期刊
PHYSIOLOGY
卷 36, 期 5, 页码 315-323出版社
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/physiol.00014.2021
关键词
enteric neurons; epithelial barrier; microbiome; opioid; tolerance
类别
资金
- National Institutes of Health [P30 DA-033934, R01 DA-03675, T32 DA007027, R25 GM-090084]
Bidirectional interactions between the gut epithelium and commensal bacteria are crucial for maintaining gut homeostasis. Chronic opioid exposure disrupts gut homeostasis through various neuro-immune-epithelial mechanisms, leading to the development of tolerance, a major factor in the current opioid crisis. The differences in molecular mechanisms of opioid tolerance between the enteric and central pain pathways present a significant challenge in managing chronic pain without adverse gastrointestinal effects.
Bidirectional interactions of the gut epithelium with commensal bacteria are critical for maintaining homeostasis within the gut. Chronic opioid exposure perturbs gut homeostasis through a multitude of neuro-immune-epithelial mechanisms, resulting in the development of analgesic tolerance, a major underpinning of the current opioid crisis. Differences in molecular mechanisms of opioid tolerance between the enteric and central pain pathways pose a significant challenge for managing chronic pain without untoward gastrointestinal effects.
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