운동으로 유도된 오피오이드를 통한 신경병증성 통증치료의 메커니즘의 이해
Understanding the Mechanism of an Exercise-induced Opioid Effect in Reducing Neuropathic Pain
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[서론] 현대 고령화 사회에서는 노인성 질환으로 야기되는 신경병증성 통증이 증가되고 있으며, 운동을 통한 이러한 만성통증을 예방과 치료에 대한 관심이 증대되고 있다. 따라서 본 연구는 운동이 신경병증성 통증을 완화시키는 메커니즘을 첫째, 운동 시 발생하는 일시적인 무통효과와 둘째, 운동으로부터 야기되는 오피오이드와 신경영양물질의 증가로 제시하여, 통증완화에 대한 효과를 설명하고자 한다. [방법] 본 연구는 현재까지 진행된 운동의 신경병증성 통증에 대한 효과를 연구한 논문들을 중심으로 문헌고찰을 통해 그 가능 기전을 조사하였다. [결과] 운동을 통해 야기되는 신경병증성 통증기전은 정확히 알려지지 않았으나 운동은 오피오이드의 증가를 유도하며, 진통제의 중독성처럼 운동으로 야기되는 오피오이드의 의존성 및 내성이 증가하는 기전으로 운동의 효과를 설명할 수 있겠다. 또한, 운동은 신경영양인자들의 증가를 유도하여 항유해자극 효과를 유도하고, 오피오이드와 세라토닌 대사경로를 통한 무통효과를 증가시켰다. [결론] 사실상, 운동과 신경병증성 통증과의 관련 연구는 여전히 부족한 실정이다. 신경병증성 통증 치료와 예방을 위한 운동의 효과를 보다 명확히 이해하기 위해서는 특정 운동강도와 지속시간에서 신경병증성 통증의 완화효과를 확인하여 만성통증의 치료와 예방에 적용할 수 있도록 연구노력이 지속되어야 할 것이다.
Abstract
[INTRODUCTION] Prior studies have increasingly indicated that chronic diseases might be causing neuropathic pain. As many patients with chronic diseases do indicate neuropathic pain, there is a growing interest in finding a treatment for this pain. One beneficial treatment might be the exercise-induced opioid effect that could help to reduce this neuropathic pain. Thus, the purpose of this study is to explain the possible mechanism related to reducing neuropathic pain as a result of the exercise-induced opioid release. [METHOD] This study reviews prior research on neuropathic pain and the exercise effect to explain the possible mechanism relating to an exercise-induced opioid effect that reduces neuropathic pain. [RESULT] The possible mechanisms relating to the exercise-induced opioid effect include: 1) an exercise-induced analgesic effect, and 2) exercise-induced opioid and neurotropic factors. The effect of exercise-induced opioids was proven by indications of opioid with drawal and by increasing opioid to lerance. Additionally, increasing the neurotropic factors would help increase the analgesic effect of opioids and serotonin. [CONCLUSION] The exercise-induced opioid effect would reduce neuropathic pain, indicate opioid withdrawal, increase opioid tolerance, and identify neurotropic factors. Future research should examine the effects of exercise intensity and duration to better understand the treatment mechanism, which ultimately will help to prevent and treat chronic pain.
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