One immune system plays many parts: The dynamic role of the immune system in chronic pain and opioid pharmacology

Neuropharmacology. 2023 May 1:228:109459. doi: 10.1016/j.neuropharm.2023.109459. Epub 2023 Feb 11.

Abstract

The transition from acute to chronic pain is an ongoing major problem for individuals, society and healthcare systems around the world. It is clear chronic pain is a complex multidimensional biological challenge plagued with difficulties in pain management, specifically opioid use. In recent years the role of the immune system in chronic pain and opioid pharmacology has come to the forefront. As a highly dynamic and versatile network of cells, tissues and organs, the immune system is perfectly positioned at the microscale level to alter nociception and drive structural adaptations that underpin chronic pain and opioid use. In this review, we highlight the need to understand the dynamic and adaptable characteristics of the immune system and their role in the transition, maintenance and resolution of chronic pain. The complex multidimensional interplay of the immune system with multiple physiological systems may provide new transformative insight for novel targets for clinical management and treatment of chronic pain. This article is part of the Special Issue on "Opioid-induced changes in addiction and pain circuits".

Keywords: A20; Chronic pain; Fcγ receptors (FcγRs); Neuroimmune interactions; Toll-like receptors.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Analgesics, Opioid / pharmacology
  • Chronic Pain* / drug therapy
  • Humans
  • Immune System
  • Opioid-Related Disorders* / drug therapy
  • Pain Management

Substances

  • Analgesics, Opioid