罂粟摘要 带状疱疹后神经痛的免疫机制及普瑞巴林治疗对其机制的影响:一项前瞻性单组观察研究
带状疱疹后神经痛的免疫机制及普瑞巴林治疗对其机制的影响:一项前瞻性单组观察研究
贵州医科大学 麻醉与心脏电生理课题组
翻译：刘云琴 编辑：马艳燕 审校：曹莹
虽然神经病理性疼痛是一种严重和常见的疼痛，但其病理生理学尚未阐明。近年来的研究主要集中于免疫系统在神经病理性疼痛发病机制中的作用。本研究的目的是通过测量患有神经性病理性疼痛的带状疱疹后神经痛（PHN）患者在普瑞巴林治疗前后外周血中的免疫标记物水平，研究免疫机制在神经病理性疼痛中的作用以及普瑞巴林的作用。
本研究纳入40名诊断为PHN的患者。治疗前和治疗3个月后，在外周血样本中测量CD4、T淋巴细胞（Tfh:CD4+CXCR5+PD1+）、Th17（CD4+CCR6+和CD4+IL17A+）、调节性T细胞（Treg:CD4+CD25+foxp3+）、Th1（CD4+CXCR3+和CD4+IFN-γ+）和Th2（CD4+IL-4+）细胞比率。
比较治疗前后的免疫标记物和炎症参数水平，辅助性T细胞比率（CD3+，CD4+）在治疗前为30.28±12.27%，治疗后为34.93±11.70%，增加具有统计学意义（P=0.028）。Th17在治疗前为4.75±5.02%，治疗后为5.80±3.13%，比率显著增加，具有统计学意义（P=0.036）。
免疫机制在神经病理性疼痛的发病机制中起着至关重要的作用，基于免疫的治疗方法将是治疗神经病理性疼痛的关键。
原始文献来源：Mercan Aysel,Uzun Sema Tuncer,Keles Sevgi et al. Immunological mechanism of postherpetic neuralgia and effect of pregabalin treatment on the mechanism: a prospective single-arm observational study.[J] .Korean J Pain, 2021, 34: 463-470.
Immunological mechanism of postherpetic neuralgia and effect of pregabalin treatment on the mechanism: a prospective single-arm observational study
Background: Although neuropathic pain is a severe and common pain, its pathophysiology has not been elucidated yet. Studies in recent years have focused on the immune system's role in the pathogenesis of neuropathic pain. The aim of this study was to investigate the role of immunological mechanisms in neuropathic pain and the effect of pregabalin by measuring immunological marker levels in peripheral blood before and after pregabalin treatment in postherpetic neuralgia (PHN) patients with neuropathic pain。
Method:Forty patients diagnosed with PHN were included in the study. CD4, T follicular cells (Tfh:CD4+CXCR5+PD1+), Th17 (CD4+CCR6+ and CD4+IL17A+), regulatory T cells (Treg: CD4+CD25+foxp3+), Th1 (CD4+ CXCR3+ and CD4+ IFN-γ+) and Th2 (CD4+IL-4+) cell ratios were measured in peripheral blood samples before treatment and after 3 months of treatment.
Results:Conclusions:Immunological mechanisms play an essential role in the pathogenesis of neuropathic pain, immunologically based treatment approach will be the critical point of treatment.
Conclusion:Immunological mechanisms play an essential role in the pathogenesis of neuropathic pain, immunologically based treatment approach will be the critical point of treatment.