[Future pain treatment].
BACKGROUND
The recent rapid progress in pain research is due in large part to advances in genetics and cell and molecular biology. We now know that chronic pain (hypersensitivity due to inflammation or nerve injury) and acute nociceptive pain are different and must be treated accordingly. We will continue to reveal sophisticated mechanisms underlying different kinds of pain that can be targeted to inhibit nociceptive transmission and produce analgesia.


METHODS
This review is based upon literature collected through the authors' own reading and through PubMed searches. New hopes for future pain treatments are discussed. Further, the impact of genetic factors on pain sensitivity and pain modulation are discussed, and conceivable therapeutic approaches based on genetic techniques are mentioned.


RESULTS
At the level of the peripheral nerve, many novel targets have recently been identified: the tetrodotoxin-resistant sodium channel, the vanilloid receptor and different calcium channels are very interesting. In the spinal cord, different approaches can be used: to either block excitatory input or to increase inhibitory control or to do both at the same time. The mechanisms for hypersensitivity are being identified and offer multiple possible targets for novel analgesics.


CONCLUSIONS
Many interesting targets for analgetics has emerged during that last few years, lending great hope for new and better (i.e. with less side effects) analgesic drugs in the future.
Rygh
L J
LJ
Fysiologisk institutt og Locus for Nevrovitenskapene Det medisinske fakultet Universitetet i Bergen Arstadveien 19 5009 Bergen. lars.jorgen.rygh@fys.uib.no
Fagerlund
T H
TH
Svendsen
F
F
D000698:Analgesia / Q000379:methods / Q000639:trends*; D000700:Analgesics / Q000008:administration & dosage / Q000493:pharmacokinetics; D000818:Animals; D015316:Genetic Therapy; D006801:Humans; D008959:Models, Neurological; D009473:Neuronal Plasticity / Q000187:drug effects / Q000235:genetics / Q000502:physiology; D009619:Nociceptors / Q000187:drug effects / Q000502:physiology; D010146:Pain / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology; D059408:Pain Management; D017933:Peripheral Nervous System / Q000187:drug effects / Q000502:physiology; D010597:Pharmacogenetics; D016194:Receptors, N-Methyl-D-Aspartate / Q000187:drug effects / Q000235:genetics / Q000502:physiology; D011957:Receptors, Opioid / Q000187:drug effects / Q000235:genetics / Q000502:physiology; D012106:Research; D013116:Spinal Cord / Q000187:drug effects / Q000502:physiology; D009435:Synaptic Transmission / Q000187:drug effects / Q000235:genetics / Q000502:physiology
D000700:Analgesics; D016194:Receptors, N-Methyl-D-Aspartate; D011957:Receptors, Opioid