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Zytokinregulation und Schmerz

Ergebnisse tierexperimenteller und klinischer Forschung

Cytokine regulation and pain

Results of experimental and clinical research

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Zusammenfassung

Zytokine sind lösliche Peptide und Proteine, die im Organismus überwiegend von Immunzellen produziert und sezerniert werden. In zahlreichen Tiermodellen gehen eine endogene Vermehrung oder exogene Zufuhr proinflammatorischer Zytokine mit Schmerzverhalten einher. Andererseits kann dieses Schmerzverhalten durch Zytokininhibitoren in Modellen für entzündliche und neuropathische Schmerzen reduziert werden. Etliche Studien weisen auch auf die Bedeutung von Zytokinen bei unterschiedlichen schmerzhaften Erkrankungen beim Menschen hin. Bei verschiedenen chronischen Schmerzsyndromen findet sich systemisch ein proinflammatorisches Zytokinprofil assoziiert. Bei manchen Schmerzsyndromen ist dieses proinflammatorische Profil begleitet von einem Mangel an analgetisch wirksamen antiinflammatorischen Zytokinen. Eine Reihe von Fallberichten und offenen Studien, jedoch auch einige kontrollierte Studien zeigten Behandlungserfolge mit Zytokininhibitoren bei Schmerzen. Der folgende Artikel fasst die wesentlichen Befunde aus tierexperimenteller und klinischer Forschung zur Rolle von Zytokinen bei Schmerz und zur potenziellen Bedeutung zytokinmodulierender Substanzen in der Schmerztherapie zusammen.

Abstract

Cytokines are soluble peptides and proteins that are predominantly produced and secreted by immune cells. In numerous animal experiments the endogenous increase or application of exogenous pro-inflammatory cytokines is associated with pain behavior. In turn, cytokine inhibitors reduce such pain behavior in inflammatory and neuropathic pain models. Several clinical studies point out that cytokines are also important in different human pain states. Several chronic pain syndromes are associated with systemic pro-inflammatory cytokine profiles. In some pain syndromes these pro-inflammatory profiles are accompanied by a lack of analgesic anti-inflammatory cytokines. Numerous case reports and open clinical studies, but also some controlled trials show successful analgesic treatment using cytokine inhibitors. The following review article summarizes the main data of animal experiments and clinical trials concerning the role of cytokines in pain and the potential importance of cytokine modulation in pain treatment.

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Danksagung

Die Arbeit der Autorinnen wurde durch das Bundesministerium für Bildung und Forschung (BMBF), den Deutschen Forschungsverbund Neuropathischer Schmerz (DFNS) sowie durch finanzielle Mittel der Universität Würzburg unterstützt.

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  1. Neurologische Klinik, Universität Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland

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Üçeyler, N., Sommer, C. Zytokinregulation und Schmerz. Schmerz 22, 652–664 (2008). https://doi.org/10.1007/s00482-008-0706-0

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