A cutting-edge new framework for the pain management in children: nanotechnology

IF 3.5 3区 医学 Q2 NEUROSCIENCES
Iuliana Magdalena Starcea, Ancuta Lupu, Ana Maria Nistor, Maria Adriana Mocanu, Roxana Alexandra Bogos, Alice Azoicai, Diana Cira, Madalina Beldie, Vasile Valeriu Lupu, Ionela Daniela Morariu, Valentin Munteanu, Razvan Tudor Tepordei, Ileana Ioniuc
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Abstract

Pain is a subjective concept which is ever-present in the medical field. Health professionals are confronted with a variety of pain types and sources, as well as the challenge of managing a patient with acute or chronic suffering. An even bigger challenge is presented in the pediatric population, which often cannot quantify pain in a numerical scale like adults. Infants and small children especially show their discomfort through behavioral and physiological indicators, leaving the health provider with the task of rating the pain. Depending on the pathophysiology of it, pain can be classified as neuropathic or nociceptive, with the first being defined by an irregular signal processing in the nervous system and the second appearing in cases of direct tissue damage or prolonged contact with a certain stimulant. The approach is generally either pharmacological or non-pharmacological and it can vary from using NSAIDs, local anesthetics, opiates to physical and psychological routes. Unfortunately, some pathologies involve either intense or chronic pain that cannot be managed with traditional methods. Recent studies have involved nanoparticles with special characteristics such as small dimension and large surface area that can facilitate carrying treatments to tissues and even offer intrinsic analgesic properties. Pediatrics has benefited significantly from the application of nanotechnology, which has enabled the development of novel strategies for drug delivery, disease diagnosis, and tissue engineering. This narrative review aims to evaluate the role of nanotechnology in current pain therapy, with emphasis on pain in children.
儿童疼痛治疗的前沿新框架:纳米技术
疼痛是一个主观概念,在医学领域无处不在。医疗专业人员面临着各种疼痛类型和来源,以及管理急性或慢性疼痛患者的挑战。儿科人群面临的挑战更大,因为他们通常无法像成人一样用数字来量化疼痛。尤其是婴幼儿,他们会通过行为和生理指标来表现自己的不适,这就给医疗服务提供者留下了评定疼痛程度的任务。根据病理生理学的不同,疼痛可分为神经性疼痛和痛觉性疼痛,前者是由神经系统中不规则的信号处理所决定的,后者则出现在组织直接受损或长时间接触某种刺激物的情况下。治疗方法一般为药物或非药物治疗,包括使用非甾体抗炎药、局部麻醉剂、鸦片制剂以及物理和心理疗法。不幸的是,有些病症涉及剧烈或慢性疼痛,无法用传统方法进行治疗。最近的研究涉及到具有小尺寸和大表面积等特殊性质的纳米粒子,这些纳米粒子可以促进对组织的治疗,甚至提供固有的镇痛特性。儿科从纳米技术的应用中获益匪浅,因为纳米技术的应用使得药物输送、疾病诊断和组织工程的新策略得以发展。本综述旨在评估纳米技术在当前疼痛治疗中的作用,重点是儿童疼痛。
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来源期刊
CiteScore
5.70
自引率
2.10%
发文量
669
审稿时长
14 weeks
期刊介绍: Frontiers in Molecular Neuroscience is a first-tier electronic journal devoted to identifying key molecules, as well as their functions and interactions, that underlie the structure, design and function of the brain across all levels. The scope of our journal encompasses synaptic and cellular proteins, coding and non-coding RNA, and molecular mechanisms regulating cellular and dendritic RNA translation. In recent years, a plethora of new cellular and synaptic players have been identified from reduced systems, such as neuronal cultures, but the relevance of these molecules in terms of cellular and synaptic function and plasticity in the living brain and its circuits has not been validated. The effects of spine growth and density observed using gene products identified from in vitro work are frequently not reproduced in vivo. Our journal is particularly interested in studies on genetically engineered model organisms (C. elegans, Drosophila, mouse), in which alterations in key molecules underlying cellular and synaptic function and plasticity produce defined anatomical, physiological and behavioral changes. In the mouse, genetic alterations limited to particular neural circuits (olfactory bulb, motor cortex, cortical layers, hippocampal subfields, cerebellum), preferably regulated in time and on demand, are of special interest, as they sidestep potential compensatory developmental effects.
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