Боль и воспаление. Часть 1. Патогенетические аспекты

Облегчение страданий, связанное с быстрым и максимально полным устранением болевых ощущений, – важнейшая задача, стоящая перед врачами многих медицинских специальностей. Очевидно, что решить ее можно лишь при четком понимании процессов, определяющих развитие и хронизацию боли. Ключевую роль здесь играет воспаление – универсальный приспособительный механизм, всегда сопровождающий повреждение живой ткани. В первой части настоящего обзора рассмотрены основные этапы развития воспалительной реакции, начиная от первичного повреждения, сопровождающегося выбросом молекул, выступающих как «сигнал тревоги», и заканчивая развертыванием полной картины воспалительного ответа с привлечением многих клеточных элементов и гиперэкспрессией цитокинов и провоспалительных медиаторов. Представлена биологическая основа феномена периферической и центральной сенситизации ноцицептивной системы, который жестко связан с воспалением. Особое внимание уделяется возможности естественного завершения воспалительной реакции, адаптивным механизмам, регулирующим данный процесс, а также причинам, препятствующим этому и определяющим хронизацию воспаления.

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