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524457 
Journal Article 
Peripheral mechanisms of pain and analgesia 
Stein, C; Clark, JD; Oh, U; Vasko, MR; Wilcox, GL; Overland, AC; Vanderah, TW; Spencer, RH 
2009 
Yes 
Brain Research Reviews
ISSN: 0165-0173 
60 
1 
90-113 
English 
This review summarizes recent findings on peripheral mechanisms underlying the generation and inhibition of pain. The focus is on events occurring in peripheral injured tissues that lead to the sensitization and excitation of primary afferent neurons, and on the modulation of such mechanisms. Primary afferent neurons are of particular interest from a therapeutic perspective because they are the initial generator of noxious impulses traveling towards relay stations in the spinal cord and the brain. Thus, if one finds ways to inhibit the sensitization and/or excitation of peripheral sensory neurons, subsequent central events such as wind-up, sensitization and plasticity may be prevented. Most importantly, if agents are found that selectively modulate primary afferent function and do not cross the blood-brain-barrier, centrally mediated untoward side effects of conventional analgesics (e.g. opioids, anticonvulsants) may be avoided. This article begins with the peripheral actions of opioids, turns to a discussion of the effects of adrenergic co-adjuvants, and then moves on to a discussion of pro-inflammatory mechanisms focusing on TRP channels and nerve growth factor, their signaling pathways and arising therapeutic perspectives. (C) 2008 Elsevier B.V. All rights reserved. 
Peripheral analgesia; Opioid receptor; Adrenergic receptor; Nerve; growth factor (NGF); Inflammation and cytokine; TRPV1; Primary; afferent; Pruritus; nerve growth-factor; mu-opioid-receptor; dorsal-root ganglia; rat; sensory neurons; corticotropin-releasing hormone; primary afferent; neurons; in-situ hybridization; gene-related peptide; protein-kinase-c; containing polymorphonuclear cells