Clinical therapies for chronic pain are limited. While targeted drugs are promising therapies for chronic pain, they exhibit insufficient efficacy and poor targeting. The occurrence of chronic pain partly results from central changes caused by alterations in neurons in the rostral ventromedial medulla (RVM) in the brainstem regulatory pathway. The RVM, which plays a key role in the descending pain control pathway, greatly contributes to the development and maintenance of pain. However, the exact roles of the RVM in chronic pain remain unclear, making it difficult to develop new drugs targeting the RVM and related pathways. Here, we first discuss the roles of the RVM and related circuits in chronic pain. Then, we analyze synaptic transmission between RVM neurons and spinal cord neurons, specifically focusing on the release of neurotransmitters, to explore the cellular mechanisms by which the RVM regulates chronic pain. Finally, we propose some ideas for the development of drugs targeting the RVM.

中文翻译：

---

慢性疼痛期间延髓延髓腹内侧作用于脊髓的细胞机制

慢性疼痛的临床治疗是有限的。虽然靶向药物是治疗慢性疼痛的有前途的疗法，但它们的疗效不足且靶向性差。慢性疼痛的发生部分是由于脑干调节通路中延髓头端腹内侧 (RVM) 神经元的改变引起的中枢变化。RVM 在下行疼痛控制通路中起关键作用，极大地促进了疼痛的发展和维持。然而，RVM 在慢性疼痛中的确切作用仍不清楚，使得开发针对 RVM 和相关通路的新药变得困难。在这里，我们首先讨论 RVM 和相关回路在慢性疼痛中的作用。然后，我们分析了 RVM 神经元和脊髓神经元之间的突触传递，特别关注神经递质的释放，探索 RVM 调节慢性疼痛的细胞机制。最后，我们为开发针对 RVM 的药物提出了一些想法。