Dworsky-Fried Zoë, Kerr Bradley J, Taylor Anna M W
Department of Pharmacology, University of Alberta, Edmonton T6G2H7, Canada.
Neuroscience and Mental Health Institute, University of Alberta, Edmonton T6G2H7, Canada.
Neurobiol Pain. 2020 Jan 29;7:100045. doi: 10.1016/j.ynpai.2020.100045. eCollection 2020 Jan-Jul.
Globally, it is estimated that one in five people suffer from chronic pain, with prevalence increasing with age. The pathophysiology of chronic pain encompasses complex sensory, immune, and inflammatory interactions within both the central and peripheral nervous systems. Microglia, the resident macrophages of the central nervous system (CNS), are critically involved in the initiation and persistence of chronic pain. Microglia respond to local signals from the CNS but are also modulated by signals from the gastrointestinal tract. Emerging data from preclinical and clinical studies suggest that communication between the gut microbiome, the community of bacteria residing within the gut, and microglia is involved in producing chronic pain. Targeted strategies that manipulate or restore the gut microbiome have been shown to reduce microglial activation and alleviate symptoms associated with inflammation. These data indicate that manipulations of the gut microbiome in chronic pain patients might be a viable strategy in improving pain outcomes. Herein, we discuss the evidence for a connection between microglia and the gut microbiome and explore the mechanisms by which commensal bacteria might influence microglial reactivity to drive chronic pain.
据估计，全球五分之一的人患有慢性疼痛，且患病率随年龄增长而上升。慢性疼痛的病理生理学包括中枢神经系统和外周神经系统内复杂的感觉、免疫和炎症相互作用。小胶质细胞是中枢神经系统（CNS）中的常驻巨噬细胞，在慢性疼痛的发生和持续中起关键作用。小胶质细胞对来自中枢神经系统的局部信号作出反应，但也受到来自胃肠道信号的调节。临床前和临床研究的新数据表明，肠道微生物群（存在于肠道内的细菌群落）与小胶质细胞之间的通讯参与了慢性疼痛的产生。已证明，操纵或恢复肠道微生物群的靶向策略可减少小胶质细胞的激活，并减轻与炎症相关的症状。这些数据表明，对慢性疼痛患者的肠道微生物群进行调控可能是改善疼痛结局的可行策略。在此，我们讨论小胶质细胞与肠道微生物群之间存在联系的证据，并探讨共生细菌可能影响小胶质细胞反应性以引发慢性疼痛的机制。
