Rol de los receptores nicotínicos de acetilcolina en mecanismos de dolor

Contenido principal del artículo

Javier Jérez Escobar
Alfonso Martínez Visbal

Resumen

Introducción: los receptores nicotínicos de acetilcolina (nAChR) en el estudio y entendimiento del dolor se han evaluado ampliamente en las últimas dos décadas. Se consideran piezas importantes para el desarrollo de analgésicos.
Objetivo: identificar conceptos y avances acerca de los nAChR y su papel en la modulación del dolor.
Metodología: se realizó búsqueda en PubMed, MEDLINE, ScienceDirect, Scielo, OvidSP, EBSCOhost y en la Biblioteca Cochrane (incluyendo la base de datos Cochrane de revisiones sistemáticas y Cochrane controlled trials register). También en las plataformas de las Revistas JAMA, Lancet, New England Journal of Medicine y Anesthesiology. Las
búsquedas se limitaron a los idiomas inglés y español, así como documentos publicados entre 1970 y 2015.
Resultados: los nAChR son canales iónicos transmisores que constan de diferentes subtipos, cada uno de los cuales tiene una farmacología y fisiología específica, con diferente distribución anatómica en el cerebro. No se limitan solo a sitios postsinápticos, también se localizan a nivel pre, peri y extrasinápticos donde pueden modular la función neuronal por una variedad de acciones. Los nAChR neuronales difieren de los nAChR periféricos, ya que no tienen las subunidades γ, δ, ε o, en su confección y constan de varios complementos de α2–α9 y subunidades β2–β4. Actualmente, seis α (α2-α7) y tres β (β2-β4) subunidades se han identificado y clonado a partir de cerebro humano. Los nAChRs son interesantes para develar los mecanismos inherentes al dolor y desarrollar nuevos analgésicos. Los ligandos a nAChR α4β2 siguen siendo la estrategia más atractiva para explicar el dolor neuropático e inflamatorio. Subunidades nicotínicas α5 reducen los estados de dolor e inflamación sobre todo neuropática. La activación central y periférica del nAChR α7, reduce la nocicepción y el dolor inflamatorio agudo.
Conclusión: se observan avances en el conocimiento de los nAChR en los mecanismos del dolor. Amplios estudios se realizan a nivel preclínico para desarrollar nuevas estrategias terapéuticas y antiinflamatorias. Rev.cienc.biomed. 2015;6(1):118-129

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