The neuropathic pain triad: neurons, immune cells and glia

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Nat Neurosci. 2007 Nov;10(11):1361-8.

The neuropathic pain triad: neurons, immune cells and glia.

Scholz J, Woolf CJ.

Neural Plasticity Research Group, Department of Anesthesia and

Critical Care, Massachusetts General Hospital and Harvard Medical

School, town, Massachusetts 02129, USA.

Nociceptive pain results from the detection of intense or noxious

stimuli by specialized high-threshold sensory neurons (nociceptors),

a transfer of action potentials to the spinal cord, and onward

transmission of the warning signal to the brain. In contrast,

clinical pain such as pain after nerve injury (neuropathic pain) is

characterized by pain in the absence of a stimulus and reduced

nociceptive thresholds so that normally innocuous stimuli produce

pain. The development of neuropathic pain involves not only neuronal

pathways, but also Schwann cells, satellite cells in the dorsal root

ganglia, components of the peripheral immune system, spinal microglia

and astrocytes. As we increasingly appreciate that neuropathic pain

has many features of a neuroimmune disorder, immunosuppression and

blockade of the reciprocal signaling pathways between neuronal and

non-neuronal cells offer new opportunities for disease modification

and more successful management of pain.