在轴性脊椎关节炎中,炎症和疼痛是相互关联的目标
Xenofon Baraliakos1, Victoria Navarro-Compán2, Nelly Ziade3
1Rheumazentrum Ruhrgebiet Herne, Ruhr Universität Bochum, Bochum, Germany. baraliakos@me.de.
Nature reviews. Rheumatology
|January 21, 2026
概括
轴性脊椎关节炎的疼痛不仅涉及炎症,还涉及脑膜和神经病变机制. 需要一种基于机制的方法来改善轴性脊柱关节炎患者的疼痛管理.
科学领域:
- 类风湿病学 类风湿病学
- 疼痛医学 医学 疼痛医学
- 免疫学 免疫学 免疫学
背景情况:
- 轴性脊椎关节炎 (axSpA) 是一种慢性炎症性疾病.
- axSpA中的疼痛超出了炎症范围,涉及复杂的机制.
- 目前的治疗主要针对炎症,往往无法解决残留疼痛.
研究的目的:
- 审查axSpA在炎症之外的各种疼痛机制.
- 为了突出诺西普拉斯和神经病痛的作用.
- 讨论生物性别差异对疼痛和治疗的影响.
主要方法:
- 对axSpA疼痛机制的文献综述.
- 在 axSpA 中分析中心敏感,纤维肌痛和神经病痛.
- 检查基于性别的疼痛感知和治疗反应的差异.
主要成果:
- 在 axSpA 中的残留疼痛往往源于无囊性 (例如,中心敏感化) 和神经病变过程.
- 纤维肌痛同时发生会加剧症状,并降低抗炎疗法的疗效.
- 女性患者经历了更广泛的疼痛,更高的中央敏感性和对生物药物的反应较差.
结论:
- 目前的axSpA治疗方法不足以治疗非炎症性疼痛.
- 开发针对不同疼痛机制的生物标志物和多式疗法至关重要.
- 为了有效的 axSpA 疼痛管理,需要转向基于机制的方法.
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