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Periphere Mechanismen von Gelenkschmerzen mit speziellem Fokus auf den synovialen Fibroblasten

Peripheral mechanisms of joint pain with special focus on the synovial fibroblast

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Zusammenfassung

Gelenkschmerz ist eine der am häufigsten auftretenden Schmerzformen. Etwa ein Drittel der Bevölkerung hat bereits einmal Gelenkschmerz erfahren. Bis heute ist diese Schmerzform nicht effektiv behandelbar, und Nebenwirkungen der verwendeten Medikamente sind häufig gefährlich. Es ist deshalb sehr wichtig, unser Verständnis über die Ursachen und die Mechanismen von Gelenkschmerzen weiter zu verbessern. Gelenke und ihre umgebenden Strukturen sind sehr gut mit Nervenfasern versorgt, die auf mechanische Beanspruchung reagieren. Lokale Entzündungsprozesse sensibilisieren diese Afferenzen, und es resultiert eine erniedrigte Schmerzschwelle.

Über die lokalen Prozesse, insbesondere im Synovialgewebe, ist wenig bekannt. Rezeptoren, die im Nervensystem beschrieben sind, werden zunehmend auch im synovialen Fibroblasten nachgewiesen. Deren Funktion ist noch weitgehend unbekannt. Allerdings sind neue therapeutische Angriffspunkte über andere Systeme, z. B. den TRPV1- oder den P2X4-Rezeptor, zu erwarten.

Abstract

Joint pain is one of the most common forms of pain and is experienced by almost a third of the population at some time. To date, it has not been possible to treat joint pain effectively and side effects of commonly prescribed drugs are often hazardous. Therefore, improvements in our understanding of causes and mechanisms associated with joint pain are required. Joints and their neighbouring structures are well endowed with nerve fibres which respond to mechanical stimuli. Following local inflammation, the activation threshold of these afferent nerve fibres is significantly decreased, such that even low level stimuli encode nociception.

Currently, there is a lack about local mechanisms in synovial tissue. Various receptors, well known from the nervous system, are increasingly being detected in synovial fibroblasts. However, little is known about their function. Innovative new therapies are expected to emerge by targeting various receptors, e.g. the TRPV1- or the P2X4 receptor system.

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  1. Rheumaklinik und Institut für Physikalische Medizin, UniversitätsSpital Zürich, Gloriastr. 25, 8091, Zürich, Schweiz

    H. Sprott

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Sprott, H. Periphere Mechanismen von Gelenkschmerzen mit speziellem Fokus auf den synovialen Fibroblasten. Z. Rheumatol. 67, 640–645 (2008). https://doi.org/10.1007/s00393-008-0354-x

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