国际麻醉学与复苏杂志   2015, Issue (4): 11-11
    
瞬时感受器电位香草酸受体1与局部麻醉药物神经毒性
陈旭辉, 任全1()
1.东南大学附属中大医院
Transient receptor potential vanilloid 1 and the neurotoxicity of local anesthesitics
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摘要:

背景 瞬时感受器电位香草酸受体1(transient receptor potential vanilloid 1, TRPV1)是一种非选择性阳离子通道,主要分布于感觉神经纤维,介导伤害性感受的传入。同时,它能够将外来刺激进行整合影响神经递质的释放以及激活细胞内蛋白酶,从而调节突触传递和细胞功能(如细胞凋亡)。局部麻醉药物可以激活TRPV1,且在高浓度时具有神经毒性,表现为病理性疼痛和痛觉过敏,可能与神经细胞的损伤有关。 目的 综述TRPV1受体在局部麻醉药物外周神经毒性中的作用机制的研究进展。 内容 TRPV1受体的活化能够升高神经纤维局部麻醉药物的浓度而增加其阻断效能,同时增加细胞内钙离子浓度,释放谷氨酸及激活N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor, NMDAR),最终通过钙超载、氧化应激损伤及细胞凋亡途径的活化导致神经元凋亡,介导局部麻醉药物物神经毒性反应。 趋向 鉴于TRPV1受体在局部麻醉药物神经毒性的发生机制中所起的作用,靶向调节TRPV1受体的功能是否可以防治局部麻醉药物的神经毒性值得研究。

关键词: 瞬时感受器电位香草酸受体1; 局部麻醉药物; 神经毒性
Abstract:

Background Transient potential receptor vanilloid 1(TRPV1), a non-selective cation channel, which mainly locates on the sensory nerve fibers, mediates nociception input and integrates external stimuli as well, affects the release of neurotransmitters and activates intracellular proteases to regulate synaptic transmission and intracellular function such as cellular apoptosis. Local anesthetics induce TRPV1 activation and at high concentration lead to neurotoxicity, such as neuropathic pain and hyperalgesia, which may be related to the nerve injury. Objective To review the research progress regarding involvement of TRPV1 in the neurotoxicity induced by local anesthetics. Content The activation of TRPV1 can increase the concentration of local anesthetic in nerve fibers and strengthen the action of blockade, increase intracellular calcium, the release of glutamate and N-methyl-D-aspartate receptor (NMDAR) activation, and consequently, mediate local anesthetic neurotoxicity via calcium overload, oxidative stress and activation of apoptotic pathways, which cause neuronal apoptosis. Trend TRPV1 receptor plays a role in neurotoxicity induced by local anesthetics, whether targeting TRPV1 receptor regulation could prevent neurotoxicity induced by local anesthetics is worthy of further investigation.

Key words: Transient potential receptor vanilloid 1; Local anesthetics; Neurotoxicity