Inflamação e dor: uma breve revisão sobre mecanismos e terapêuticas
DOI:
https://doi.org/10.15343/0104-7809.202650e18302025PPalavras-chave:
Anti-inflamatórios, Prostaglandinas, Citocinas, Nocicepção, AnalgésicosResumo
A inflamação é uma resposta imunológica complexa a estímulos nocivos, como patógenos, células danificadas e toxinas, desempenhando papel fundamental na defesa do organismo e na reparação tecidual. Esta revisão narrativa selecionou 41 estudos recentes que abordam os mecanismos celulares, moleculares e fisiopatológicos da inflamação e sua relação com a dor, incluindo influências do estilo de vida e estratégias terapêuticas atuais e emergentes. A inflamação aguda caracteriza-se por início rápido, vasodilatação, aumento da permeabilidade vascular e recrutamento predominante de neutrófilos, com mediadores como prostaglandinas, leucotrienos, histamina, bradicinina e citocinas pró-inflamatórias, podendo gerar manifestações sistêmicas, como edema periférico e pulmonar. A inflamação crônica decorre da falha na resolução, com infiltrado mononuclear persistente, remodelamento tecidual, fibrose e ativação da resposta adaptativa. A dor inflamatória resulta da sensibilização periférica de nociceptores e da ativação central, mediada por neurotransmissores excitatórios, canais iônicos e receptores específicos, favorecendo hiperalgesia e cronificação. A resolução ativa, promovida por lipoxinas, resolvinas e maresinas, modula inflamação e nocicepção. Intervenções terapêuticas incluem anti-inflamatórios não esteroidais, glicocorticoides, terapias biológicas e inibidores de JAK/STAT, embora seus efeitos adversos ressaltem a necessidade de novas abordagens seguras. Fatores do estilo de vida, como obesidade, estresse crônico e sedentarismo, contribuem para inflamação de baixo grau e dor persistente. Compreender essas interações é crucial para desenvolver estratégias integradas que conciliem eficácia anti-inflamatória e analgésica com segurança clínica.
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Este artigo é uma tradução em Português (Brasil) do artigo:
Inflammation and pain: a brief review of mechanisms and therapeutics
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Chen R, et al. Pattern recognition receptors: function, regulation and therapeutic potential. Signal Transduct Target Ther. 2025;10(1):216. https://doi. org/10.1038/s41392-025-02264-1
Chen L, Deng H, Cui H, Fang J, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018;9(6):7204. https://doi.org/10.18632/oncotarget.23208
Zhou Y, Hong Y, Huang H. Triptolide attenuates inflammatory response in membranous glomerulonephritis rat via downregulation of NF-κB signaling pathway. Kidney Blood Press Res. 2016;41(6):901-910. https://doi.org/10.1159/000452591
Medzhitov R. The spectrum of inflammatory responses. Science. 2021;374(6571):1070-1075. https://doi.org/10.1126/science.abi5200
Abdulkhaleq L, Assi M, Abdullah R, Zamri-Saad M, et al. The crucial roles of inflammatory mediators in inflammation: a review. Vet World. 2018;11(5):627 635. https://doi.org/10.14202/vetworld.2018.627-635
Mortimer PM, McIntyre SA, Thomas DC. Beyond the extra respiration of phagocytosis: NADPH oxidase 2 in adaptive immunity and inflammation. Front Immunol. 2021;12:733918. https://doi.org/10.3389/fimmu.2021.733918
Vieira NF, Barbosa TP, Cárnio EC. Performance of nitric oxide in sepsis: a scoping review. Acta Paul Enferm. 2024;37:eAPE00512. https://doi. org/10.37689/acta-ape/2024AR00005122
Chi Y, Liu X, Chai J. A narrative review of changes in microvascular permeability after burn. Ann Transl Med. 2021;9(8):719. https://doi.org/10.21037/ atm-21-1267
Cheetham CJ, et al. Neutrophil-derived proteases in lung inflammation: old players and new prospects. Int J Mol Sci. 2024;25(10):5492. https://doi. org/10.3390/ijms25105492
Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: pathogenesis and clinical significance. J Parenter Enteral Nutr. 2019;43(2):181-193. https://doi. org/10.1002/jpen.1451
Wang J, et al. Progress in structure-based drug development targeting chemokine receptors. Front Pharmacol. 2025;16:1603950. https://doi. org/10.3389/fphar.2025.1603950
Germolec DR, Shipkowski KA, Frawley RP, Evans E. Markers of inflammation. In: Immunotoxicity Testing. Cham: Springer; 2018. p. 57-79. https://doi. org/10.1007/978-1-4939-8549-4_5
Yanase Y, et al. Basophil characteristics as a marker of the pathogenesis of chronic spontaneous urticaria. Int J Mol Sci. 2023;24(12):10320. https:// doi.org/10.3390/ijms241210320
Yan M, et al. Platelet signaling in immune landscape: comprehensive mechanism and clinical therapy. Biomark Res. 2024;12(1):164. https://doi. org/10.1186/s40364-024-00700-y
Jin C, et al. Cellular and molecular mechanisms of wound repair: from biology to therapeutic innovation. Cells. 2025;14(23):1850. https://doi. org/10.3390/cells14231850
Sonnenberg GF, Artis D. Innate lymphoid cells in the initiation, regulation and resolution of inflammation. Nat Med. 2015;21(7):698-708. https://doi. org/10.1038/nm.3892
Macia Guardado M, et al. The role of prostaglandins as major inflammatory mediators in colorectal cancer. Int J Mol Sci. 2025;26(24):12191. https:// doi.org/10.3390/ijms262412191
Cascella M, et al. Pathophysiology of nociception and rare genetic disorders with increased pain threshold or pain insensitivity. Pathophysiology. 2022;29(3):435-452. https://doi.org/10.3390/pathophysiology29030035
Liu S, Kelliher L. Physiology of pain: a narrative review on the pain pathway and its application in pain management. Dig Med Res. 2022;5:100. https:// doi.org/10.21037/dmr-21-100
Serhan CN. Treating inflammation and infection in the 21st century: new hints from decoding resolution mediators and mechanisms. FASEB J. 2017;31(4):1273-1288. https://doi.org/10.1096/fj.201601222R
Cummins CL, Goldstein I. New anti-inflammatory mechanism of glucocorticoids uncovered. Trends Endocrinol Metab. 2025. https://doi.org/10.1016/j. tem.2024.08.003
Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A, et al. EULAR recommendations for the management of rheumatoid arthritis: 2019 update. Ann Rheum Dis. 2020;79(6):685-699. https://doi.org/10.1136/ard-2024-226019
Schett G, McInnes IB, Neurath MF. Reframing immune-mediated inflammatory diseases through signature cytokine hubs. Nat Rev Rheumatol. 2021;17(12):719-734. https://doi.org/10.1056/NEJMra1909094
Taylor PC, Keystone EC, van der Heijde D, Weinblatt ME, Del Carmen Morales L, Reyes Gonzaga J, et al. Baricitinib versus placebo or adalimumab in rheumatoid arthritis. Ann Rheum Dis. 2020;79(7):988-997. https://doi.org/10.1136/annrheumdis-2017-212461
Nash P, et al. Expert consensus statement on the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: 2024 update. Ann Rheum Dis. 2025;84(5):664-679. https://doi.org/10.1016/j.ard.2025.01.032
Gushiken LFS, et al. Cutaneous wound healing: an update from physiopathology to current therapies. Life (Basel). 2021;11(7):665. https://doi. org/10.3390/life11070665
Zhao R, Liang H, Clarke E, Jackson C, et al. Inflammation in chronic wounds. Int J Mol Sci. 2016;17(12):2085. https://doi.org/10.3390/ijms17122085
Garlanda C, Di Ceglie I, Jaillon S. IL-1 family cytokines in inflammation and immunity. Cell Mol Immunol. 2025;22:1-18. https://doi.org/10.1038/ s41423-025-01358-8
Neal SV, Rudmann DG, Corps KN. Artificial intelligence in veterinary clinical pathology: an introduction and review. Vet Clin Pathol. 2025. https:// doi.org/10.1111/vcp.70012
Peh HY, Chen J. Pro-resolving lipid mediators and therapeutic innovations in resolution of inflammation. Pharmacol Ther. 2025;265:108753. https:// doi.org/10.1016/j.pharmthera.2024.108753
Park WH. Eicosanoids and inflammation: a delicate balance of pro-inflammatory and pro-resolving mediators. Biochem Pharmacol. 2025:117662. https://doi.org/10.1016/j.bcp.2025.117662
Basbaum AI, Bautista DM, Scherrer G, Julius D. Cellular and molecular mechanisms of pain. Cell. 2009;139(2):267-284. https://doi.org/10.1016/j. cell.2009.09.028
Karcz M, et al. Pathophysiology of pain and mechanisms of neuromodulation: a narrative review. J Pain Res. 2024;17:3757-3790. https://doi. org/10.2147/JPR.S475351
Curatolo M. Central sensitization and pain: pathophysiologic and clinical insights. Curr Neuropharmacol. 2024;22(1):15-22. https://doi. org/10.2174/1570159X20666221012112725
Chen Y, et al. The mechanisms of specialize d pro-resolving mediators in pain relief. Front Immunol. 2025;16:1634724. https://doi.org/10.3389/ fimmu.2025.1634724
Johnson BW, Strand NH, Raynak JC, Jara C, et al. Cannabinoids in chronic pain management. Biomedicines. 2025;13(3):530. https://doi.org/10.3390/ biomedicines13030530
Paolini L, Sigaux J, Boissier MC, Rivière E. Immune control of pain. Joint Bone Spine. 2025:105999. https://doi.org/10.1016/j.jbspin.2025.105999
Santiago BVM, et al. Prevalence of chronic pain in Brazil: a systematic review and meta-analysis. Clinics (Sao Paulo). 2023;78:100209. https://doi. org/10.1016/j.clinsp.2023.100209
Tumilaar SG, et al. A comprehensive review of free radicals, oxidative stress, and antioxidants. J Chem. 2024;2024:5594386. https://doi. org/10.1155/2024/5594386
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2026-01-22
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Franco, R. M., Pinto, F. R. M., Dias, E. H. V., & Franco, R. R. (2026). Inflamação e dor: uma breve revisão sobre mecanismos e terapêuticas. O Mundo Da Saúde, 50. https://doi.org/10.15343/0104-7809.202650e18302025P
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