切换至 "中华医学电子期刊资源库"

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/OL]. 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/OL]. 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.
[1] 黄蓉, 梁自毓, 祁文瑾. NLRP3炎症小体在胎膜早破孕妇血清中的表达及其意义[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 540-548.
[2] 王振宇, 张洪美, 荆琳, 何名江, 闫奇. 膝骨关节炎相关炎症因子与血浆代谢物间的因果关系及中介效应[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 467-473.
[3] 张洁, 罗小霞, 余鸿. 系统性免疫炎症指数对急性胰腺炎患者并发器官功能损伤的预测价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 68-71.
[4] 唐梅, 周丽, 牛岑月, 周小童, 王倩. ICG荧光导航的腹腔镜肝切除术临床意义[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 655-658.
[5] 付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
[6] 杜贵伟, 陆勇, 成博, 贺薏, 梁爽. 钬激光碎石术术后联合坦索罗辛治疗对输尿管结石患者的影响分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 491-496.
[7] 高娟, 徐建庆, 闫芳, 丁盛华, 刘霞. Rutkow、TAPP、TEP 手术治疗单侧腹股沟疝患者的临床疗效及对血清炎症因子水平的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 675-680.
[8] 袁志静, 黄杰, 何国安, 方辉强. 罗哌卡因联合右美托咪定局部阻滞麻醉在老年腹腔镜下无张力疝修补术中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 557-561.
[9] 张锋, 孙孟奇, 方秀春. 静注右美托咪定、利多卡因对腹腔镜疝修补术患者围手术期心率、麻醉苏醒质量的比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 562-565.
[10] 邢嘉翌, 龚佳晟, 祝佳佳, 陆群. 肺癌化疗患者继发肺部感染的病原菌耐药性及炎症因子变化分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 714-718.
[11] 孙璐, 蒋亚玲, 陈凌君. 布托啡诺对脑缺血再灌注损伤大鼠神经炎症和JAK2/STAT3信号通路的影响[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 344-350.
[12] 陈利, 杨长青, 朱风尚. 重视炎症性肠病和代谢相关脂肪性肝病间的串话机制研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 385-389.
[13] 王湛, 李文坤, 杨奕, 徐芳, 周敏思, 苏珈仪, 王亚丹, 吴静. 炎症指标在早发性结直肠肿瘤中的应用[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 802-810.
[14] 欧春影, 李晓宾, 郭靖, 朱亮, 许可, 王梦, 安晓雷. 丁苯酞对血管性认知障碍大鼠炎症因子的影响及对认知障碍的改善作用[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 483-487.
[15] 牟磊, 徐东成, 韩鑫, 徐长江, 韩坤锜, 薛叶潇, 牟媛, 秦文玲, 刘相静, 陈哲, 高楠. 五虫通络胶囊防治椎动脉开口支架术后再狭窄发生的效果[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 467-472.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?