Microbiota: a novel regulator of pain

J Neural Transm (Vienna). 2020 Apr;127(4):445-465. doi: 10.1007/s00702-019-02083-z. Epub 2019 Sep 24.

Abstract

Among the various regulators of the nervous system, the gut microbiota has been recently described to have the potential to modulate neuronal cells activation. While bacteria-derived products can induce aversive responses and influence pain perception, recent work suggests that "abnormal" microbiota is associated with neurological diseases such as Alzheimer's, Parkinson's disease or autism spectrum disorder (ASD). Here we review how the gut microbiota modulates afferent sensory neurons function and pain, highlighting the role of the microbiota/gut/brain axis in the control of behaviors and neurological diseases. We outline the changes in gut microbiota, known as dysbiosis, and their influence on painful gastrointestinal disorders. Furthermore, both direct host/microbiota interaction that implicates activation of "pain-sensing" neurons by metabolites, or indirect communication via immune activation is discussed. Finally, treatment options targeting the gut microbiota, including pre- or probiotics, will be proposed. Further studies on microbiota/nervous system interaction should lead to the identification of novel microbial ligands and host receptor-targeted drugs, which could ultimately improve chronic pain management and well-being.

Keywords: Microbiota; Microbiota/gut/brain axis; Probiotic treatment; Visceral pain.

Publication types

  • Review

MeSH terms

  • Autism Spectrum Disorder* / etiology
  • Autism Spectrum Disorder* / immunology
  • Autism Spectrum Disorder* / metabolism
  • Autism Spectrum Disorder* / physiopathology
  • Chronic Pain* / etiology
  • Chronic Pain* / immunology
  • Chronic Pain* / metabolism
  • Chronic Pain* / physiopathology
  • Cystitis, Interstitial* / etiology
  • Cystitis, Interstitial* / immunology
  • Cystitis, Interstitial* / metabolism
  • Cystitis, Interstitial* / physiopathology
  • Dysbiosis* / complications
  • Dysbiosis* / immunology
  • Dysbiosis* / metabolism
  • Dysbiosis* / physiopathology
  • Gastrointestinal Microbiome / physiology*
  • Humans
  • Inflammatory Bowel Diseases* / etiology
  • Inflammatory Bowel Diseases* / immunology
  • Inflammatory Bowel Diseases* / metabolism
  • Inflammatory Bowel Diseases* / physiopathology
  • Irritable Bowel Syndrome* / etiology
  • Irritable Bowel Syndrome* / immunology
  • Irritable Bowel Syndrome* / metabolism
  • Irritable Bowel Syndrome* / physiopathology
  • Neurons, Afferent* / immunology
  • Neurons, Afferent* / metabolism
  • Neurons, Afferent* / microbiology
  • Nociception / physiology*
  • Visceral Pain* / etiology
  • Visceral Pain* / immunology
  • Visceral Pain* / metabolism
  • Visceral Pain* / physiopathology