Neuropathic pain,often featuring allodynia,imposes significant physical and psychological burdens on patients,with limited treatments due to unclear central mechanisms.Addressing this challenge remains a crucial unsol...Neuropathic pain,often featuring allodynia,imposes significant physical and psychological burdens on patients,with limited treatments due to unclear central mechanisms.Addressing this challenge remains a crucial unsolved issue in pain medicine.Our previous study,using protein kinase C gamma(PKCγ)-tdTomato mice,highlights the spinal feedforward inhibitory circuit involving PKCγ neurons in gating neuropathic allodynia.However,the regulatory mechanisms governing this circuit necessitate further elucidation.We used diverse transgenic mice and advanced techniques to uncover the regulatory role of the descending serotonin(5-HT)facilitation system on spinal PKCγ neurons.Our findings revealed that 5-HT neurons from the rostral ventromedial medulla hyperpolarize spinal inhibitory interneurons via 5-HT_(2C) receptors,disinhibiting the feedforward inhibitory circuit involving PKCγ neurons and exacerbating allodynia.Inhibiting spinal 5-HT_(2C) receptors restored the feedforward inhibitory circuit,effectively preventing neuropathic allodynia.These insights offer promising therapeutic targets for neuropathic allodynia management,emphasizing the potential of spinal 5-HT_(2C) receptors as a novel avenue for intervention.展开更多
目的:荟萃分析方法评价5-羟色胺(5-HT)1A受体部分激动剂治疗功能性消化不良(FD)的临床疗效及安全性。方法:计算机检索PubMed、Web of Science、CNKI等数据库建库起公开发表的5-HT1A受体部分激动剂治疗FD的随机对照研究(RCT)。RevMan 5....目的:荟萃分析方法评价5-羟色胺(5-HT)1A受体部分激动剂治疗功能性消化不良(FD)的临床疗效及安全性。方法:计算机检索PubMed、Web of Science、CNKI等数据库建库起公开发表的5-HT1A受体部分激动剂治疗FD的随机对照研究(RCT)。RevMan 5.4软件对纳入的资料荟萃分析,并进行亚组分析、分层分析,评价5-HT1A受体部分激动剂对FD的疗效及安全性。结果:纳入19项RCT,共计1575例患者(治疗组801例,对照组774例)。荟萃分析显示:治疗组总有效率高于对照组(OR=4.18,95%CI:3.05~5.73,P<0.00001),而消化道症状评分(SMD=-1.30,95%CI:-1.95~-0.64,P=0.0001)、焦虑状态评分(SMD=-1.22,95%CI:-1.79~-0.65,P<0.0001)和抑郁状态评分(SMD=-1.52,95%CI:-2.41~-0.63,P=0.0008)均低于对照组,嗜睡(OR=4.78,95%CI:1.80~12.70,P<0.05)、口干(OR=3.07,95%CI:1.31~7.19,P<0.05)发生率均高于对照组。结论:与常规或安慰剂治疗相比,联合应用5-HT1A受体部分激动剂能提高总体疗效,但嗜睡及口干发生率较高。展开更多
基金supported by the National Natural Science Foundation of China(81971058,82371226,82101295,82301398)the National Funded Postdoctoral Researcher Program(GZC20233585)The Boost Plan of Xijing Hospital(XJZT24QN25,XJZT25CX22).
文摘Neuropathic pain,often featuring allodynia,imposes significant physical and psychological burdens on patients,with limited treatments due to unclear central mechanisms.Addressing this challenge remains a crucial unsolved issue in pain medicine.Our previous study,using protein kinase C gamma(PKCγ)-tdTomato mice,highlights the spinal feedforward inhibitory circuit involving PKCγ neurons in gating neuropathic allodynia.However,the regulatory mechanisms governing this circuit necessitate further elucidation.We used diverse transgenic mice and advanced techniques to uncover the regulatory role of the descending serotonin(5-HT)facilitation system on spinal PKCγ neurons.Our findings revealed that 5-HT neurons from the rostral ventromedial medulla hyperpolarize spinal inhibitory interneurons via 5-HT_(2C) receptors,disinhibiting the feedforward inhibitory circuit involving PKCγ neurons and exacerbating allodynia.Inhibiting spinal 5-HT_(2C) receptors restored the feedforward inhibitory circuit,effectively preventing neuropathic allodynia.These insights offer promising therapeutic targets for neuropathic allodynia management,emphasizing the potential of spinal 5-HT_(2C) receptors as a novel avenue for intervention.
文摘目的:荟萃分析方法评价5-羟色胺(5-HT)1A受体部分激动剂治疗功能性消化不良(FD)的临床疗效及安全性。方法:计算机检索PubMed、Web of Science、CNKI等数据库建库起公开发表的5-HT1A受体部分激动剂治疗FD的随机对照研究(RCT)。RevMan 5.4软件对纳入的资料荟萃分析,并进行亚组分析、分层分析,评价5-HT1A受体部分激动剂对FD的疗效及安全性。结果:纳入19项RCT,共计1575例患者(治疗组801例,对照组774例)。荟萃分析显示:治疗组总有效率高于对照组(OR=4.18,95%CI:3.05~5.73,P<0.00001),而消化道症状评分(SMD=-1.30,95%CI:-1.95~-0.64,P=0.0001)、焦虑状态评分(SMD=-1.22,95%CI:-1.79~-0.65,P<0.0001)和抑郁状态评分(SMD=-1.52,95%CI:-2.41~-0.63,P=0.0008)均低于对照组,嗜睡(OR=4.78,95%CI:1.80~12.70,P<0.05)、口干(OR=3.07,95%CI:1.31~7.19,P<0.05)发生率均高于对照组。结论:与常规或安慰剂治疗相比,联合应用5-HT1A受体部分激动剂能提高总体疗效,但嗜睡及口干发生率较高。
