Nawarathna Gayani, Fakhruddin Kausar S, Shorbagi Ali I S A, Samaranayake Lakshman P
Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, UAE.
Gut Microbiome (Camb). 2023 Jun 19;4:e10. doi: 10.1017/gmb.2023.7. eCollection 2023.
Environmental stressors can disrupt the gut-brain relationship and alter the gut microbial composition, potentially leading to chronic pain, including neuropathic pain (NP). To understand this complex relationship, we conducted a systematic scoping review to examine the gut microbial-neuroimmune connection to NP and the potential therapeutic targets. The review includes English-language manuscripts in databases such as MEDLINE, Cochrane, and DOAJ between January 2000 and April 2022. Out of the 48 full texts examined, only 15 articles met the inclusion criteria. These included a randomised controlled trial involving 327 individuals, an in vitro, and 13 animal model studies. The findings suggest that the gut flora plays a role in the immunological, neurological, and metabolic signalling pathways associated with NP. Animal studies have been the primary focus in this area, indicating that an imbalanced-gut microbiome and subsequent activation of biochemical and neuro-immunologic pathways may influence the development of NP. This review provides a comprehensive summary of the gut microbiome-immune-NP axis and identifies potential therapeutic targets. However, since most of the evidence comes from animal studies, future research should include clinical trials to gain a better understanding of the role of gut microbiota in NP and discover new therapeutic strategies.
环境应激源可破坏肠道与大脑的关系，改变肠道微生物组成，可能导致慢性疼痛，包括神经性疼痛（NP）。为了解这种复杂关系，我们进行了一项系统的范围综述，以研究肠道微生物与神经免疫的联系以及NP的潜在治疗靶点。该综述纳入了2000年1月至2022年4月期间MEDLINE、Cochrane和DOAJ等数据库中的英文手稿。在审查的48篇全文中，只有15篇文章符合纳入标准。这些文章包括一项涉及327人的随机对照试验、一项体外研究和13项动物模型研究。研究结果表明，肠道菌群在与NP相关的免疫、神经和代谢信号通路中发挥作用。动物研究一直是该领域的主要关注点，表明肠道微生物群失衡以及随后生化和神经免疫通路的激活可能影响NP的发展。本综述全面总结了肠道微生物群-免疫-NP轴，并确定了潜在的治疗靶点。然而，由于大多数证据来自动物研究，未来的研究应包括临床试验，以更好地了解肠道微生物群在NP中的作用，并发现新的治疗策略。
