Gut Feelings: Microbiota and Pain
Acute pain is intrinsic to our humanity and constitutes a protective warning mechanism to avoid further injury. Chronic pain instead, is one of the most common reasons why patients seek medical treatment. While many medications exist, chronic pain management, including abdominal pain, is challenging. The opioid crisis highlights the urgent need for new therapies, which in turn require the understanding of the complex mechanisms underlying pain pathways, and the context in which these pathways are activated. Elucidating these mechanisms and triggering factors would not only improve therapeutic development but also pave the way to new biomarkers and diagnostics. Both general physicians and gastroenterologists are frequently consulted by patients with chronic abdominal pain, which often leads to extensive diagnostic work-up to differentiate between underlying organic or functional causes. One of the most common functional causes of chronic abdominal pain is irritable bowel syndrome (IBS), a complex disorder of the gut-brain axis. Exciting new data has strongly implicated microbe-host interactions in the regulation of visceral pain perception. Most studies are preclinical or translational and identify novel bacterially mediated pathways involving the production of pain signalling molecules such as proteases and histamine. Identification of the microbes and mechanisms through which gut microbes and pathogens control visceral pain perception will open new avenues for diagnostics and treatment in the near future. In this Collection of Gut Microbes, four review articles and one original paper address this emerging topic, highlighting the current state of research on the role of bacteria and fungi in the regulation of pain, with emphasis on chronic abdominal pain, as well as potential avenues for new diagnostic and therapeutic developments.
Edited by
Elena Verdú(McMaster University, Hamilton, Canada)
Stephen Vanner(Queen´s University, Kingston, Canada)