Abstract

Recently, a growing body of evidence has emerged regarding the interplay between microbiota and the nervous system. This relationship has been associated with several pathological conditions and also with the onset and regulation of pain. Dysregulation of the axis leads to a huge variety of diseases such as visceral hypersensitivity, stress-induced hyperalgesia, allodynia, inflammatory pain and functional disorders. In pain management, probiotics have shown promising results. This narrative review describes the peripheral and central mechanisms underlying pain processing and regulation, highlighting the role of the gut-brain axis in the modulation of pain. We summarized the main findings in regard to the stress impact on microbiota’s composition and its influence on pain perception. We also focused on the relationship between gut microbiota and both visceral and inflammatory pain and we provided a summary of the main evidence regarding the mechanistic effects and probiotics use.

Highlights

  • Pain is a natural protective mechanism of the body that arises from nociceptors and involves the interaction of different neuroanatomic and neurochemical systems

  • We aim to provide a comprehensive overview regarding the influence of gut microbiota on pain perception and the potential application of probiotics in pain management

  • Animal models pointed out that the use of antibiotics early in life produces long-lasting enhancement of visceral pain through alteration of gut microbiota, such as increased visceral hypersensitivity to colorectal distension, as observed in rats treated with vancomycin, whose effect was dependent on the time of exposure [5,72]

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Summary

Introduction

Pain is a natural protective mechanism of the body that arises from nociceptors and involves the interaction of different neuroanatomic and neurochemical systems. Chronic pain (which has a duration of more than three months) is a persistent pain associated with injury, disorders or diseases (i.e., arthritis, functional gastrointestinal disorders, inflammatory bowel diseases, diabetes or tumor growth) This can be a consequence of damage to nerve fibers which leads to an increased spontaneous firing or alterations in their conduction or neurotransmitter properties [3]. Still limited, emerging research reports the involvement of the gut microbiota in the release of signal molecules (i.e., metabolites, neurotransmitters, neuromodulators), which are directly involved in pain transmission and modulation [5] In this narrative review, we aim to provide a comprehensive overview regarding the influence of gut microbiota on pain perception and the potential application of probiotics in pain management

The Pathway of Pain at a Glance
Microbiota and Gut-Brain Axis
Microbiota and Pain Regulation
Visceral Pain
Inflammatory Pain
Peripheral and Central Mechanism of Pain Regulation
Conclusions
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