背景:偏头痛是一种使人衰弱的神经系统疾病,具有疼痛特征,暗示夸张的机械感觉。不同家族的机械敏感受体,对各种机械刺激有特殊反应,由于它们在偏头痛相关的伤害性感受中的潜在作用,已经引起了越来越多的关注。了解这些机制对于改善治疗策略至关重要。本系统综述全面检查了机械敏感机制在偏头痛疼痛途径中的参与。
方法:整个Cochrane图书馆的系统搜索,Scopus,WebofScience,根据PRISMA指南,Medline于2023年8月8日进行,为期2000年至2023年。这篇综述是在两位作者的细致评估之后构建的,他们独立地对所选研究应用了严格的纳入标准和质量评估。所有作者共同撰写了这篇评论。
结果:我们通过分析确定了36项相关研究。此外,通过文献检索选择了另外3个研究。本系统综述中包含的39篇论文涵盖了假定的机械敏感性压电和K2P的作用,以及ASIC,NMDA,和TRP家族在偏头痛疼痛级联中的通道。现有知识的结果,主要包括偏头痛的临床前动物模型和很少的临床研究,强调机械敏感受体和偏头痛症状之间的复杂关系。该综述介绍了机械敏感性受体的激活机制,该机制可能与伤害性信号的产生和偏头痛相关的临床症状有关。靶向这些受体作为潜在的治疗干预措施的性别差异以及与各自药物开发相关的挑战也得到承认。
结论:总体而言,这项分析确定了关键的分子参与者,并揭示了我们对偏头痛机械传导的理解中的显著差距.这篇综述为填补这些空白提供了基础,并根据新兴的机械神经生物学领域的成就提出了偏头痛治疗的新治疗选择。
BACKGROUND: Migraine is a debilitating neurological disorder with pain profile, suggesting exaggerated mechanosensation. Mechanosensitive receptors of different families, which specifically respond to various mechanical stimuli, have gathered increasing attention due to their potential role in migraine related nociception. Understanding these mechanisms is of principal importance for improved therapeutic strategies. This systematic
review comprehensively examines the involvement of mechanosensitive mechanisms in migraine pain pathways.
METHODS: A systematic search across the Cochrane Library, Scopus, Web of Science, and Medline was conducted on 8th August 2023 for the period from 2000 to 2023, according to PRISMA guidelines. The
review was constructed following a meticulous evaluation by two authors who independently applied rigorous inclusion criteria and quality assessments to the selected studies, upon which all authors collectively wrote the review.
RESULTS: We identified 36 relevant studies with our analysis. Additionally, 3 more studies were selected by literature search. The 39 papers included in this systematic
review cover the role of the putative mechanosensitive Piezo and K2P, as well as ASICs,
NMDA, and TRP family of channels in the migraine pain cascade. The outcome of the available knowledge, including mainly preclinical animal models of migraine and few clinical studies, underscores the intricate relationship between mechanosensitive receptors and migraine pain symptoms. The
review presents the mechanisms of activation of mechanosensitive receptors that may be involved in the generation of nociceptive signals and migraine associated clinical symptoms. The gender differences of targeting these receptors as potential therapeutic interventions are also acknowledged as well as the challenges related to respective drug development.
CONCLUSIONS: Overall, this analysis identified key molecular players and uncovered significant gaps in our understanding of mechanotransduction in migraine. This review offers a foundation for filling these gaps and suggests novel therapeutic options for migraine treatments based on achievements in the emerging field of mechano-neurobiology.