transient receptor potential channels sodium channels and potassium channels associated with pain caused by OM and other diseases while also speculating on the possible electrophysiological mechanism underlying OM-induced pain. The ion channel serves as a crucial target for drug intervention and the use of targeted openers and antagonists has been shown to effectively alleviate pain associated. Combined with the current main treatment methods of OM caused by chemoradiotherapy we hope to offer novel insights for the management of OM-related pain.

  

Key words: Oral mucositis , Ion channels , Pain mechanisms , Chemoradiotherapy , Inflammation

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