Role of transient receptor potential vanilloid subfamily 1 in mediating the analgesic effects of acupuncture on pathological pain☆: 瞬时受体电位香草酸亚家族1介导针刺治疗病理性疼痛的作用

The 2020 edition of the International Association for the Study of Pain (IASP) defined pain as an unpleasant feeling and emotional experience related to actual or potential tissue damage [1]. Pain can be divided into nociceptive and pathological pain depending on its cause, location, nature, and duration, with the latter, further divided into inflammatory pain, neuropathic pain, and cancer pain according to its cause [2]. Opioids are currently the treatment of choice for pathological pain, but their adverse effects, including tolerance, addiction, constipation, and respiratory depression, severely restrict the clinical application of opioid peptide drugs [3].

Acupuncture has been used for over 3 000 years to treat pain, and its analgesic efficacy is now recognized worldwide. Acupuncture's connections to the body's endogenous central opiates have been studied for 30 years. However, relatively recent studies showed that the analgesic effects of acupuncture could be related to the changes in the expression and activity of various ion channels of biomembrane and voltage-gated channels, including transient receptor potential vanilloid subfamily 1 (TRPV1), transient receptor potential vanilloid subfamily 2 (TRPV2), and transient receptor potential vanilloid subfamily 4 (TRPV4), an acid-sensing ion channel 3 (ASIC3) and Nav channels. TRPV1 is abundantly expressed in the peripheral and central nervous system (CNS) and plays a crucial role in the incidence and progression of pathological pain. TRPV1 is the most studied ion channel mediating acupuncture analgesia.

This review summarized for the first time the role of TRPV1 in the initiation of acupoint acupuncture signals. Second, the effect of TRPV1 in acupuncture on inflammatory pain, neuropathic pain, visceral pain, fibromyalgia, and cancer pain was reviewed. We found that acupuncture could reduce TRPV1 expression and activity at three levels: the peripheral dorsal root ganglia (DRG), the central spinal cord (SC), and the brain, thereby inhibiting pain sensitization, relieving pain sensation, and reducing depression. From the perspective of neuro-immune interaction, this review also summarized the upstream regulatory mechanism of acupuncture inhibiting TRPV1 expression and activity.

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