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Tytuł:
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Neuropathic Pain: From Mechanisms to Treatment.
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Autorzy:
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Finnerup NB; Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; and Department of Pharmacology, Heidelberg University, Heidelberg, Germany.
Kuner R; Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; and Department of Pharmacology, Heidelberg University, Heidelberg, Germany.
Jensen TS; Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; and Department of Pharmacology, Heidelberg University, Heidelberg, Germany.
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Źródło:
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Physiological reviews [Physiol Rev] 2021 Jan 01; Vol. 101 (1), pp. 259-301. Date of Electronic Publication: 2020 Jun 25.
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Typ publikacji:
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Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review
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Język:
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English
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Imprint Name(s):
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Publication: Bethesda, MD : American Physiological Society
Original Publication: Washington [etc.] American Physiological Society.
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MeSH Terms:
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Central Nervous System/*physiopathology
Neuralgia/*physiopathology
Neuralgia/*therapy
Animals ; Humans ; Nerve Fibers ; Peripheral Nerves/physiopathology ; Peripheral Nervous System/physiopathology
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Contributed Indexing:
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Keywords: allodynia; immune cells; ion channels; neuropathic pain; pharmacology; primary neuron; spinal cord circuits
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Entry Date(s):
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Date Created: 20200626 Date Completed: 20210506 Latest Revision: 20210506
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Update Code:
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20240105
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DOI:
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10.1152/physrev.00045.2019
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PMID:
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32584191
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Neuropathic pain caused by a lesion or disease of the somatosensory nervous system is a common chronic pain condition with major impact on quality of life. Examples include trigeminal neuralgia, painful polyneuropathy, postherpetic neuralgia, and central poststroke pain. Most patients complain of an ongoing or intermittent spontaneous pain of, for example, burning, pricking, squeezing quality, which may be accompanied by evoked pain, particular to light touch and cold. Ectopic activity in, for example, nerve-end neuroma, compressed nerves or nerve roots, dorsal root ganglia, and the thalamus may in different conditions underlie the spontaneous pain. Evoked pain may spread to neighboring areas, and the underlying pathophysiology involves peripheral and central sensitization. Maladaptive structural changes and a number of cell-cell interactions and molecular signaling underlie the sensitization of nociceptive pathways. These include alteration in ion channels, activation of immune cells, glial-derived mediators, and epigenetic regulation. The major classes of therapeutics include drugs acting on α 2 δ subunits of calcium channels, sodium channels, and descending modulatory inhibitory pathways.