title: Epigenetics of chronic pain after thoracic surgery.
abstract: OBJECTIVE
  Chronic pain after surgery is a major public health problem and a major concern for perioperative physicians. Thoracic surgery presents a unique challenge, as thoracotomy is among the highest risk surgeries to develop persistent postsurgical pain. The purpose of this review is to discuss the relevance of research in pain epigenetics to patients with persistent pain after thoracic surgery.
  
  
  RESULTS
  Recent advances have linked chronic pain states to genetic and epigenetic changes. Progress in our understanding of chronic pain has highlighted the importance of immune modulation of pain. It is possible that epigenetic changes driving chronic pain occur in the perioperative setting via histone modification and DNA methylation.
  
  
  CONCLUSIONS
  The transition from acute to chronic pain after thoracic surgery may be mediated by epigenetics. Here, we discuss epigenetic modifications that have been discovered in animal models of chronic pain that may predispose patients to persistent neuropathic pain after thoracic surgery.
authors.affiliation: aDepartment of Anesthesiology, Duke University Medical Center bDepartment of Anesthesiology, Durham VA Medical Center, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Mauck
authors.forename: Thomas
authors.initials: T
authors.lastname: Van de Ven
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Shaw
mesh_terms: D059350:Chronic Pain / Q000209:etiology / Q000235:genetics*; D019175:DNA Methylation / Q000235:genetics; D004777:Environment; D044127:Epigenesis, Genetic; D006657:Histones / Q000235:genetics; D006801:Humans; D009437:Neuralgia; D010149:Postoperative Pain / Q000235:genetics*; D019616:Thoracic Surgical Procedures / Q000379:methods*
chemical_list: D006657:Histones