Stabilizing the neural barrier - A novel approach in pain therapy

Ann-Kristin Reinhold; Beate Hartmannsberger; Malgorzata Burek; Heike L Rittner

doi:10.1016/j.pharmthera.2023.108484

Stabilizing the neural barrier - A novel approach in pain therapy

Pharmacol Ther. 2023 Sep:249:108484. doi: 10.1016/j.pharmthera.2023.108484. Epub 2023 Jun 28.

Authors

Ann-Kristin Reinhold¹, Beate Hartmannsberger¹, Malgorzata Burek¹, Heike L Rittner²

Affiliations

¹ University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Oberdürrbacher Str. 6, 97080 Würzburg, Germany.
² University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Oberdürrbacher Str. 6, 97080 Würzburg, Germany. Electronic address: Rittner_h@ukw.de.

PMID: 37390969
DOI: 10.1016/j.pharmthera.2023.108484

Abstract

Chronic and neuropathic pain are a widespread burden. Incomplete understanding of underlying pathomechanisms is one crucial factor for insufficient treatment. Recently, impairment of the blood nerve barrier (BNB) has emerged as one key aspect of pain initiation and maintenance. In this narrative review, we discuss several mechanisms and putative targets for novel treatment strategies. Cells such as pericytes, local mediators like netrin-1 and specialized proresolving mediators (SPMs), will be covered as well as circulating factors including the hormones cortisol and oestrogen and microRNAs. They are crucial in either the BNB or similar barriers and associated with pain. While clinical studies are still scarce, these findings might provide valuable insight into mechanisms and nurture development of therapeutic approaches.

Keywords: Blood-nerve barrier; Cortisol; Netrin-1; Neuropathic pain; Oestrogen; Resolvin; microRNA.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Blood-Nerve Barrier / physiology
Humans
MicroRNAs*
Neuralgia*
Pericytes / physiology

Substances

MicroRNAs