Towards a neurobiological understanding of pain in chronic pancreatitis: mechanisms and implications for treatment

Publikation: Bidrag til tidsskriftReview (oversigtsartikel)Forskningpeer review

Standard

Towards a neurobiological understanding of pain in chronic pancreatitis : mechanisms and implications for treatment. / Olesen, Søren S; Krauss, Theresa; Demir, Ihsan Ekin; Wilder-Smith, Oliver H; Ceyhan, Güralp O; Pasricha, Pankaj J; Drewes, Asbjørn M.

I: Pain Reports, Bind 2, Nr. 6, e625, 2017.

Publikation: Bidrag til tidsskriftReview (oversigtsartikel)Forskningpeer review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{3b6664ed5b5742a79d4f9af9c054e7b1,
title = "Towards a neurobiological understanding of pain in chronic pancreatitis: mechanisms and implications for treatment",
abstract = "Introduction: Chronic pancreatitis (CP) is a disease characterized by inflammation of the pancreas resulting in replacement of the normal functioning parenchyma by fibrotic connective tissue. This process leads to progressively impairment of exocrine and endocrine function and many patients develop a chronic pain syndrome.Objectives: We aimed to characterize the neurobiological signature of pain associated with CP and to discuss its implications for treatment strategies.Methods: Relevant basic and clinical articles were selected for review following an extensive search of the literature.Results: Pathophysiological changes in the peripheral (pancreatic gland) and central nervous system characterize the pain syndrome associated with CP; involved mechanisms can be broken down to 3 main branches: (1) peripheral sensitization, (2) pancreatic neuropathy, and (3) neuroplastic changes in the central pain pathways. Disease flares (recurrent pancreatitis) may accelerate the pathophysiological process and further sensitize the pain system, which ultimately results in an autonomous and self-perpetuating pain state that may become independent of the peripheral nociceptive drive. These findings share many similarities with those observed in neuropathic pain disorders and have important implications for treatment; adjuvant analgesics are effective in a subset of patients, and neuromodulation and neuropsychological interventions may prove useful in the future.Conclusion: Chronic pancreatitis is associated with abnormal processing of pain at the peripheral and central level of the pain system. This neurobiological understanding of pain has important clinical implications for treatment and prevention of pain chronification.",
keywords = "Journal Article, Review",
author = "Olesen, {S{\o}ren S} and Theresa Krauss and Demir, {Ihsan Ekin} and Wilder-Smith, {Oliver H} and Ceyhan, {G{\"u}ralp O} and Pasricha, {Pankaj J} and Drewes, {Asbj{\o}rn M}",
year = "2017",
doi = "10.1097/PR9.0000000000000625",
language = "English",
volume = "2",
journal = "Pain Reports",
issn = "2471-2531",
publisher = "International Association for the Study of Pain",
number = "6",

}

RIS

TY - JOUR

T1 - Towards a neurobiological understanding of pain in chronic pancreatitis

T2 - Pain Reports

AU - Olesen, Søren S

AU - Krauss, Theresa

AU - Demir, Ihsan Ekin

AU - Wilder-Smith, Oliver H

AU - Ceyhan, Güralp O

AU - Pasricha, Pankaj J

AU - Drewes, Asbjørn M

PY - 2017

Y1 - 2017

N2 - Introduction: Chronic pancreatitis (CP) is a disease characterized by inflammation of the pancreas resulting in replacement of the normal functioning parenchyma by fibrotic connective tissue. This process leads to progressively impairment of exocrine and endocrine function and many patients develop a chronic pain syndrome.Objectives: We aimed to characterize the neurobiological signature of pain associated with CP and to discuss its implications for treatment strategies.Methods: Relevant basic and clinical articles were selected for review following an extensive search of the literature.Results: Pathophysiological changes in the peripheral (pancreatic gland) and central nervous system characterize the pain syndrome associated with CP; involved mechanisms can be broken down to 3 main branches: (1) peripheral sensitization, (2) pancreatic neuropathy, and (3) neuroplastic changes in the central pain pathways. Disease flares (recurrent pancreatitis) may accelerate the pathophysiological process and further sensitize the pain system, which ultimately results in an autonomous and self-perpetuating pain state that may become independent of the peripheral nociceptive drive. These findings share many similarities with those observed in neuropathic pain disorders and have important implications for treatment; adjuvant analgesics are effective in a subset of patients, and neuromodulation and neuropsychological interventions may prove useful in the future.Conclusion: Chronic pancreatitis is associated with abnormal processing of pain at the peripheral and central level of the pain system. This neurobiological understanding of pain has important clinical implications for treatment and prevention of pain chronification.

AB - Introduction: Chronic pancreatitis (CP) is a disease characterized by inflammation of the pancreas resulting in replacement of the normal functioning parenchyma by fibrotic connective tissue. This process leads to progressively impairment of exocrine and endocrine function and many patients develop a chronic pain syndrome.Objectives: We aimed to characterize the neurobiological signature of pain associated with CP and to discuss its implications for treatment strategies.Methods: Relevant basic and clinical articles were selected for review following an extensive search of the literature.Results: Pathophysiological changes in the peripheral (pancreatic gland) and central nervous system characterize the pain syndrome associated with CP; involved mechanisms can be broken down to 3 main branches: (1) peripheral sensitization, (2) pancreatic neuropathy, and (3) neuroplastic changes in the central pain pathways. Disease flares (recurrent pancreatitis) may accelerate the pathophysiological process and further sensitize the pain system, which ultimately results in an autonomous and self-perpetuating pain state that may become independent of the peripheral nociceptive drive. These findings share many similarities with those observed in neuropathic pain disorders and have important implications for treatment; adjuvant analgesics are effective in a subset of patients, and neuromodulation and neuropsychological interventions may prove useful in the future.Conclusion: Chronic pancreatitis is associated with abnormal processing of pain at the peripheral and central level of the pain system. This neurobiological understanding of pain has important clinical implications for treatment and prevention of pain chronification.

KW - Journal Article

KW - Review

U2 - 10.1097/PR9.0000000000000625

DO - 10.1097/PR9.0000000000000625

M3 - Review article

VL - 2

JO - Pain Reports

JF - Pain Reports

SN - 2471-2531

IS - 6

M1 - e625

ER -

ID: 268426609