Epigenetics of Pain Management

Although currently available therapeutics provide moderate relief from acute pain, therapeutic agents used for treating chronic pain are typically limited by adverse side effects, including tolerance, addiction, and constipation. Thus, there is a significant medical need for novel therapies devoid of serious adverse effects for the treatment of chronic pain. Histone deacetylase inhibitors and other epigenetic drugs, such as histone acetlytransferases inhibitors, have been shown to have a role in managing pain perception. This chapter will briefly review spinal and central pain pathways mediating nociception. We will discuss the animal models, which have enhanced our understanding of how epigenetic processes may play a role in the pathophysiological mechanisms of chronic pain. We will also review the basic molecular epigenetic mechanisms of pain processing, and throughout the chapter the authors have attempted to critically evaluate the latest research from both experimental animal models and human studies to highlight the role of epigenetic drugs in managing both acute and chronic pain. However, it is pertinent to note that the role of epigenetics in pain perception is a field in its infancy, and thus limited data is to hand of the exact molecular mechanisms that mediate pain perception.