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2015 ; 11
(ä): 63
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Novel cytogenic and neurovascular niches due to blood-brain barrier compromise in
the chronic pain brain
#MMPMID26453186
Tajerian M
; Clark JD
Mol Pain
2015[Oct]; 11
(ä): 63
PMID26453186
show ga
BACKGROUND: The mechanisms by which painful injuries are linked to the multitude
of pain-related comorbidities and neuroplastic changes in the brain remain poorly
understood. Here we propose a model that relies on epi-neuronal communication
through the vascular system to effect various brain structures. Specifically, we
hypothesize that the differential vulnerability of the blood-brain barrier (BBB)
in different brain regions is associated with region-specific neuroplastic and
neurovascular changes that are in turn associated with particular pain-related
comorbidities. PRESENTATION OF THE HYPOTHESIS: We will present our hypothesis by
focusing on two main points: (A) chronic pain (CP) is associated with
differential BBB compromise. (B) Circulating mediators leaking through the BBB
create cytogenic and neovascular niches associated with pain-related
co-morbidities. TESTING THE HYPOTHESIS: Pre-clinically, our hypothesis can be
tested by observing, in parallel, BBB compromise, (neo)vascularization,
neurogenesis, and their co-localization in animal pain models using imaging,
microscopy, biochemical and other tools. Furthermore, the BBB can be
experimentally damaged in specific brain regions, and the consequences of those
lesions studied on nociception and associated comorbidities. Recently developed
imaging techniques allow the analysis of blood brain barrier integrity in
patients providing a route for translation of the laboratory findings. Though
perhaps more limited, post-mortem examination of brains with available pain
histories constitutes a second approach to addressing this hypothesis.
IMPLICATIONS OF THE HYPOTHESIS: Understanding changes in BBB permeability in
chronic pain conditions has clear implications both for understanding the
pathogenesis of chronic pain and for the design of novel treatments to prevent
chronic pain and its consequences. More broadly, this hypothesis may help us to
understand how peripheral injuries impact the brain via mechanisms other than
commonly studied efferent sensory pathways.