About this Research Topic
Chronic pain is a major health care problem that affects some 30%-50% of the world population and almost 20% of the Europeans actually suffers from chronic or intermittent pain; the latter results in suffering and disability for patients and increasing economic loss for society. It is calculated that only 1/3 of patients receives pain relief from current analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), local anaesthetics, some antidepressants and anticonvulsants, including carbamazepine and gabapentin, opiates. Advancements in the understanding of the mechanisms that produce pain have disclosed new potential therapeutic targets for the development of more effective drugs. For instance, validation of experimental models recapitulating allodynia contributed a great deal of precious information on the long-term plasticity changes occurring in pain transmission and modulation.
During chronic pain changes have been described upon long-term potentiation (LTP) of excitatory synaptic transmission, as well as postsynaptic signalling pathways and also upon genes and gene products expression. Likewise, influence of central nervous system (CNS) glial cells (including microglia, astrocytes and oligodendrocytes) on pain processing has also been investigated. The evidence gathered so far implicates that several soluble factors and CNS glia, via modulating fundamental mechanisms of neuronal function and synaptic communication, can contribute to sensitization and pain-related behavior though its translational value to clinic remains to be established. In spite of the development of specific drugs for neuropathic pain, the treatment of severe pain relies on the use of opioids, an area in great need of therapeutic improvement. Higher prevalence of pain is registered in aging and this problem becomes even more burdensome in patients suffering from dementia, due to the impaired communication capabilities.
The aim of this themed issue is to set a forum for Original Research and Review articles updating the following unsolved topics:
- Neurotransmitters, peptides, ion channels and anomalous plasticity;
- Role of neuron-glial interactions in central sensitization;
- New trends in pain therapy: from drug design to botanicals;
- Pharmacology of chronic pain in fragile populations: the case of dementia;
- Assessment and management of pain in the cognitively impaired elderly.
Keywords: Chronic pain, sensitization, natural and synthetic analgesics, pain, dementia
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