Progress on the pathogenesis and diagnosis and treatment of postherpetic neuralgia
Li Ruonan1, Song Jin2, Wang Yuzhong2
1College of Clinical Medicine, Jining Medical University, Jining 272067, China; 2Department of Neurology, the Affiliated Hospital of Jining Medical University, Jining 272029, China
Abstract:Herpes zoster is a skin infection caused by reactivation of the latent varicella-zoster virus in the cranial ganglia and dorsal root ganglia of the spinal cord. Postherpetic neuralgia (PHN) is the most common chronic complication of herpes zoster. It occurs in the elderly and immunosuppressed patients, and seriously affects the patients′ work and quality of life due to its refractory nature. In the past, most of the studies on PHN focused on clinical research and therapeutic strategies, but less on its specific pathogenesis. This article summarizes the current status and progress of clinical research on PHN in its pathogenesis, risk factors, prognosis, and preventive and curative measures, aiming to provide a reference for clinical prevention and treatment of PHN.
厉若男 宋进 王玉忠. 带状疱疹后神经痛的发病机制和诊治研究进展[J]. 中华诊断学电子杂志, 2024, 12(3): 199-205.
Li Ruonan1, Song Jin2, Wang Yuzhong2. Progress on the pathogenesis and diagnosis and treatment of postherpetic neuralgia. zhzdx, 2024, 12(3): 199-205.
[1]Koshy E,Mengting L,Kumar H,et al.Epidemiology,treatment and prevention of herpes zoster: a comprehensive review[J].Indian J Dermatol Venereol Leprol,2018,84(3):251-262.DOI: 10.4103/ijdvl.IJDVL_1021_16.
[2]Saguil A,Kane S,Mercado M,et al.Herpes zoster and postherpetic neuralgia:prevention and management[J].Am Fam Physician,2017,96(10):656-663.
[3]Yang F,Yu SY,Fan BF,et al.The epidemiology of herpes zoster and postherpetic neuralgia in China:results from a cross-sectional study[J].Pain Ther,2019,8(2):249-259.DOI:10.1007/s40122-019-0127-z.
[4]Gross GE,Eisert L,Doerr HW,et al.S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia[J].J Dtsch Dermatol Ges,2020,18(1):55-78.DOI:10.1111/ddg.14013.
[5]带状疱疹后神经痛诊疗共识编写专家组.带状疱疹后神经痛诊疗中国专家共识[J].中国疼痛医学杂志,2016,22(3):161-167.DOI:10.3969/j.issn.1006-9852.2016.03.001.
[6]Niv D,Maltsman-Tseikhin A,Lang E.Postherpetic neuralgia:what do we know and where are we heading?[J].Pain Physician,2004,7(2):239-247.
[7]Kennedy P.The spectrum of neurological manifestations of varicella-zoster virus reactivation[J].Viruses,2023,15(8):1663.DOI:10.3390/v15081663.
[8]Niemeyer CS,Harlander-Locke M,Bubak AN,et al.Trigeminal postherpetic neuralgia:from pathophysiology to treatment[J].Curr Pain Headache Rep,2024,28(4):295-306.DOI:10.1007/s11916-023-01209-z.
[9]Feller L,Khammissa R,Fourie J,et al.Postherpetic neuralgia and trigeminal neuralgia[J].Pain Res Treat,2017(2017):1681765.DOI:10.1155/2017/1681765.
[10]Como CN,Bubak AN,Blackmon AM,et al.Varicella zoster virus induces differential cell-type specific responses in human corneal epithelial cells and keratocytes[J].Invest Ophthalmol Vis Sci,2019,60(2):704-711.DOI:10.1167/iovs.18-25801.
[11]Liang X,Fan Y.Bidirectional two-sample Mendelian randomization analysis reveals a causal effect of interleukin-18 levels on postherpetic neuralgia risk[J].Front Immunol,2023(14):1183378.DOI:10.3389/fimmu.2023.1183378.
[12]Peng Q,Guo X,Luo Y,et al.Dynamic immune landscape and VZV-specific T cell responses in patients with herpes zoster and postherpetic neuralgia[J].Front Immunol,2022(13):887892.DOI:10.3389/fimmu.2022.887892.
[13]Gershon AA,Breuer J,Cohen JI,et al.Varicella zoster virus infection[J].Nat Rev Dis Primers,2015(1):15016.DOI:10.1038/nrdp.2015.16.
[14]Gossrau G,Klimova A,Lapp HS,et al.C-tactile touch perception in patients with chronic pain disorders[J].Pain Rep,2021,6(2):e941.DOI:10.1097/PR9.0000000000000941.
[15]Philip A,Thakur R.Post herpetic neuralgia[J].J Palliat Med,2011,14(6):765-773.DOI:10.1089/jpm.2011.9685.
[16]Baron R,Saguer M.Mechanical allodynia in postherpetic neuralgia:evidence for central mechanisms depending on nociceptive C-fiber degeneration[J].Neurology,1995,45(12 Suppl 8):S63-S65.DOI:10.1212/wnl.45.12_suppl_8.s63.
[17]Zhang Q,Martin-Caraballo M,Hsia SV.Modulation of voltage-gated sodium channel activity in human dorsal root ganglion neurons by herpesvirus quiescent infection[J].J Virol,2020,94(3):e01823-01819.DOI:10.1128/JVI.01823-19.
[18]Kennedy PG,Montague P,Scott F,et al.Varicella-zoster viruses associated with post-herpetic neuralgia induce sodium current density increases in the ND7-23 Nav-1.8 neuroblastoma cell line[J].PLoS One,2013,8(1):e51570.DOI:10.1371/journal.pone.0051570.
[19]Zhou H,Wang Z,Jin H,et al.A systematic review and meta-analysis of independent risk factors for postherpetic neuralgia[J].Ann Palliat Med,2021,10(12):12181-12189.DOI:10.21037/apm-21-3028.
[20]Li HL,Gong G,Wang JL,et al.Analysis of risk factors for postherpetic neuralgia in patients with postmalignancy herpes zoster[J].Pain Physician,2023,26(4):E397-E403.
[21]Steinmann M,Lampe D,Grosser J,et al.Risk factors for herpes zoster infections:a systematic review and meta-analysis unveiling common trends and heterogeneity patterns[J].Infection,2024,52(3):1009-1026 .DOI:10.1007/s15010-023-02156-y.
[22]Stinson C,Deng M,Yee MB,et al.Sex differences underlying orofacial varicella zoster associated pain in rats[J].BMC Neurol,2017,17(1):95.DOI:10.1186/s12883-017-0882-6.
[23]Wei S,Li X,Wang H,et al.Analysis of the risk factors for postherpetic neuralgia[J].Dermatology,2019,235(5):426-433.DOI:10.1159/000500482.
[24]Morena D,Lumbreras S,Rodríguez JM,et al.Chronic respiratory diseases as a risk factor for herpes zoster infection[J].Arch Bronconeumol,2023,59(12):797-804.DOI:10.1016/j.arbres.2023.08.010.
[25]Wen SY,Ou-Yang C,Chang C,et al.Impact of type 1 versus type 2 diabetes on developing herpes zoster and post-herpetic neuralgia:a population-based cohort study[J].Acta Derm Venereol,2023(103):adv9400.DOI:10.2340/actadv.v103.9400.
[26]McKay SL,Guo A,Pergam SA,et al.Herpes zoster risk in immunocompromised adults in the United States:a systematic review[J].Clin Infect Dis,2020,71(7):e125-e134.DOI:10.1093/cid/ciz1090.
[27]Chen JY,Lan KM,Sheu MJ,et al.Peptic ulcer as a risk factor for postherpetic neuralgia in adult patients with herpes zoster[J].J Med Virol,2015,87(2):222-229.DOI:10.1002/jmv.24051.
[28]赵玉会,付光蕾,钟媛,等.带状疱疹后神经痛评估工具的研究进展[J].当代护士(中旬刊),2021,28(4):8-10.DOI:10.19792/j.cnki.1006-6411.2021.11.003.
[29]Wang W,Liu XX.Retrospective clinical observation of correlation between galectin-3 and early herpes zoster neuralgia and post-herpetic neuralgia[J].Altern Ther Health Med,2024:AT10172[2024-03-11].http://pubmed.ncbi.nlm.nih.gov/38401085/[published online ahead of print February 9,2024].
[30]Wang TT,Fei Y,Yao M,et al.Correlation between galectin-3 and early herpes zoster neuralgia and postherpetic neuralgia:a retrospective clinical observation[J].Pain Res Manag,2020(2020):8730918.DOI:10.1155/2020/8730918.
[31]Fukuyasu A,Kamata M,Sy Hau C,et al.Serum interleukin-10 level increases in patients with severe signs or symptoms of herpes zoster and predicts the duration of neuralgia[J].J Dermatol,2021,48(4):511-518.DOI:10.1111/1346-8138.15818.
[32]周淼,李祥,杨旭东.带状疱疹后遗神经痛的药物治疗及预防研究进展[J].中国中西医结合皮肤性病学杂志,2020,19(5):489-493.DOI:10.3969/j.issn.1672-0709.2020.05.035.
[33]Seetan K,Albashir S,Jarrar B,et al.Assessment of serum vitamin d levels in the serum of patients with postherpetic neuralgia and its correlation to pain severity:a cross-sectional comparative study[J].Int J Clin Pract,2021,75(11):e14750.DOI:10.1111/ijcp.14750.
[34]de Oliveira C,Biddulph JP,Hirani V,et al.Vitamin D and inflammatory markers:cross-sectional analyses using data from the English Longitudinal Study of Ageing (ELSA)[J].J Nutr Sci,2017(6):e1.DOI:10.1017/jns.2016.37.
[35]Jiang J,Huang X,Gao X,et al.Vitamin D3 supplementation attenuates surgery-induced neuroinflammation and cognitive impairment by regulating NLRP3 inflammasome in mice[J].Mediators Inflamm,2022(2022):4696415.DOI:10.1155/2022/4696415.
[36]Cao X, Shen Z, Wang X, et al. A meta-analysis of randomized controlled trials comparing the efficacy and safety of pregabalin and gabapentin in the treatment of postherpetic neuralgia[J].Pain Ther,2023,12(1):1-18.DOI:10.1007/s40122-022-00451-4.
[37]Liu X,Wei LL,Zeng Q,et al.The treatment of topical drugs for postherpetic neuralgia:a network meta-analysis[J].Pain Physician,2020,23(6):541-551.
[38]Irving G,Backonja M,Rauck R,et al.NGX-4010,a capsaicin 8% dermal patch,administered alone or in combination with systemic neuropathic pain medications,reduces pain in patients with postherpetic neuralgia[J].Clin J Pain,2012,28(2):101-107.DOI:10.1097/AJP.0b013e318227403d.
[39]Fetell M,Sendel M,Li T,et al.Cutaneous nerve fiber and peripheral Nav1.7 assessment in a large cohort of patients with postherpetic neuralgia[J].Pain,2023,164(11):2435-2446.DOI:10.1097/j.pain.0000000000002950.
[40]Kato J,Baba M,Kuroha M,et al.Safety and efficacy of mirogabalin for peripheral neuropathic pain:pooled analysis of two pivotal phase III studies[J].Clin Ther,2021,43(5):822-835.e16.DOI:10.1016/j.clinthera.2021.03.015.
[41]Tyring SK,Lee P,Hill GT Jr,et al.FV-100 versus valacyclovir for the prevention of post-herpetic neuralgia and the treatment of acute herpes zoster-associated pain:a randomized-controlled trial[J].J Med Virol,2017,89(7):1255-1264.DOI:10.1002/jmv.24750.
[42]Zhou Z,Hu X,Yan F,et al.Observation on the effect of platelet-rich plasma combined with drugs in the treatment of herpes zoster neuralgia[J].Int J Neurosci,2024,134(6):628-634.DOI:10.1080/00207454.2022.2138381.
[43]Doo AR,Choi JW,Lee JH,et al.The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia[J].Korean J Pain,2019,32(3):215-222.DOI:10.3344/kjp.2019.32.3.215.
[44]沈意娜,许丽媛.带状疱疹后神经痛护理文献研究进展[J].中国疼痛医学杂志,2022,28(1):60-64.DOI:10.3969/j.issn.1006-9852.2022.01.011.
[45]陈曦,黄卓英,赵淮波,等.带状疱疹治疗及预防[J].中华医学杂志,2021,101(7):515-519.DOI:10.3760/cma.j.cn112137-20200901-02517.
[46]Lin CS,Lin YC,Lao HC,et al.Interventional treatments for postherpetic neuralgia:a systematic review[J].Pain Physician,2019,22(3):209-228.
[47]Isagulyan ED,Semenov DE,Polushkin AA,et al.Electrical dorsal root ganglion stimulation (DRGS) for the treatment of refractory postherpetic neuralgia[J].Zh Vopr Neirokhir Im N N Burdenko,2024,88(1):21-27.DOI:10.17116/neiro20248801121.
[48]努尔比亚·阿布拉,杨阳,李冉,等.早期脉冲射频治疗带状疱疹神经痛临床研究[J].中国疼痛医学杂志,2022,28(1):30-35.DOI:10.3969/j.issn.1006-9852.2022.01.006.
[49]Sun W,Jin Y,Liu H,et al.Short-term spinal cord stimulation is an effective therapeutic approach for herpetic-related neuralgia-a Chinese nationwide expert consensus[J].Front Aging Neurosci,2022(14):939432.DOI:10.3389/fnagi.2022.939432.
[50]Li X,Chen P,He J,et al.Comparison of the efficacy and safety of temporary spinal cord stimulation versus pulsed radiofrequency for postherpetic neuralgia:a prospective randomized controlled trial[J].Pain Res Manag,2022(2022):3880424.DOI:10.1155/2022/3880424.
[51]Huang J, Yang S, Yang J, et al. Early treatment with temporary spinal cord stimulation effectively prevents development of postherpetic neuralgia[J].Pain Physician,2020,23(2):E219-E230.
[52]Wang Y,Li W,Peng W,et al.Acupuncture for postherpetic neuralgia:systematic review and meta-analysis[J].Medicine (Baltimore),2018,97(34):e11986.DOI:10.1097/MD.0000000000011986.
[53]Li LM, Zhang ZL, Zheng BS, et al. Effective treatment of high-voltage pulsed radiofrequency combined with oxygen-ozone injection in acute zoster neuralgia[J].Clin Neurol Neurosurg,2022(223):107496.DOI:10.1016/j.clineuro.2022.107496.
[54]Yu J,Tu M,Shi Y,et al.Acupuncture therapy for treating postherpetic neuralgia:a protocol for an overview of systematic reviews and meta-analysis[J].Medicine (Baltimore),2020,99(47):e23283.DOI:10.1097/MD.0000000000023283.
[55]Xia YF,Sun RH,Li SM,et al.Different acupuncture therapies for postherpetic neuralgia:an overview of systematic reviews and meta-analysis[J].Chin J Integr Med,2024.https://pubmed.ncbi.nlm.nih.gov/38212497/.[published online ahead of print Jan 12,2024].DOI:10.1007/s11655-023-3613-4.
[56]王如想,倪华栋,谢可越,等.CT引导下背根神经节脉冲射频联合臭氧注射治疗颈部和上肢急性期带状疱疹神经痛的疗效及安全性分析[J].中华医学杂志,2023,103(7):500-505.DOI:10.3760/cma.j.cn112137-20220624-01391.
[57]周增华,廖莎,胡鑫,等.超声引导下富血小板血浆联合药物治疗带状疱疹性神经痛的效果观察[J].实用医学杂志,2021,37(8):1093-1095.DOI:10.3969/j.issn.1006-5725.2021.08.027.
[58]徐幼苗,杨旭,刘婷婷,等.脉冲射频联合富血小板血浆治疗老年带状疱疹的临床研究[J].中国现代医学杂志,2021,31(8):65-69.DOI:10.3969/j.issn.1005-8982.2021.08.012.
[59]陈艳,刘亚琳,贾培媛,等.带状疱疹预防用疫苗临床评价的考虑[J].中国新药杂志,2021,30(19):1808-1813.DOI:10.3969/j.issn.1003-3734.2021.19.012.
[60]Klein NP,Bartlett J,Fireman B,et al.Long-term effectiveness of zoster vaccine live for postherpetic neuralgia prevention[J].Vaccine,2019,37(36):5422-5427.DOI:10.1016/j.vaccine.2019.07.004.
[61]Mbinta JF,Wang AX,Nguyen BP,et al.Herpes zoster vaccine effectiveness against herpes zoster and postherpetic neuralgia in New Zealand:a retrospective cohort study[J].Lancet Reg Health West Pac,2023(31):100601.DOI:10.1016/j.lanwpc.2022.100601.
[62]Chen YT,Wang HH,Wang TJ,et al.Early application of low-level laser may reduce the incidence of postherpetic neuralgia (PHN)[J].J Am Acad Dermatol,2016,75(3):572-577.DOI:10.1016/j.jaad.2016.03.050.
[63]Kim K, Jo D, Kim E. Pulsed radiofrequency to the dorsal root ganglion in acute herpes zoster and postherpetic neuralgia[J].Pain Physician,2017 ,20(3):E411-E418.
[64]Makharita MY,Amr YM.Effect of repeated paravertebral injections with local anesthetics and steroids on prevention of post-herpetic neuralgia[J].Pain Physician,2020,23(6):565-572.