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Báo cáo y học: "Future targets to control osteoarthritis pain"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Future targets to control osteoarthritis pain. | Available online http arthritis-research.eom content 9 3 212 Review Arthritis and pain Future targets to control osteoarthritis pain Andy Dray1 and Simon J Read2 AstraZeneca R D Montreal Frederick Banting St Montreal H4S 1Z9 Canada 2AstraZeneca R D Mereside Alderley Park Macclesfield Cheshire SK10 4TG UK Corresponding author Andy Dray Andy.Dray@astrazeneca.com Published 30 May 2007 This article is online at http arthritis-research.com content 9 3 212 2007 BioMed Central Ltd Arthritis Research Therapy 2007 9 212 doi 10.1186 ar2178 Abstract Clinical presentation of osteoarthritis OA is dominated by pain during joint use and at rest. OA pain is caused by aberrant functioning of a pathologically altered nervous system with key mechanistic drivers from peripheral nerves and central pain pathways. This review focuses on symptomatic pain therapy exemplified by molecular targets that alter sensitization and hyperexcitability of the nervous system for example opioids and cannabinoids. We highlight opportunities for targeting inflammatory mediators and their key receptors for example prostanoids kinins cytokines and chemokines ion channels for example NaV1.8 NaV1.7 and CaV2.2 and neurotrophins for example nerve growth factor noting evidence that relates to their participation in OA etiology and treatment. Future neurological treatments of pain appear optimistic but will require the systematic evaluation of emerging opportunities. Introduction Osteoarthritis OA is recognized by degeneration of articular cartilage synovitis remodeling of subchondral bone and atrophy weakness of joint muscles. Clinical presentation is dominated by pain during joint use and often at rest. There are circadian variations in pain severity in both knee and hand OA with pain worsening in the evening 1 2 . Pain frequency and intensity has been related to obesity helplessness and education as well as a significant co-morbid association with anxiety and depression 3 . There are major distinctions .