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中华普通外科学文献(电子版) ›› 2023, Vol. 17 ›› Issue (03) : 237 -240. doi: 10.3877/cma.j.issn.1674-0793.2023.03.016

综述

右美托咪定缓解神经病理性疼痛作用机制的研究进展
钟轼, 李斌飞, 温君琳, 古晨, 廖小卒()   
  1. 524023 湛江,广东医科大学;528404 广东省中山市人民医院麻醉科
    528404 广东省中山市人民医院麻醉科
  • 收稿日期:2022-11-05 出版日期:2023-06-01
  • 通信作者: 廖小卒

Research progress on the mechanism of dexmedetomidine in relieving neuropathic pain

Shi Zhong, Binfei Li, Junlin Wen, Chen Gu, Xiaozu Liao()   

  1. Guangdong Medical University, Zhanjiang 524023, China; Department of Anesthesiology, Zhongshan City People’s Hospital, Zhongshan 528404, China
    Department of Anesthesiology, Zhongshan City People’s Hospital, Zhongshan 528404, China
  • Received:2022-11-05 Published:2023-06-01
  • Corresponding author: Xiaozu Liao
引用本文:

钟轼, 李斌飞, 温君琳, 古晨, 廖小卒. 右美托咪定缓解神经病理性疼痛作用机制的研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(03): 237-240.

Shi Zhong, Binfei Li, Junlin Wen, Chen Gu, Xiaozu Liao. Research progress on the mechanism of dexmedetomidine in relieving neuropathic pain[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(03): 237-240.

右美托咪定是新一代高效、高选择性α2肾上腺素能受体激动剂,现已普遍在麻醉围手术期及重症监护室中使用。临床和动物实验研究均显示,右美托咪定能够缓解神经病理性疼痛,其机制与促使乙酰胆碱释放、减少炎症和氧化应激因子释放、降低免疫抑制、抑制细胞凋亡和胶质细胞活化等有关。这些研究成果预示着右美托咪定有望成为一种新的防治神经病理性疼痛药物。

Dexmedetomidine is a new generation of highly selective α2 adrenergic receptor agonist, which has been widely used in perioperative anesthesia and intensive care units. Clinical and animal studies have shown that dexmedetomidine can relieve neuropathic pain, since it is associated with promoting the release of acetylcholine, reducing the release of inflammation factors and oxidative stress factors, reducing immune suppression, inhibiting cell apoptosis and glial cell activation. These findings indicate that dexmedetomidine is expected to be a new therapeutic agent for neuropathic pain.

[1]
杜涛, 袁文茜, 曹伯旭, 等. 慢性神经病理性疼痛[J]. 中国疼痛医学杂志, 2021, 27(7): 481-485.
[2]
Scholz J, Finnerup NB, Attal N, et al. The IASP classification of chronic pain for ICD11: chronic neuropathic pain[J]. Pain, 2019, 160(1): 53-59.
[3]
Yin D, Chen Y, Li Y, et al. Interleukin-1 receptor associated kinase 1 mediates the maintenance of neuropathic pain after chronic constriction injury in rats[J]. Neurochem Res, 2019, 44(5): 1214-1227.
[4]
朱谦, 樊碧发, 张达颖, 等. 周围神经病理性疼痛诊疗中国专家共识[J]. 中国疼痛医学杂志, 2020, 26(5): 321-328.
[5]
Weerink M, Struys M, Hannivoort LN, et al.Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine[J].Clin Pharmacokinet, 2017, 56(8): 893-913.
[6]
Zhao Y, He J, Yu N, et al. Mechanisms of dexmedetomidine in neuropathic pain[J]. Front Neurosci, 2020, 14: 330.
[7]
Serednicki WT, Wrzosek A, Woron J, et al. Topical clonidine for neuropathic pain in adults[J]. Cochrane Database Syst Rev, 2022, 5(5): CD010967.
[8]
Xun S, Zheng R. Dexmedetomidine alleviates neuropathic pain by regulating JAK/STAT pathway in rats[J]. J Cell Biochem, 2020, 121(3): 2277-2283.
[9]
张应涛,张庆,田杰利,等.七氟烷联合右美托咪定对腹腔镜下子宫肌瘤切除术患者生命体征、血清炎性因子和疼痛介质P物质、前列腺素E2的影响[J].现代生物医学进展, 2022, 22(18): 3573-3576, 3600.
[10]
张晓晓,马岳,胡越成,等.右美托咪定对不同组织系统离子通道的作用[J].医学综述, 2020, 26(23): 4739-4744.
[11]
Han QQ, Li XY, Wang YX. Dexmedetomidine attenuates lipopolysaccharide-induced inflammation through macrophageal IL-10 expression following α7 nAchR activation[J]. Int Immunopharmacol, 2022, 109: 108920.
[12]
Xu S, Yi Y, Wang Y, et al. Dexmedetomidine alleviates neuropathic pain via the TRPC6-p38 MAPK pathway in the dorsal root ganglia of rats[J]. J Pain Res, 2022, 15: 2437-2448.
[13]
Ji RR, Nackley A, Huh Y, et al. Neuroinflammation and central sensitization in chronic and widespread pain[J]. Anesthesiology, 2018, 129(2): 343-366.
[14]
Shan W, Liao X, Tang Y, et al. Dexmedetomidine alleviates inflammation in neuropathic pain by suppressing NLRP3 via Nrf2 activation[J]. Exp Ther Med, 2021, 22(4): 1046.
[15]
Qiu Z, Lu P, Wang K, et al. Dexmedetomidine inhibits neuroinflammation by altering microglial M1/M2 polarization through MAPK/ERK pathway[J]. Neurochem Res, 2020, 45(2): 345-353.
[16]
Jian SL, Chen WW, Su YC, et al. Glycolysis regulates the expansion of myeloid-derived suppressor cells in tumor-bearing hosts through prevention of ROS-mediated apoptosis[J]. Cell Death Dis, 2017, 8(5): e2779.
[17]
Magar S, Nayak D, Mahajan UB, et al. Retraction Note: Ultra-diluted toxicodendron pubescens attenuates pro-inflammatory cytokines and ROS-mediated neuropathic pain in rats[J]. Sci Rep, 2019, 9(1): 8641.
[18]
Liu P, Chen T, Tan F, et al. Dexmedetomidine alleviated neuropathic pain in dorsal root ganglion neurons by inhibition of anaerobic glycolysis activity and enhancement of ROS tolerance[J]. Biosci Rep, 2020, 40(5): BSR20191994.
[19]
Arruri V, Komirishetty P, Areti A, et al. Nrf2 and NF-kappa B modulation by Plumbagin attenuates functional, behavioural and biochemical deficits in rat model of neuropathic pain[J]. Pharmacol Rep, 2017, 69(4): 625-632.
[20]
Zhao L, Zhai M, Yang X, et al. Dexmedetomidine attenuates neuronal injury after spinal cord ischaemia-reperfusion injury by targeting the CNPY2-endoplasmic reticulum stress signalling[J]. J Cell Mol Med, 2019, 23(12): 8173-8183.
[21]
Lu Y, Lin B, Zhong J. The therapeutic effect of dexmedetomidine on rat diabetic neuropathy pain and the mechanism[J]. Biol Pharm Bull, 2017, 40(9): 1432-1438.
[22]
Rodríguez-González R, Sobrino T, Veiga S, et al. Neuroprotective effects of dexmedetomidine conditioning strategies: evidences from an in vitro model of cerebral ischemia[J]. Life Sci, 2016, 144: 162-169.
[23]
Feng P, Zhang A, Su M, et al. Dexmedetomidine inhibits apoptosis of astrocytes induced by oxygen-glucose deprivation via targeting JAK/STAT3 signal pathway[J]. Brain Res, 2021, 1750: 147141.
[24]
Wang K, Wu M, Xu J, et al. Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis[J]. Br J Anaesth, 2019, 123(6): 777-794.
[25]
Cai QH, Tang Y, Fan SH, et al. In vivo effects of dexmedetomidine on immune function and tumor growth in rats with ovarian cancer through inhibiting the p38 MAPK/NF-κB signaling pathway[J]. Biomed Pharmacother, 2017, 95: 1830-1837.
[26]
Brinkman JE, Sharma S. Physiology, sleep. StatPearls[Internet]. Treasure Island, FL: StatPearls Publishing, 2018.p. 18e28.
[27]
Zhao E, Bai L, Li S, et al. Dexmedetomidine alleviates CCI-induced neuropathic pain via inhibiting HMGB1-mediated astrocyte activation and the TLR4/NF-κB signaling pathway in rats[J]. Neurotox Res, 2020, 38(3): 723-732.
[28]
Zhang W, Yu T, Cui X, et al. Analgesic effect of dexmedetomidine in rats after chronic constriction injury by mediating microRNA-101 expression and the E2F2-TLR4-NF-κB axis[J]. Exp Physiol, 2020, 105(9): 1588-1597.
[29]
Obata H. Analgesic mechanisms of antidepressants for neuropathic pain[J]. Int J Mol Sci, 2017, 18(11): 2483.
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