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      Neuroinflammation and central sensitization in chronic and widespread pain

      research-article
      , PhD a , b , , PhD a , , BS a , , PhD a , , DDS, PhD a
      Anesthesiology

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          Abstract

          Chronic pain is maintained in part by central sensitization, a phenomenon of synaptic plasticity and increased neuronal responsiveness in central pain pathways after painful insults. Accumulating evidence suggests that central sensitization is also driven by neuroinflammation in the peripheral and central nervous system (CNS). A characteristic feature of neuroinflammation is the activation of glial cells, such as microglia and astrocytes, in the spinal cord and brain, leading to the release of pro-inflammatory cytokines and chemokines. Recent studies suggest that central cytokines and chemokines are powerful neuromodulators and play a sufficient role in inducing hyperalgesia and allodynia after the CNS administration. Sustained increase of cytokines and chemokines in the CNS also promotes chronic widespread pain that affects multiple body sites. Thus, neuroinflammation drives widespread chronic pain via central sensitization. We also discuss sex-dependent glial/immune signaling in chronic pain and new therapeutic approaches that control neuroinflammation for the resolution of chronic pain.

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          Author and article information

          Journal
          1300217
          533
          Anesthesiology
          Anesthesiology
          Anesthesiology
          0003-3022
          1528-1175
          18 January 2018
          August 2018
          01 August 2019
          : 129
          : 2
          : 343-366
          Affiliations
          [a ]Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710
          [b ]Department of Neurobiology, Duke University Medical Center, Durham, NC 27710
          Author notes
          Correspondence should be addressed: Ru-Rong Ji, PhD, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, 27710, ru-rong.ji@ 123456duke.edu
          Article
          PMC6051899 PMC6051899 6051899 nihpa935636
          10.1097/ALN.0000000000002130
          6051899
          29462012
          d332df93-e60c-4e19-bd68-e77c0fc33b01
          Categories
          Article

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