Odell Daniel W
Division of Pain Medicine, Department of Anesthesiology, University of Utah and Supportive Oncology and Survivorship, Huntsman Cancer Hospital, Salt Lake City, Utah, USA.
Curr Opin Anaesthesiol. 2018 Aug;31(4):402-406. doi: 10.1097/ACO.0000000000000613.
The field of epigenetics continues its influential rise as a means to better understand an organism's unique developmental identity over a lifespan. Whereas a genome is constant and unchanging, an epigenome is dynamic and alterable. Epigenetic changes are in response to innumerable internal and external influences including environmental changes such as diet, exercise, disease, toxins, and stress. Epigenetics is of particular interest in the medical research community both for the potential to cause disease and as a target for therapeutic interventions. This article provides a succinct explanation of the potential for epigenetics to influence the understanding of pain as well as a review of relevant research on the topic.
Studies on epigenetics and pain remain largely preclinical and investigate the theoretical ability of epigenetics to alter the nociceptive pathways both in the periphery and centrally. Significant evidence now exists for the ability of epigenetics to modify broadly categorized pain types, including inflammatory, neuropathic, visceral, and cancer related.
Both patients and providers recognize that novel medications for the treatment of both acute and chronic pain conditions are sorely needed. The understanding of epigenetics and its influence on nociception remains in relative infancy but early evidence is strong for potential therapeutic benefits to treat these conditions.
表观遗传学领域作为一种更好地理解生物体在整个生命周期中独特发育特征的手段，其影响力持续上升。基因组是恒定不变的，而表观基因组是动态且可改变的。表观遗传变化是对无数内部和外部影响的响应，包括饮食、运动、疾病、毒素和压力等环境变化。表观遗传学在医学研究领域备受关注，既因其具有引发疾病的可能性，也因其可作为治疗干预的靶点。本文简要解释了表观遗传学在影响疼痛理解方面的潜力，并对该主题的相关研究进行了综述。
关于表观遗传学与疼痛的研究大多仍处于临床前阶段，主要探讨表观遗传学在外周和中枢改变伤害感受通路的理论能力。目前有大量证据表明，表观遗传学能够改变广泛分类的疼痛类型，包括炎症性疼痛、神经性疼痛、内脏性疼痛和癌症相关疼痛。
患者和医疗服务提供者都认识到，治疗急慢性疼痛的新型药物极为迫切需要。对表观遗传学及其对伤害感受的影响的理解仍处于相对初期阶段，但早期证据有力地表明其在治疗这些疾病方面具有潜在的治疗益处。
