title: Emerging targets in treating pain.
abstract: OBJECTIVE
  To provide an overview on drug targets and emerging pharmacological treatment options for chronic pain.
  
  
  RESULTS
  Chronic pain poses an enormous socioeconomic burden for the more than 30% of people who suffer from it, costing over $600 billion per year in the USA. In recent years, there has been a surge in preclinical and clinical research endeavors to try to stem this epidemic. Preclinical studies have identified a wide array of potential targets, with some of the most promising translational research being performed on novel opioid receptors, cannabinoid receptors, selective ion channel blockers, cytokine inhibitors, nerve growth factor inhibitors, N-methyl-D-aspartate receptor antagonists, glial cell inhibitors, and bisphosphonates.
  
  
  CONCLUSIONS
  There are many obstacles for the development of effective medications to treat chronic pain, including the inherent challenges in identifying pathophysiological mechanisms, the overlap and multiplicity of pain pathways, and off-target adverse effects stemming from the ubiquity of drug target receptor sites and the lack of highly selective receptor ligands. Despite these barriers, the number and diversity of potential therapies have continued to grow, to include disease-modifying and individualized drug treatments.
authors.affiliation: aAnesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland bAnesthesiology, MedStar Georgetown University Hospital, Washington, District of Columbia cAnesthesiology and Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine and Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Chang
authors.forename: Rahul
authors.initials: R
authors.lastname: Raghavan
authors.forename: Sandy
authors.initials: S
authors.lastname: Christiansen
authors.forename: Steven P
authors.initials: SP
authors.lastname: Cohen
mesh_terms: D059350:Chronic Pain / Q000188:drug therapy*; D016207:Cytokines / Q000037:antagonists & inhibitors; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D007473:Ion Channels / Q000037:antagonists & inhibitors; D020932:Nerve Growth Factor / Q000037:antagonists & inhibitors; D009457:Neuroglia; D059408:Pain Management / Q000379:methods*; D043882:Receptors, Cannabinoid / Q000187:drug effects; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors / Q000187:drug effects; D011957:Receptors, Opioid / Q000187:drug effects
chemical_list: D016207:Cytokines; D004164:Diphosphonates; D007473:Ion Channels; D043882:Receptors, Cannabinoid; D016194:Receptors, N-Methyl-D-Aspartate; D011957:Receptors, Opioid; D020932:Nerve Growth Factor