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Cao B, Xu Q, Shi Y, Zhao R, Li H, Zheng J, Liu F, Wan Y, Wei B. Pathology of pain and its implications for therapeutic interventions. Signal Transduct Target Ther 2024; 9:155. [PMID: 38851750 PMCID: PMC11162504 DOI: 10.1038/s41392-024-01845-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 04/08/2024] [Accepted: 04/25/2024] [Indexed: 06/10/2024] Open
Abstract
Pain is estimated to affect more than 20% of the global population, imposing incalculable health and economic burdens. Effective pain management is crucial for individuals suffering from pain. However, the current methods for pain assessment and treatment fall short of clinical needs. Benefiting from advances in neuroscience and biotechnology, the neuronal circuits and molecular mechanisms critically involved in pain modulation have been elucidated. These research achievements have incited progress in identifying new diagnostic and therapeutic targets. In this review, we first introduce fundamental knowledge about pain, setting the stage for the subsequent contents. The review next delves into the molecular mechanisms underlying pain disorders, including gene mutation, epigenetic modification, posttranslational modification, inflammasome, signaling pathways and microbiota. To better present a comprehensive view of pain research, two prominent issues, sexual dimorphism and pain comorbidities, are discussed in detail based on current findings. The status quo of pain evaluation and manipulation is summarized. A series of improved and innovative pain management strategies, such as gene therapy, monoclonal antibody, brain-computer interface and microbial intervention, are making strides towards clinical application. We highlight existing limitations and future directions for enhancing the quality of preclinical and clinical research. Efforts to decipher the complexities of pain pathology will be instrumental in translating scientific discoveries into clinical practice, thereby improving pain management from bench to bedside.
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Affiliation(s)
- Bo Cao
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Qixuan Xu
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Yajiao Shi
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China
| | - Ruiyang Zhao
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Hanghang Li
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Jie Zheng
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China
| | - Fengyu Liu
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China.
| | - You Wan
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China.
| | - Bo Wei
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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Bosson C, Rendu J, Pelletier L, Abriat A, Chatagnon A, Brocard J, Brocard J, Figarella-Branger D, Ducreux S, van Coppenolle F, Sagui E, Marty I, Roux-Buisson N, Faure J. Variations in the TRPV1 gene are associated to exertional heat stroke. J Sci Med Sport 2020; 23:1021-1027. [PMID: 32471784 DOI: 10.1016/j.jsams.2020.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Exertional Heat Stroke (EHS) is one of the top three causes of sudden death in athletes. Extrinsic and intrinsic risk factors have been identified but the genetic causes still remain unclear. Our aim was to identify genes responsible for EHS, which is a necessary step to identify patients at risk and prevent crises. DESIGN Genetic and functional laboratory studies METHODS: Whole Exome Sequencing (WES) was performed to search for candidate genes in a cohort of 15 soldiers who had a documented EHS episode. In silico and in vitro functional studies were performed to evaluate the effect of mutations identified in the candidate gene TRPV1. RESULTS WES led to the identification of two missense variations in the TRPV1 gene. These variations were very rare or unreported in control databases and located in critical domains of the protein. In vitro functional studies revealed that both variations induce a strong modification of the channel response to one of its natural agonist, the capsaicin. CONCLUSIONS We evidenced mutations altering channel properties of the TRPV1 gene and demonstrated that TRPV1, which is involved in thermoregulation and nociception, is a new candidate gene for EHS. Our data provide the bases to explore genetic causes and molecular mechanisms governing the pathophysiology of EHS.
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Affiliation(s)
- Caroline Bosson
- CHU Grenoble Alpes IBP, Génétique Moléculaire : Maladies Héréditaires et Oncologie, France; Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France
| | - John Rendu
- CHU Grenoble Alpes IBP, Génétique Moléculaire : Maladies Héréditaires et Oncologie, France; Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France
| | - Laurent Pelletier
- Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France
| | - Amandine Abriat
- Military Hospital Laveran, Service of Neurology, Marseille, France
| | - Amandine Chatagnon
- CHU Grenoble Alpes IBP, Génétique Moléculaire : Maladies Héréditaires et Oncologie, France
| | - Julie Brocard
- Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France
| | - Jacques Brocard
- Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France
| | - Dominique Figarella-Branger
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, Hôpital de la Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France; Univ Aix-Marseille I, France
| | - Sylvie Ducreux
- Univ Lyon, CarMeN Laboratory, INSERM, INRA, INSA, Lyon, Université Claude Bernard, Bron, France
| | - Fabien van Coppenolle
- Univ Lyon, CarMeN Laboratory, INSERM, INRA, INSA, Lyon, Université Claude Bernard, Bron, France
| | | | - Isabelle Marty
- Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France
| | - Nathalie Roux-Buisson
- CHU Grenoble Alpes IBP, Génétique Moléculaire : Maladies Héréditaires et Oncologie, France; Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France.
| | - Julien Faure
- CHU Grenoble Alpes IBP, Génétique Moléculaire : Maladies Héréditaires et Oncologie, France; Grenoble Institute of Neurosciences, Inserm U1216, Cellular Myology and Pathology, Grenoble Alpes, University, Grenoble, France
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