Plenary Session 4: Pain

The Point of No Return – Mechanisms Driving the Transition from Acute to Chronic Pain

Date/Time: Saturday, May 4, 2019 - 10:45 AM to 12:15 PM
Log in to Add to My Schedule

Description:

The Point of No Return – Mechanisms Driving the Transition from Acute to Chronic Pain
Jon Levine, MD, PhD - UC San Francisco

A definition for chronic pain that may be useful in mechanistically distinguishing it from acute pain will be proposed, and two mechanisms of transition to chronic pain discussed, to identify changes in the nervous system that makes pain persist despite the absence of apparent disease activity. In the first mechanism (Hyperalgesic Priming Type I) a molecular signaling pathway in the pain-transmitting sensory neuron responsible, for the transition from acute to chronic pain, and a second pathway that serves as a memory molecule for the persistence of the pain will be presented. The first mechanism involves a molecule, PKC epsilon, present in the pain-transmitting sensory nerve for which chemical compounds that inhibit its activity have been developed. Development of approaches to inhibit pain memory molecules, could be used to reverse mechanisms underlying chronic pain, in a number of clinical conditions. The second mechanism (Hyperalgesic Priming Type II), is induced by drugs used to treat pain, such as opioid analgesics, and may contribute to exacerbation or chronification of pain syndromes for which they are being used as a treatment. Furthermore, sexual dimorphism in the mechanisms of chronic pain will be presented. Finally, the potential role of these mechanisms in osteoarthritis will be presented.

Speaker(s):