Zhao Minghe, Zhang Ling, Liu Zhihui
Department of Anesthesiology, Baotou Central Hospital, Baotou, China.
Baotou Clinical Medical College, Inner Mongolia Medical University, Baotou, China.
Front Pain Res (Lausanne). 2025 Jul 3;6:1626515. doi: 10.3389/fpain.2025.1626515. eCollection 2025.
Emerging evidence has illuminated the pivotal role of gut microbiota in modulating pain sensitivity through bidirectional gut-brain interactions. Current research demonstrates that gut microbial communities significantly influence pain perception by regulating both central and peripheral sensitization mechanisms across various pain modalities. This review synthesizes current knowledge on the mechanisms underlying gut microbiota-mediated pain sensitization, encompassing: (1) cross-talk within the microbiome-gut-brain axis, (2) regulatory effects of microbial metabolites on central and peripheral sensitization pathways, and (3) bioactive compounds derived from gut microbiota that participate in pain modulation. Furthermore, we systematically evaluate the therapeutic potential of microbiota-targeted interventions including probiotic supplementation, fecal microbiota transplantation, and dietary modifications in pain management. To advance this promising field, future investigations should prioritize three key directions: establishing causal relationships through rigorous verification, accelerating clinical translation of preclinical findings, and developing personalized microbial-based therapeutic strategies.
新出现的证据表明，肠道微生物群通过双向肠-脑相互作用在调节疼痛敏感性方面发挥着关键作用。目前的研究表明，肠道微生物群落通过调节各种疼痛模式下的中枢和外周敏化机制，对疼痛感知有显著影响。本综述综合了目前关于肠道微生物群介导的疼痛敏化机制的知识，包括：（1）微生物群-肠-脑轴内的相互作用，（2）微生物代谢产物对中枢和外周敏化途径的调节作用，以及（3）源自肠道微生物群的生物活性化合物参与疼痛调节。此外，我们系统地评估了以微生物群为靶点的干预措施在疼痛管理中的治疗潜力，包括补充益生菌、粪便微生物群移植和饮食调整。为了推动这一有前景的领域发展，未来的研究应优先考虑三个关键方向：通过严格验证建立因果关系、加速临床前研究结果的临床转化，以及制定基于微生物群的个性化治疗策略。
