国际麻醉学与复苏杂志   2014, Issue (9): 5-5
    
过氧亚硝酸阴离子引起阿片耐受或痛觉过敏的 研究进展
王春艳, 王国林1()
1.天津医科大学总医院
The role of peroxynitrite in opioid tolerance or opioid induced hyperalgesia
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摘要:

背景 吗啡等阿片类药物是临床疼痛治疗的代表性药物,主要用于急、慢性疼痛和癌痛的治疗,但长期应用可产生诸多副作用,如吗啡耐受和痛觉过敏等,从而大大限制了阿片类药物在临床上的使用。 目的 通过对近年过氧亚硝基阴离子在吗啡耐受和痛觉过敏中所起作用的研究进行总结,帮助读者了解国外相关研究的最新趋势和进展。 内容 就过氧亚硝基阴离子的生成途径、消除方式和过氧亚硝基阴离子在阿片耐受或痛觉过敏中的作用方式进行综述。得出如下结论,过氧亚硝基阴离子主要通过硝基化体内蛋白质酪氨酸残基、激活神经炎症和促进细胞凋亡3个方面,引起阿片耐受或痛觉过敏。 趋向 随着越来越多的学者对过氧亚硝基阴离子在吗啡耐受和痛觉过敏中发挥的重要作用达成共识,过氧亚硝基阴离子有望成为临床疼痛治疗的新靶点。

关键词: 过氧亚硝基阴离子; 吗啡耐受; 痛觉过敏; 硝基化; 神经免疫; 细胞凋亡
Abstract:

Background Opioids are the most powerful analgesics for the treatment of acute pain, chronic pain and cancer pain. Although opioids have analgesic effect, long term opioids exposure can induce many side effects including morphine tolerance and hyperalgesia. The use of opioids, therefore, is largely limited in clinical settings. Objective The relevant literatures in recent years involved in the role of peroxynitrite in morphine tolerance and hyperalgesia were summarized, which helps readership to update the latest information about this topic. Content The generation of peroxynitrite, eliminating methods and the role of peroxynitrite in opioids tolerance or hyperalgesia were reviewed in this article. Those researches suggest that peroxynitrite plays an important role in morphine tolerance and hyperalgesia mainly through nitrating protein tyrosine residues, activating the neuroinflammation and promoting neuron apoptosis. Trend Since the effect of peroxynitrite is widely acknowledged, peroxynitrite may become a new target to relieve pain in the clinical setting.

Key words: Peroxynitrite; Morphine tolerance; Hyperalgesia; Nitration; Neuroinflammation; Apoptosis