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Trends Neurosci. 2009 Dec;32(12):611-8. doi: 10.1016/j.tins.2009.07.007. Epub 2009 Sep 24.

Critical role of nociceptor plasticity in chronic pain.

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Department of Oral and Maxillofacial Surgery and Division of Neuroscience, University of California, San Francisco, CA 94143-0440, USA.


The transition from acute to chronic pain states might be the most important challenge in research to improve clinical treatment of debilitating pain. We describe a recently identified mechanism of neuronal plasticity in primary afferent nociceptive nerve fibers (nociceptors) by which an acute inflammatory insult or environmental stressor can trigger long-lasting hypersensitivity of nociceptors to inflammatory cytokines. This phenomenon, "hyperalgesic priming," depends on the epsilon isoform of protein kinase C (PKCepsilon) and a switch in intracellular signaling pathways that mediate cytokine-induced nociceptor hyperexcitability. We discuss the impact of this discovery on our understanding of, and ultimately our ability to treat, a variety of enigmatic and debilitating pain conditions, including those associated with repetitive injury, and generalized pain conditions, such as fibromyalgia.

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