통증(Pain) & 통각(Nociception)
차례
말초 통각신경
통각신경 (Nociceptors)
Thermal Nociceptors: Aδ fiber, > 45°C or < 5°C
- Mechanical Nociceptors: Aδ fiber, 기계적 자극
- Polymodal Nociceptors: C fiber, 기계,화학,온도자극
- Silent Nociceptors: 내장기관. 이차통증과민화, 중추감각
Nociceptive Receptors
Distal End (Peripheral Terminal)
TRP channels
The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature 1997.
Inflammatory mediator receptors
Receptor Sensitization
Spinal Dorsal Horn
Proximal End (Central Terminal)
Referred Pain
Dorsal Horn Synapses
척수후각 내 TRPV1!! 거기서 뭐 해??
Pre-synaptic TRPV1 function proposed in J.Neurosci 2009
Post-synaptic TRPV1 function proposed in Neuron 2012
Second-order Neurons (Interneurons & Projection Neurons)
통각과민
통각 전도로
Dorsal Column System & Spinothalamic Tract
시상
피질
통증의 정의 from International Association for the Study of Pain:
- An unpleasant sensory and emotional experience
- associated with actual or potential tissue damage,
- or described in terms of such damage.
Cingulate cortex, Insular cortex are active during pain perception.
the Pain Chronicles by Melanie Thernstrom
내인성 통증조절 기전
전구체 |
Peptide |
Receptor |
POMC |
β-endorphin |
μ/δ |
Endomorphin-1 |
μ |
|
Endomorphin-2 |
μ |
|
Proenkyphalin |
Met-enkephalin |
δ |
Leu-enkephalin |
δ |
|
Prodynorphin |
Dynorphin A |
κ |
Dynorphin B |
κ |
|
Pro-orphanin FQ |
Orphanin FQ |
Orphan receptor |
진통제
/AP /APLab /Blood /Circulation /CirculationLab /CompoundAP /GSRLab /Heart /MembraneTransport /MuscleLab /Pain /PainMxFacial /Respiration /Stress |