1 800 121 CELLULAR, MOLECULAR, AND EPIGENETIC MECHANISMS IN NON-ASSOCIATIVE CONDITIONING: IMPLICATIONS FOR PAIN AND MEMORY. SENSITIZATION IS A FORM OF NON-ASSOCIATIVE CONDITIONING IN WHICH AMPLIFICATION OF BEHAVIORAL RESPONSES CAN OCCUR FOLLOWING PRESENTATION OF AN AVERSIVE OR NOXIOUS STIMULUS. UNDERSTANDING THE CELLULAR AND MOLECULAR UNDERPINNINGS OF SENSITIZATION HAS BEEN AN OVERARCHING THEME SPANNING THE FIELD OF LEARNING AND MEMORY AS WELL AS THAT OF PAIN RESEARCH. IN THIS REVIEW WE EXAMINE HOW SENSITIZATION, BOTH IN THE CONTEXT OF LEARNING AS WELL AS PAIN PROCESSING, SHARES EVOLUTIONARILY CONSERVED BEHAVIORAL, CELLULAR/SYNAPTIC, AND EPIGENETIC MECHANISMS ACROSS PHYLA. FIRST, WE CHARACTERIZE THE BEHAVIORAL PHENOMENON OF SENSITIZATION BOTH IN INVERTEBRATES AND VERTEBRATES. PARTICULAR EMPHASIS IS PLACED ON LONG-TERM SENSITIZATION (LTS) OF WITHDRAWAL REFLEXES IN APLYSIA FOLLOWING AVERSIVE STIMULATION OR INJURY, ALTHOUGH ADDITIONAL INVERTEBRATE MODELS ARE ALSO COVERED. IN THE CONTEXT OF VERTEBRATES, SENSITIZATION OF MAMMALIAN HYPERAROUSAL IN A MODEL OF POST-TRAUMATIC STRESS DISORDER (PTSD), AS WELL AS MAMMALIAN MODELS OF INFLAMMATORY AND NEUROPATHIC PAIN IS CHARACTERIZED. SECOND, WE INVESTIGATE THE CELLULAR AND SYNAPTIC MECHANISMS UNDERLYING THESE BEHAVIORS. WE FOCUS OUR DISCUSSION ON SEROTONIN-MEDIATED LONG-TERM FACILITATION (LTF) AND AXOTOMY-MEDIATED LONG-TERM HYPEREXCITABILITY (LTH) IN REDUCED APLYSIA SYSTEMS, AS WELL AS MAMMALIAN SPINAL PLASTICITY MECHANISMS OF CENTRAL SENSITIZATION. THIRD, WE EXPLORE RECENT EVIDENCE IMPLICATING EPIGENETIC MECHANISMS IN LEARNING- AND PAIN-RELATED SENSITIZATION. THIS REVIEW ILLUSTRATES THE FUNDAMENTAL AND FUNCTIONAL OVERLAY OF THE LEARNING AND MEMORY FIELD WITH THE PAIN FIELD WHICH ARGUES FOR HOMOLOGOUS PERSISTENT PLASTICITY MECHANISMS IN RESPONSE TO SENSITIZING STIMULI OR INJURY ACROSS PHYLA. 2013 2 6912 31 [UNDERSTANDING OF THE PSYCHIATRY IN PALLIATIVE CARE: DYSFUNCTION OF THE REWARDING SYSTEM UNDER THE PAIN STATE ASSOCIATED WITH EXACERBATING PAIN]. RECENT HUMAN BRAIN IMAGING STUDIES HAVE EXAMINED DIFFERENCES IN ACTIVITY IN THE NUCLEUS ACCUMBENS (N.ACC.) IN RESPONSE TO HEAT STIMULI BETWEEN CONTROLS AND PATIENTS WITH CHRONIC PAIN, AND HAVE REVEALED THAT THE N.ACC. PLAYS A ROLE IN PREDICTING THE VALUE OF A NOXIOUS STIMULUS AND ITS OFFSET, AND IN THE CONSEQUENT CHANGES IN THE MOTIVATIONAL STATE. NEVERTHELESS, THE MOLECULAR MECHANISMS OF CHANGE IN THE CIRCUITRY INVOLVED IN EMOTION AND MOTIVATION IN RESPONSE TO CHRONIC PAIN STIMULI WERE NOT FULLY EXPLORED. ON THE OTHER HAND, IT HAS BEEN CONSIDERED THAT MICRO RNAS (MIRNAS) PLAY IMPORTANT ROLES AS KEY MODULATORS OF POST-TRANSCRIPTIONAL GENE EXPRESSION. WE HAVE REPORTED THAT CHANGES IN MIRNAS ARE ASSOCIATED WITH PREDICTED CHANGES IN GENE EXPRESSION OF CANDIDATE TARGETS IN THE N.ACC. UNDER NEUROPATHIC PAIN. THEREFORE, WE HAVE INTRODUCED A NEW INSIGHT INTO AN EPIGENETIC DYSFUNCTION OF "MESOLIMBIC MOTIVATION/VALUATION CIRCUITRY" UNDER A NEUROPATHIC PAIN-LIKE STATE. THESE FINDINGS RAISE INTRIGUING POSSIBILITIES THAT MIRNA-MODULATING CELLULAR EVENTS ALONG WITH EPIGENETIC MODIFICATIONS MAY BE ASSOCIATED WITH NEURAL PLASTICITY AND NEURONAL ADAPTIVE RESPONSES IN MESOLIMBIC MOTIVATION/VALUATION CIRCUITRY UNDER WHICH THE NEUROPATHIC PAIN MAY INDUCE NEGATIVE EMOTIONS, EXACERBATING PAIN. 2013 3 5051 38 PHARMACOLOGICAL RESCUE OF NOCICEPTIVE HYPERSENSITIVITY AND OXYTOCIN ANALGESIA IMPAIRMENT IN A RAT MODEL OF NEONATAL MATERNAL SEPARATION. OXYTOCIN (OT), KNOWN FOR ITS NEUROHORMONAL EFFECTS AROUND BIRTH, HAS RECENTLY BEEN SUGGESTED FOR BEING A CRITICAL DETERMINANT IN NEURODEVELOPMENTAL DISORDERS. THIS HYPOTHALAMIC NEUROPEPTIDE EXERTS A POTENT ANALGESIC EFFECT THROUGH AN ACTION ON THE NOCICEPTIVE SYSTEM. THIS ENDOGENOUS CONTROL OF PAIN HAS AN IMPORTANT ADAPTIVE VALUE BUT MIGHT BE ALTERED BY EARLY LIFE STRESS, POSSIBLY CONTRIBUTING TO ITS LONG-TERM CONSEQUENCES ON PAIN RESPONSES AND ASSOCIATED COMORBIDITIES. WE TESTED THIS HYPOTHESIS USING A RAT MODEL OF NEONATAL MATERNAL SEPARATION (NMS) KNOWN TO INDUCE LONG-TERM CONSEQUENCES ON SEVERAL BRAIN FUNCTIONS INCLUDING CHRONIC STRESS, ANXIETY, ALTERED SOCIAL BEHAVIOR, AND VISCERAL HYPERSENSITIVITY. WE FOUND THAT ADULT RATS WITH A HISTORY OF NMS WERE HYPERSENSITIVE TO NOXIOUS MECHANICAL/THERMAL HOT STIMULI AND TO INFLAMMATORY PAIN. WE FAILED TO OBSERVE OT RECEPTOR-MEDIATED STRESS-INDUCED ANALGESIA AND OT ANTIHYPERALGESIA AFTER CARRAGEENAN INFLAMMATION. THESE ALTERATIONS WERE PARTIALLY RESCUED IF NMS PUPS WERE TREATED BY INTRAPERITONEAL DAILY INJECTION DURING NMS WITH OT OR ITS DOWNSTREAM SECOND MESSENGER ALLOPREGNANOLONE. THE INVOLVEMENT OF EPIGENETIC CHANGES IN THESE ALTERATIONS WAS CONFIRMED SINCE NEONATAL TREATMENT WITH THE HISTONE DEACETYLASE INHIBITOR SAHA, NOT ONLY NORMALIZED NOCICEPTIVE SENSITIVITIES BUT ALSO RESTORED OT RECEPTOR-MEDIATED STRESS-INDUCED ANALGESIA AND THE ENDOGENOUS ANTIHYPERALGESIA IN INFLAMED NMS RATS. THERE IS GROWING EVIDENCE IN THE LITERATURE THAT EARLY LIFE STRESS MIGHT IMPAIR THE NOCICEPTIVE SYSTEM ONTOGENY AND FUNCTION. THIS STUDY SUGGESTS THAT THESE ALTERATIONS MIGHT BE RESTORED WHILE STIMULATING OT RECEPTOR SIGNALING OR HISTONE DEACETYLASE INHIBITORS, USING MOLECULES THAT ARE CURRENTLY AVAILABLE OR PART OF CLINICAL TRIALS FOR OTHER PATHOLOGIES. 2018 4 2053 29 EPIGENETIC CONNECTIONS OF THE TRPA1 ION CHANNEL IN PAIN TRANSMISSION AND NEUROGENIC INFLAMMATION - A THERAPEUTIC PERSPECTIVE IN MIGRAINE? PERSISTENT REPROGRAMMING OF EPIGENETIC PATTERN LEADS TO CHANGES IN GENE EXPRESSION OBSERVED IN MANY NEUROLOGICAL DISORDERS. TRANSIENT RECEPTOR POTENTIAL CATION CHANNEL SUBFAMILY A MEMBER 1 (TRPA1), A MEMBER OF THE TRP CHANNELS SUPERFAMILY, IS ACTIVATED BY MANY MIGRAINE TRIGGERS AND EXPRESSED IN TRIGEMINAL NEURONS AND BRAIN REGIONS THAT ARE IMPORTANT IN MIGRAINE PATHOGENESIS. TRP CHANNELS CHANGE NOXIOUS STIMULI INTO PAIN SIGNALS WITH THE INVOLVEMENT OF EPIGENETIC REGULATION. THE EXPRESSION OF THE TRPA1 ENCODING GENE, TRPA1, IS MODULATED IN PAIN-RELATED SYNDROMES BY EPIGENETIC ALTERATIONS, INCLUDING DNA METHYLATION, HISTONE MODIFICATIONS, AND EFFECTS OF NON-CODING RNAS: MICRO RNAS (MIRNAS), LONG NON-CODING RNAS, AND CIRCULAR RNAS. TRPA1 MAY CHANGE EPIGENETIC PROFILE OF MANY PAIN-RELATED GENES AS IT MAY MODIFY ENZYMES RESPONSIBLE FOR EPIGENETIC MODIFICATIONS AND EXPRESSION OF NON-CODING RNAS. TRPA1 MAY INDUCE THE RELEASE OF CALCITONIN GENE RELATED PEPTIDE (CGRP), FROM TRIGEMINAL NEURONS AND DURAL TISSUE. THEREFORE, EPIGENETIC REGULATION OF TRPA1 MAY PLAY A ROLE IN EFFICACY AND SAFETY OF ANTI-MIGRAINE THERAPIES TARGETING TRP CHANNELS AND CGRP. TRPA1 IS ALSO INVOLVED IN NEUROGENIC INFLAMMATION, IMPORTANT IN MIGRAINE PATHOGENESIS. THE FUNDAMENTAL ROLE OF TRPA1 IN INFLAMMATORY PAIN TRANSMISSION MAY BE EPIGENETICALLY REGULATED. IN CONCLUSION, EPIGENETIC CONNECTIONS OF TRPA1 MAY PLAY A ROLE IN EFFICACY AND SAFETY OF ANTI-MIGRAINE THERAPY TARGETING TRP CHANNELS OR CGRP AND THEY SHOULD BE FURTHER EXPLORED FOR EFFICIENT AND SAFE ANTIMIGRAINE TREATMENT. THIS NARRATIVE/PERSPECTIVE REVIEW PRESENTS INFORMATION ON THE STRUCTURE AND FUNCTIONS OF TRPA1 AS WELL AS ROLE OF ITS EPIGENETIC CONNECTIONS IN PAIN TRANSMISSION AND POTENTIAL IN MIGRAINE THERAPY. 2023 5 2310 34 EPIGENETIC REGULATION OF CHRONIC PAIN. CHRONIC PAIN ARISING FROM PERIPHERAL INFLAMMATION AND TISSUE OR NERVE INJURY IS A COMMON CLINICAL SYMPTOM. ALTHOUGH INTENSIVE RESEARCH ON THE NEUROBIOLOGICAL MECHANISMS OF CHRONIC PAIN HAS BEEN CARRIED OUT DURING PREVIOUS DECADES, THIS DISORDER IS STILL POORLY MANAGED BY CURRENT DRUGS SUCH AS OPIOIDS AND NONSTEROIDAL ANTI-INFLAMMATORY DRUGS. INFLAMMATION, TISSUE INJURY AND/OR NERVE INJURY-INDUCED CHANGES IN GENE EXPRESSION IN SENSORY NEURONS OF THE DORSAL ROOT GANGLION, SPINAL CORD DORSAL HORN AND PAIN-ASSOCIATED BRAIN REGIONS ARE THOUGHT TO PARTICIPATE IN CHRONIC PAIN GENESIS; HOWEVER, HOW THESE CHANGES OCCUR IS STILL ELUSIVE. EPIGENETIC MODIFICATIONS INCLUDING DNA METHYLATION AND COVALENT HISTONE MODIFICATIONS CONTROL GENE EXPRESSION. RECENT STUDIES HAVE SHOWN THAT PERIPHERAL NOXIOUS STIMULATION CHANGES DNA METHYLATION AND HISTONE MODIFICATIONS AND THAT THESE CHANGES MAY BE RELATED TO THE INDUCTION OF PAIN HYPERSENSITIVITY UNDER CHRONIC PAIN CONDITIONS. THIS REVIEW SUMMARIZES THE CURRENT KNOWLEDGE AND PROGRESS IN EPIGENETIC RESEARCH IN CHRONIC PAIN AND DISCUSSES THE POTENTIAL ROLE OF EPIGENETIC MODIFICATIONS AS THERAPEUTIC ANTINOCICEPTIVE TARGETS IN THIS DISORDER. 2015 6 1126 37 COMPLEX REGULATION OF THE REGULATOR OF SYNAPTIC PLASTICITY HISTONE DEACETYLASE 2 IN THE RODENT DORSAL HORN AFTER PERIPHERAL INJURY. HISTONE DEACETYLASES (HDACS), HDAC2 IN PARTICULAR, HAVE BEEN SHOWN TO REGULATE VARIOUS FORMS OF LEARNING AND MEMORY. SINCE COGNITIVE PROCESSES SHARE MECHANISMS WITH SPINAL NOCICEPTIVE SIGNALLING, WE DECIDED TO INVESTIGATE THE HDAC2 EXPRESSION IN THE DORSAL HORN AFTER PERIPHERAL INJURY. USING IMMUNOHISTOCHEMISTRY, WE FOUND THAT SPINAL HDAC2 WAS MAINLY SEEN IN NEURONS AND ASTROCYTES, WITH NEURONAL EXPRESSION IN NAIVE TISSUE 2.6 TIMES GREATER THAN THAT IN ASTROCYTES. CYSTEINE (S)-NITROSYLATION OF HDAC2 RELEASES HDAC2 GENE SILENCING AND IS CONTROLLED BY NITRIC OXIDE (NO). A DURATION OF 48 H AFTER INTRAPLANTAR INJECTION OF COMPLETE FREUND'S ADJUVANT, THERE WAS AN IPSILATERAL INCREASE IN THE MOST IMPORTANT NO-PRODUCING ENZYME IN PAIN STATES, NITRIC OXIDE SYNTHASE (NNOS), ACCOMPANIED BY AN INCREASE IN HDAC2 S-NITROSYLATION. MOREOVER, A SUBSET OF NNOS-POSITIVE NEURONS EXPRESSED CFOS, A KNOWN TARGET OF HDAC2, SUGGESTING THAT DEREPRESSION OF CFOS EXPRESSION FOLLOWING HDAC2 S-NITROSYLATION MIGHT OCCUR AFTER NOXIOUS STIMULATION. WE SAW NO CHANGE IN GLOBAL HDAC2 EXPRESSION IN BOTH SHORT- AND LONG-TERM PAIN STATES. HOWEVER, HDAC2 WAS INCREASED IN ASTROCYTES 7 DAYS AFTER NEUROPATHIC INJURY SUGGESTING THAT HDAC2 MIGHT INHIBIT ASTROCYTIC GENE EXPRESSION IN NEUROPATHIC PAIN STATES. ALL TOGETHER, OUR RESULTS INDICATE THAT THE EPIGENETIC REGULATION OF TRANSCRIPTIONAL PROGRAMMES IN THE DORSAL HORN AFTER INJURY IS CELL SPECIFIC. MOREOVER, THE PROMINENT ROLE OF NO IN PERSISTENT PAIN STATES SUGGESTS THAT HDAC2 S-NITROSYLATION COULD PLAY A CRUCIAL ROLE IN THE REGULATION OF GENE EXPRESSION LEADING TO HYPERSENSITIVITY. OUR MANUSCRIPT DESCRIBES FOR THE FIRST TIME THE REGULATION OF THE MEMORY REGULATOR HISTONE DEACETYLASE 2 (HDAC2) IN THE SUPERFICIAL DORSAL HORN OF ADULT RATS FOLLOWING PERIPHERAL INJURY. OUR CELL-SPECIFIC APPROACH HAS REVEALED A COMPLEX PATTERN OF EXPRESSION OF SPINAL HDAC2 THAT DEPENDS ON THE INJURY AND THE CELL TYPE, SUGGESTING A SOPHISTICATED REGULATION OF GENE EXPRESSION BY HDAC2. 2016 7 4144 33 MECHANISMS OF STRESS-INDUCED VISCERAL PAIN. EVIDENCE SUGGESTS THAT LONG-TERM STRESS FACILITATES VISCERAL PAIN THROUGH SENSITIZATION OF PAIN PATHWAYS AND PROMOTES CHRONIC VISCERAL PAIN DISORDERS SUCH AS THE IRRITABLE BOWEL SYNDROME (IBS). THIS REVIEW WILL DESCRIBE THE IMPORTANCE OF STRESS IN EXACERBATING IBS-INDUCED ABDOMINAL PAIN. ADDITIONALLY, WE WILL BRIEFLY REVIEW OUR UNDERSTANDING OF THE ACTIVATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS BY BOTH CHRONIC ADULT STRESS AND FOLLOWING EARLY LIFE STRESS IN THE PATHOGENESIS OF IBS. THE REVIEW WILL FOCUS ON THE GLUCOCORTICOID RECEPTOR AND CORTICOTROPIN-RELEASING HORMONE-MEDIATED MECHANISMS IN THE AMYGDALA INVOLVED IN STRESS-INDUCED VISCERAL HYPERSENSITIVITY. ONE POTENTIAL MECHANISM UNDERLYING PERSISTENT EFFECTS OF STRESS ON VISCERAL SENSITIVITY COULD BE EPIGENETIC MODULATION OF GENE EXPRESSION. WHILE THERE ARE RELATIVELY FEW STUDIES EXAMINING EPIGENETICALLY MEDIATED MECHANISMS INVOLVED IN STRESS-INDUCED VISCERAL NOCICEPTION, ALTERATIONS IN DNA METHYLATION AND HISTONE ACETYLATION PATTERNS WITHIN THE BRAIN, HAVE BEEN LINKED TO ALTERATIONS IN NOCICEPTIVE SIGNALING VIA INCREASED EXPRESSION OF PRO-NOCICEPTIVE NEUROTRANSMITTERS. THIS REVIEW WILL DISCUSS THE LATEST STUDIES INVESTIGATING THE LONG-TERM EFFECTS OF STRESS ON VISCERAL SENSITIVITY. ADDITIONALLY, WE WILL CRITICALLY REVIEW THE IMPORTANCE OF EXPERIMENTAL MODELS OF ADULT STRESS AND EARLY LIFE STRESS IN ENHANCING OUR UNDERSTANDING OF THE BASIC MOLECULAR MECHANISMS OF NOCICEPTIVE PROCESSING. 2018 8 5876 27 SYNAPTIC PLASTICITY AND PAIN AVERSION. NEGATIVE AFFECTIVE EMOTIONS ARE DEFINED AS THE CONCEPTUAL FEATURE OF PAIN. A NUMBER OF CLINICAL AND ANIMAL STUDIES HAVE INDICATED THAT THE LIMBIC SYSTEM INCLUDING THE ANTERIOR CINGULATE CORTEX (ACC) AND AMYGDALA PLAYS A CRITICAL ROLE IN THE PROCESSING OF AFFECTIVE COMPONENTS OF PAIN. GLUTAMATERGIC TRANSMISSION PLAYS AN IMPORTANT ROLE IN THE PROCESSING OF AFFECTIVE ASPECTS OF PAIN. LONG-TERM CHANGES ON GLUTAMATERGIC SYNAPSES CONTRIBUTE TO THE EXPRESSION OF AVERSION BEHAVIOR INDUCED BY PAIN. IN THIS ARTICLE, THE NEUROCIRCUITS INVOLVED IN THE PROCESSING OF AFFECTIVE ASPECTS OF PAIN, THE GLUTAMATERGIC SYNAPTIC PLASTICITY IN THESE BRAIN REGIONS, AND THE EPIGENETIC MECHANISMS UNDERLYING PAIN-RELATED SYNAPTIC PLASTICITY WILL BE REVIEWED AND DISCUSSED. NEW DISCOVERIES REGARDING THE INTERACTION BETWEEN THE SYNAPTIC PLASTICITY AND AFFECTIVE COMPONENTS OF PAIN MAY ADVANCE OUR UNDERSTANDING ON THE PAIN MECHANISM, AND LEAD TO NEW STRATEGIES FOR PAIN TREATMENT. 2011 9 4098 29 MBD1 CONTRIBUTES TO THE GENESIS OF ACUTE PAIN AND NEUROPATHIC PAIN BY EPIGENETIC SILENCING OF OPRM1 AND KCNA2 GENES IN PRIMARY SENSORY NEURONS. THE TRANSMISSION OF NORMAL SENSORY AND/OR ACUTE NOXIOUS INFORMATION REQUIRES INTACT EXPRESSION OF PAIN-ASSOCIATED GENES WITHIN THE PAIN PATHWAYS OF NERVOUS SYSTEM. EXPRESSIONAL CHANGES OF THESE GENES AFTER PERIPHERAL NERVE INJURY ARE ALSO CRITICAL FOR NEUROPATHIC PAIN INDUCTION AND MAINTENANCE. METHYL-CPG-BINDING DOMAIN PROTEIN 1 (MBD1), AN EPIGENETIC REPRESSOR, REGULATES GENE TRANSCRIPTIONAL ACTIVITY. WE REPORT HERE THAT MBD1 IN THE PRIMARY SENSORY NEURONS OF DRG IS CRITICAL FOR THE GENESIS OF ACUTE PAIN AND NEUROPATHIC PAIN AS DRG MBD1-DEFICIENT MICE EXHIBIT THE REDUCED RESPONSES TO ACUTE MECHANICAL, HEAT, COLD, AND CAPSAICIN STIMULI AND THE BLUNTED NERVE INJURY-INDUCED PAIN HYPERSENSITIVITIES. FURTHERMORE, DRG OVEREXPRESSION OF MBD1 LEADS TO SPONTANEOUS PAIN AND EVOKED PAIN HYPERSENSITIVITIES IN THE WT MICE AND RESTORES ACUTE PAIN SENSITIVITIES IN THE MBD1-DEFICIENT MICE. MECHANISTICALLY, MDB1 REPRESSES OPRM1 AND KCNA2 GENE EXPRESSION BY RECRUITING DNA METHYLTRANSFERASE DNMT3A INTO THESE TWO GENE PROMOTERS IN THE DRG NEURONS. DRG MBD1 IS LIKELY A KEY PLAYER UNDER THE CONDITIONS OF ACUTE PAIN AND NEUROPATHIC PAIN.SIGNIFICANCE STATEMENT IN THE PRESENT STUDY, WE REVEALED THAT THE MICE WITH DEFICIENCY OF METHYL-CPG-BINDING DOMAIN PROTEIN 1 (MBD1), AN EPIGENETIC REPRESSOR, IN THE DRG DISPLAYED THE REDUCED RESPONSES TO ACUTE NOXIOUS STIMULI AND THE BLUNTED NEUROPATHIC PAIN. WE ALSO SHOWED THAT DRG OVEREXPRESSION OF MBD1 PRODUCED THE HYPERSENSITIVITIES TO NOXIOUS STIMULI IN THE WT MICE AND RESCUED ACUTE PAIN SENSITIVITIES IN THE MBD1-DEFICIENT MICE. WE HAVE ALSO PROVIDED THE EVIDENCE THAT MDB1 REPRESSES OPRM1 AND KCNA2 GENE EXPRESSION BY RECRUITING DNA METHYLTRANSFERASE DNMT3A INTO THESE TWO GENE PROMOTERS IN THE DRG NEURONS. DRG MBD1 MAY PARTICIPATE IN THE GENESIS OF ACUTE PAIN AND NEUROPATHIC PAIN LIKELY THROUGH REGULATING DNMT3A-CONTROLLED OPRM1 AND KCNA2 GENE EXPRESSION IN THE DRG NEURONS. 2018 10 2198 44 EPIGENETIC MODIFICATION OF DRG NEURONAL GENE EXPRESSION SUBSEQUENT TO NERVE INJURY: ETIOLOGICAL CONTRIBUTION TO COMPLEX REGIONAL PAIN SYNDROMES (PART I). DRG IS OF IMPORTANCE IN RELAYING PAINFUL STIMULATION TO THE HIGHER PAIN CENTERS AND THEREFORE COULD BE A CRUCIAL TARGET FOR EARLY INTERVENTION AIMED AT SUPPRESSING PRIMARY AFFERENT STIMULATION. COMPLEX REGIONAL PAIN SYNDROME (CRPS) IS A COMMON PAIN CONDITION WITH AN UNKNOWN ETIOLOGY. RECENTLY ADDED NEW INFORMATION ENRICHES OUR UNDERSTANDING OF CRPS PATHOPHYSIOLOGY. RESEARCHES ON GENETICS, BIOGENIC AMINES, NEUROTRANSMITTERS, AND MECHANISMS OF PAIN MODULATION, CENTRAL SENSITIZATION, AND AUTONOMIC FUNCTIONS IN CRPS REVEALED VARIOUS ABNORMALITIES INDICATING THAT MULTIPLE FACTORS AND MECHANISMS ARE INVOLVED IN THE PATHOGENESIS OF CRPS. EPIGENETICS REFERS TO MITOTICALLY AND MEIOTICALLY HERITABLE CHANGES IN GENE EXPRESSION THAT DO NOT AFFECT THE DNA SEQUENCE. AS EPIGENETIC MODIFICATIONS POTENTIALLY PLAY AN IMPORTANT ROLE IN INFLAMMATORY CYTOKINE METABOLISM, NEUROTRANSMITTER RESPONSIVENESS, AND ANALGESIC SENSITIVITY, THEY ARE LIKELY KEY FACTORS IN THE DEVELOPMENT OF CHRONIC PAIN. IN THIS DYAD REVIEW SERIES, WE SYSTEMATICALLY EXAMINE THE NERVE INJURY-RELATED CHANGES IN THE NEUROLOGICAL SYSTEM AND THEIR CONTRIBUTION TO CRPS. IN THIS PART, WE FIRST REVIEWED AND SUMMARIZED THE ROLE OF NEURAL SENSITIZATION IN DRG NEURONS IN PERFORMING FUNCTION IN THE CONTEXT OF PAIN PROCESSING. PARTICULAR EMPHASIS IS PLACED ON THE CELLULAR AND MOLECULAR CHANGES AFTER NERVE INJURY AS WELL AS DIFFERENT MODELS OF INFLAMMATORY AND NEUROPATHIC PAIN. THESE WERE CONSIDERED AS THE POTENTIAL MOLECULAR BASES THAT UNDERLIE NERVE INJURY-ASSOCIATED PATHOGENESIS OF CRPS. 2014 11 2179 29 EPIGENETIC MECHANISMS OF NEURAL PLASTICITY IN CHRONIC NEUROPATHIC PAIN. NEUROPATHIC PAIN IS A CHALLENGING CLINICAL PROBLEM AND REMAINS DIFFICULT TO TREAT. ALTERED GENE EXPRESSION IN PERIPHERAL SENSORY NERVES AND NEURONS DUE TO NERVE INJURY IS WELL DOCUMENTED AND CONTRIBUTES CRITICALLY TO THE SYNAPTIC PLASTICITY IN THE SPINAL CORD AND THE INITIATION AND MAINTENANCE OF CHRONIC PAIN. HOWEVER, OUR UNDERSTANDING OF THE EPIGENETIC MECHANISMS REGULATING THE TRANSCRIPTION OF PRO-NOCICEPTIVE (E.G., NMDA RECEPTORS AND ALPHA2DELTA-1) AND ANTINOCICEPTIVE (E.G., POTASSIUM CHANNELS AND OPIOID AND CANNABINOID RECEPTORS) GENES ARE STILL LIMITED. IN THIS REVIEW, WE SUMMARIZE RECENT STUDIES DETERMINING THE ROLES OF HISTONE MODIFICATIONS (INCLUDING METHYLATION, ACETYLATION, AND UBIQUITINATION), DNA METHYLATION, AND NONCODING RNAS IN NEUROPATHIC PAIN DEVELOPMENT. WE REVIEW THE EPIGENETIC WRITER, READER, AND ERASER PROTEINS THAT PARTICIPATE IN THE TRANSCRIPTIONAL CONTROL OF THE EXPRESSION OF KEY ION CHANNELS AND NEUROTRANSMITTER RECEPTORS IN THE DORSAL ROOT GANGLION AFTER TRAUMATIC NERVE INJURY, WHICH IS COMMONLY USED AS A PRECLINICAL MODEL OF NEUROPATHIC PAIN. A BETTER UNDERSTANDING OF EPIGENETIC REPROGRAMMING INVOLVED IN THE TRANSITION FROM ACUTE TO CHRONIC PAIN COULD LEAD TO THE DEVELOPMENT OF NEW TREATMENTS FOR NEUROPATHIC PAIN. 2022 12 5831 46 STRESS-INDUCED CHRONIC VISCERAL PAIN OF GASTROINTESTINAL ORIGIN. VISCERAL PAIN IS GENERALLY POORLY LOCALIZED AND CHARACTERIZED BY HYPERSENSITIVITY TO A STIMULUS SUCH AS ORGAN DISTENSION. IN CONCERT WITH CHRONIC VISCERAL PAIN, THERE IS A HIGH COMORBIDITY WITH STRESS-RELATED PSYCHIATRIC DISORDERS INCLUDING ANXIETY AND DEPRESSION. THE MECHANISMS LINKING VISCERAL PAIN WITH THESE OVERLAPPING COMORBIDITIES REMAIN TO BE ELUCIDATED. EVIDENCE SUGGESTS THAT LONG TERM STRESS FACILITATES PAIN PERCEPTION AND SENSITIZES PAIN PATHWAYS, LEADING TO A FEED-FORWARD CYCLE PROMOTING CHRONIC VISCERAL PAIN DISORDERS SUCH AS IRRITABLE BOWEL SYNDROME (IBS). EARLY LIFE STRESS (ELS) IS A RISK-FACTOR FOR THE DEVELOPMENT OF IBS, HOWEVER THE MECHANISMS RESPONSIBLE FOR THE PERSISTENT EFFECTS OF ELS ON VISCERAL PERCEPTION IN ADULTHOOD REMAIN INCOMPLETELY UNDERSTOOD. IN RODENT MODELS, STRESS IN ADULT ANIMALS INDUCED BY RESTRAINT AND WATER AVOIDANCE HAS BEEN EMPLOYED TO INVESTIGATE THE MECHANISMS OF STRESS-INDUCE PAIN. ELS MODELS SUCH AS MATERNAL SEPARATION, LIMITED NESTING, OR ODOR-SHOCK CONDITIONING, WHICH ATTEMPT TO MODEL EARLY CHILDHOOD EXPERIENCES SUCH AS NEGLECT, POVERTY, OR AN ABUSIVE CAREGIVER, CAN PRODUCE CHRONIC, SEXUALLY DIMORPHIC INCREASES IN VISCERAL SENSITIVITY IN ADULTHOOD. CHRONIC VISCERAL PAIN IS A CLASSIC EXAMPLE OF GENE X ENVIRONMENT INTERACTION WHICH RESULTS FROM MALADAPTIVE CHANGES IN NEURONAL CIRCUITRY LEADING TO NEUROPLASTICITY AND ABERRANT NEURONAL ACTIVITY-INDUCED SIGNALING. ONE POTENTIAL MECHANISM UNDERLYING THE PERSISTENT EFFECTS OF STRESS ON VISCERAL SENSITIVITY COULD BE EPIGENETIC MODULATION OF GENE EXPRESSION. WHILE THERE ARE RELATIVELY FEW STUDIES EXAMINING EPIGENETICALLY MEDIATED MECHANISMS INVOLVED IN VISCERAL NOCICEPTION, STRESS-INDUCED VISCERAL PAIN HAS BEEN LINKED TO ALTERATIONS IN DNA METHYLATION AND HISTONE ACETYLATION PATTERNS WITHIN THE BRAIN, LEADING TO INCREASED EXPRESSION OF PRO-NOCICEPTIVE NEUROTRANSMITTERS. THIS REVIEW WILL DISCUSS THE POTENTIAL NEURONAL PATHWAYS AND MECHANISMS RESPONSIBLE FOR STRESS-INDUCED EXACERBATION OF CHRONIC VISCERAL PAIN. ADDITIONALLY, WE WILL REVIEW THE IMPORTANCE OF SPECIFIC EXPERIMENTAL MODELS OF ADULT STRESS AND ELS IN ENHANCING OUR UNDERSTANDING OF THE BASIC MOLECULAR MECHANISMS OF PAIN PROCESSING. 2017 13 2214 36 EPIGENETIC MODIFICATIONS ASSOCIATED TO NEUROINFLAMMATION AND NEUROPATHIC PAIN AFTER NEURAL TRAUMA. ACCUMULATING EVIDENCE SUGGESTS THAT EPIGENETIC ALTERATIONS LIE BEHIND THE INDUCTION AND MAINTENANCE OF NEUROPATHIC PAIN. NEUROPATHIC PAIN IS USUALLY A CHRONIC CONDITION CAUSED BY A LESION, OR PATHOLOGICAL CHANGE, WITHIN THE NERVOUS SYSTEM. NEUROPATHIC PAIN APPEARS FREQUENTLY AFTER NERVE AND SPINAL CORD INJURIES OR DISEASES, PRODUCING A DEBILITATION OF THE PATIENT AND A DECREASE OF THE QUALITY OF LIFE. AT THE CELLULAR LEVEL, NEUROPATHIC PAIN IS THE RESULT OF NEURONAL PLASTICITY SHAPED BY AN INCREASE IN THE SENSITIVITY AND EXCITABILITY OF SENSORY NEURONS OF THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM. ONE OF THE MECHANISMS THOUGHT TO CONTRIBUTE TO HYPEREXCITABILITY AND THEREFORE TO THE ONTOGENY OF NEUROPATHIC PAIN IS THE ALTERED EXPRESSION, TRAFFICKING, AND FUNCTIONING OF RECEPTORS AND ION CHANNELS EXPRESSED BY PRIMARY SENSORY NEURONS. BESIDES, NEURONAL AND GLIAL CELLS, SUCH AS MICROGLIA AND ASTROCYTES, TOGETHER WITH BLOOD BORNE MACROPHAGES, PLAY A CRITICAL ROLE IN THE INDUCTION AND MAINTENANCE OF NEUROPATHIC PAIN BY RELEASING POWERFUL NEUROMODULATORS SUCH AS PRO-INFLAMMATORY CYTOKINES AND CHEMOKINES, WHICH ENHANCE NEURONAL EXCITABILITY. ALTERED GENE EXPRESSION OF NEURONAL RECEPTORS, ION CHANNELS, AND PRO-INFLAMMATORY CYTOKINES AND CHEMOKINES, HAVE BEEN ASSOCIATED TO EPIGENETIC ADAPTATIONS OF THE INJURED TISSUE. WITHIN THIS REVIEW, WE DISCUSS THE INVOLVEMENT OF THESE EPIGENETIC CHANGES, INCLUDING HISTONE MODIFICATIONS, DNA METHYLATION, NON-CODING RNAS, AND ALTERATION OF CHROMATIN MODIFIERS, THAT HAVE BEEN SHOWN TO TRIGGER MODIFICATION OF NOCICEPTION AFTER NEURAL LESIONS. IN PARTICULAR, THE FUNCTION ON THESE PROCESSES OF EZH2, JMJD3, MECP2, SEVERAL HISTONE DEACETYLASES (HDACS) AND HISTONE ACETYL TRANSFERASES (HATS), G9A, DNMT, REST AND DIVERSE NON-CODING RNAS, ARE DESCRIBED. DESPITE THE EFFORT ON DEVELOPING NEW THERAPIES, CURRENT TREATMENTS HAVE ONLY PRODUCED LIMITED RELIEF OF THIS PAIN IN A PORTION OF PATIENTS. THUS, THE PRESENT REVIEW AIMS TO CONTRIBUTE TO FIND NOVEL TARGETS FOR CHRONIC NEUROPATHIC PAIN TREATMENT. 2018 14 6139 30 THE ETIOLOGICAL CONTRIBUTION OF GABAERGIC PLASTICITY TO THE PATHOGENESIS OF NEUROPATHIC PAIN. NEUROPATHIC PAIN DEVELOPING AFTER PERIPHERAL OR CENTRAL NERVE INJURY IS THE RESULT OF PATHOLOGICAL CHANGES GENERATED THROUGH COMPLEX MECHANISMS. DISRUPTION IN THE HOMEOSTASIS OF EXCITATORY AND INHIBITORY NEURONS WITHIN THE CENTRAL NERVOUS SYSTEM IS A CRUCIAL FACTOR IN THE FORMATION OF HYPERALGESIA OR ALLODYNIA OCCURRING WITH NEUROPATHIC PAIN. THE CENTRAL GABAERGIC PATHWAY HAS RECEIVED ATTENTION FOR ITS EXTENSIVE DISTRIBUTION AND FUNCTION IN NEURAL CIRCUITS, INCLUDING THE GENERATION AND DEVELOPMENT OF NEUROPATHIC PAIN. GABAERGIC INHIBITORY CHANGES THAT OCCUR IN THE INTERNEURONS ALONG DESCENDING MODULATORY AND NOCICEPTIVE PATHWAYS IN THE CENTRAL NERVOUS SYSTEM ARE BELIEVED TO GENERATE NEURONAL PLASTICITY, SUCH AS SYNAPTIC PLASTICITY OR FUNCTIONAL PLASTICITY OF THE RELATED GENES OR PROTEINS, THAT IS THE FOUNDATION OF PERSISTENT NEUROPATHIC PAIN. THE PRIMARY GABAERGIC PLASTICITY OBSERVED IN NEUROPATHIC PAIN INCLUDES GABAERGIC SYNAPSE HOMO- AND HETEROSYNAPTIC PLASTICITY, DECREASED SYNTHESIS OF GABA, DOWN-EXPRESSION OF GLUTAMIC ACID DECARBOXYLASE AND GABA TRANSPORTER, ABNORMAL EXPRESSION OF NKCC1 OR KCC2, AND DISTURBED FUNCTION OF GABA RECEPTORS. IN THIS REVIEW, WE DESCRIBE POSSIBLE MECHANISMS ASSOCIATED WITH GABAERGIC PLASTICITY, SUCH AS CENTRAL SENSITIZATION AND GABAERGIC INTERNEURON APOPTOSIS, AND THE EPIGENETIC ETIOLOGIES OF GABAERGIC PLASTICITY IN NEUROPATHIC PAIN. MOREOVER, WE SUMMARIZE POTENTIAL THERAPEUTIC TARGETS OF GABAERGIC PLASTICITY THAT MAY ALLOW FOR SUCCESSFUL RELIEF OF HYPERALGESIA FROM NERVE INJURY. FINALLY, WE COMPARE THE EFFECTS OF THE GABAERGIC SYSTEM IN NEUROPATHIC PAIN TO OTHER TYPES OF CHRONIC PAIN TO UNDERSTAND THE CONTRIBUTION OF GABAERGIC PLASTICITY TO NEUROPATHIC PAIN. 2019 15 5545 25 ROLE OF EPIGENETIC MECHANISMS IN CHRONIC PAIN. PAIN IS AN UNPLEASANT BUT ESSENTIAL-TO-LIFE SENSATION, USUALLY RESULTING FROM TISSUE DAMAGE. WHEN PAIN PERSISTS LONG AFTER THE INJURY HAS RESOLVED, IT BECOMES PATHOLOGICAL. THE PRECISE MOLECULAR AND CELLULAR MECHANISMS CAUSING THE TRANSITION FROM ACUTE TO CHRONIC PAIN ARE NOT FULLY UNDERSTOOD. A KEY ASPECT OF PAIN CHRONICITY IS THAT SEVERAL PLASTICITY EVENTS HAPPEN ALONG THE NEURAL PATHWAYS INVOLVED IN PAIN. THESE LONG-LASTING ADAPTIVE CHANGES ARE ENABLED BY ALTERATION IN THE EXPRESSION OF RELEVANT GENES. AMONG THE DIFFERENT MODULATORS OF GENE TRANSCRIPTION IN ADAPTIVE PROCESSES IN THE NERVOUS SYSTEM, EPIGENETIC MECHANISMS PLAY A PIVOTAL ROLE. IN THIS REVIEW, I WILL FIRST OUTLINE THE MAIN CLASSES OF EPIGENETIC MEDIATORS AND THEN DISCUSS THEIR IMPLICATIONS IN CHRONIC PAIN. 2022 16 2199 35 EPIGENETIC MODIFICATION OF DRG NEURONAL GENE EXPRESSION SUBSEQUENT TO NERVE INJURY: ETIOLOGICAL CONTRIBUTION TO COMPLEX REGIONAL PAIN SYNDROMES (PART II). CUMULATING EVIDENCE INDICATED THAT NERVE INJURY-ASSOCIATED CELLULAR AND MOLECULAR CHANGES PLAY AN ESSENTIAL ROLE IN CONTRIBUTING TO THE DEVELOPMENT OF PATHOLOGICAL PAIN, AND MORE RECENT FINDINGS IMPLICATED THE CRITICAL ROLE OF EPIGENETIC MECHANISMS IN PAIN-RELATED SENSITIZATION IN THE DRG SUBSEQUENT TO NERVE INJURY. IN THIS PART OF THE DYAD REVIEW (PART II), WE REVIEWED AND PAID SPECIAL ATTENTION ON THE ETIOLOGICAL CONTRIBUTION OF DGR GENE EXPRESSION MODULATED BY EPIGENETIC MECHANISMS OF CRPS. AS ESSENTIAL EFFECTORS TO DIFFERENT MOLECULAR ACTIVATION, WE FIRST DISCUSSED THE ACTIVATION OF VARIOUS SIGNALING PATHWAYS THAT SUBSEQUENTLY FROM NERVE INJURY, AND IN FURTHER ILLUSTRATED THE FUNDAMENTAL AND FUNCTIONAL UNDERPINNINGS OF NERVE INJURY-INDUCED PAIN, IN WHICH WE ARGUED FOR THE POTENTIAL EPIGENETIC MECHANISMS IN RESPONSE TO SENSITIZING STIMULI OR INJURY. THEREFORE, UNDERSTANDING THE SPECIFIC MEDIATING FACTORS THAT INFLUENCE INDIVIDUAL EPIGENETIC DIFFERENCES CONTRIBUTING TO PAIN SENSITIVITY AND RESPONSIVENESS TO ANALGESICS POSSESSES CRUCIAL CLINICAL IMPLICATIONS. 2014 17 189 34 ACETYL-L-CARNITINE IN CHRONIC PAIN: A NARRATIVE REVIEW. ACETYL-L-CARNITINE (ALC) IS AN ENDOGENOUS MOLECULE THAT NOT ONLY PLAYS A ROLE IN ENERGY METABOLISM, BUT ALSO HAS ANTIOXIDANT PROPERTIES, PROTECTS FROM OXIDATIVE STRESS, MODULATES BRAIN NEUROTRANSMITTERS SUCH AS ACETYLCHOLINE, SEROTONIN AND DOPAMINE, AND ACTS ON NEUROTROPHIC FACTORS SUCH AS NERVE GROWTH FACTOR (NGF) AND METABOTROPIC GLUTAMATE (MGLU) RECEPTORS BY MEANS OF EPIGENETIC MECHANISMS. IMPORTANTLY, IT INDUCES MGLU2 EXPRESSION AT NERVE TERMINALS, THUS GIVING RISE TO ANALGESIA AND PREVENTING SPINAL SENSITISATION. IT HAS ALSO BEEN FOUND TO HAVE EVEN LONG-TERM NEUROTROPHIC AND ANALGESIC ACTIVITY IN EXPERIMENTAL MODELS OF CHRONIC INFLAMMATORY AND NEUROPATHIC PAIN. THE AIM OF THIS NARRATIVE REVIEW IS TO SUMMARISE THE CURRENT EVIDENCE REGARDING THE USE OF ALC IN PATIENTS WITH CHRONIC PAIN, AND COGNITIVE AND MOOD DISORDERS, AND INVESTIGATE THE RATIONALE UNDERLYING ITS USE IN PATIENTS WITH FIBROMYALGIA SYNDROME, WHICH IS CHARACTERISED BY NOCIPLASTIC CHANGES THAT INCREASE THE SENSITIVITY OF THE NERVOUS SYSTEM TO PAIN. 2021 18 6866 34 [PAIN AND EMOTIONAL DYSREGULATION: CELLULAR MEMORY DUE TO PAIN]. GENETIC FACTORS ARE INVOLVED IN DETERMINANTS FOR THE RISK OF PSYCHIATRIC DISORDERS, AND NEUROLOGICAL AND NEURODEGENERATIVE DISEASES. CHRONIC PAIN STIMULI AND INTENSE PAIN HAVE EFFECTS AT A CELLULAR AND/OR GENE EXPRESSION LEVEL, AND WILL EVENTUALLY INDUCE "CELLULAR MEMORY DUE TO PAIN", WHICH MEANS THAT TISSUE DAMAGE, EVEN IF ONLY TRANSIENT, CAN ELICIT EPIGENETICALLY ABNORMAL TRANSCRIPTION/TRANSLATION AND POST-TRANSLATIONAL MODIFICATION IN RELATED CELLS DEPENDING ON THE DEGREE OR KIND OF INJURY OR ASSOCIATED CONDITIONS. SUCH CELL MEMORY/TRANSFORMATION DUE TO PAIN CAN CAUSE AN ABNORMALITY IN A FUNDAMENTAL INTRACELLULAR RESPONSE, SUCH AS A CHANGE IN THE THREE-DIMENSIONAL STRUCTURE OF DNA, TRANSCRIPTION, OR TRANSLATION. ON THE OTHER HAND, PAIN IS A MULTIDIMENSIONAL EXPERIENCE WITH SENSORY-DISCRIMINATIVE AND MOTIVATIONAL-AFFECTIVE COMPONENTS. RECENT HUMAN BRAIN IMAGING STUDIES HAVE EXAMINED DIFFERENCES IN ACTIVITY IN THE NUCLEUS ACCUMBENS BETWEEN CONTROLS AND PATIENTS WITH CHRONIC PAIN, AND HAVE REVEALED THAT THE NUCLEUS ACCUMBENS PLAYS A ROLE IN PREDICTING THE VALUE OF A NOXIOUS STIMULUS AND ITS OFFSET, AND IN THE CONSEQUENT CHANGES IN THE MOTIVATIONAL STATE. IN THIS REVIEW, WE PROVIDE A VERY BRIEF OVERVIEW OF A COMPREHENSIVE UNDERSTANDING OF CHRONIC PAIN ASSOCIATED WITH EMOTIONAL DYSREGULATION DUE TO TRANSCRIPTIONAL REGULATION, EPIGENETIC MODIFICATION AND MIRNA REGULATION. 2015 19 5310 21 PSYCHOBIOLOGY AND MOLECULAR GENETICS OF RESILIENCE. EVERY INDIVIDUAL EXPERIENCES STRESSFUL LIFE EVENTS. IN SOME CASES ACUTE OR CHRONIC STRESS LEADS TO DEPRESSION AND OTHER PSYCHIATRIC DISORDERS, BUT MOST PEOPLE ARE RESILIENT TO SUCH EFFECTS. RECENT RESEARCH HAS BEGUN TO IDENTIFY THE ENVIRONMENTAL, GENETIC, EPIGENETIC AND NEURAL MECHANISMS THAT UNDERLIE RESILIENCE, AND HAS SHOWN THAT RESILIENCE IS MEDIATED BY ADAPTIVE CHANGES IN SEVERAL NEURAL CIRCUITS INVOLVING NUMEROUS NEUROTRANSMITTER AND MOLECULAR PATHWAYS. THESE CHANGES SHAPE THE FUNCTIONING OF THE NEURAL CIRCUITS THAT REGULATE REWARD, FEAR, EMOTION REACTIVITY AND SOCIAL BEHAVIOUR, WHICH TOGETHER ARE THOUGHT TO MEDIATE SUCCESSFUL COPING WITH STRESS. 2009 20 5419 38 REGULATION OF GENE EXPRESSION AND PAIN STATES BY EPIGENETIC MECHANISMS. THE INDUCTION OF INFLAMMATORY OR NEUROPATHIC PAIN STATES IS KNOWN TO INVOLVE MOLECULAR ACTIVITY IN THE SPINAL SUPERFICIAL DORSAL HORN AND DORSAL ROOT GANGLIA, INCLUDING INTRACELLULAR SIGNALING EVENTS WHICH LEAD TO CHANGES IN GENE EXPRESSION. THESE CHANGES ULTIMATELY CAUSE ALTERATIONS IN MACROMOLECULAR SYNTHESIS, SYNAPTIC TRANSMISSION, AND STRUCTURAL ARCHITECTURE WHICH SUPPORT CENTRAL SENSITIZATION, A PROCESS REQUIRED FOR THE ESTABLISHMENT OF LONG-TERM PAIN STATES. EPIGENETIC MECHANISMS ARE ESSENTIAL FOR LONG-TERM SYNAPTIC PLASTICITY AND MODULATION OF GENE EXPRESSION. THIS IS BECAUSE EPIGENETIC MODIFICATIONS ARE KNOWN TO REGULATE GENE TRANSCRIPTION BY AIDING THE PHYSICAL RELAXATION OR CONDENSATION OF CHROMATIN. THESE PROCESSES ARE THEREFORE POTENTIAL REGULATORS OF THE MOLECULAR CHANGES UNDERLYING PERMANENT PAIN STATES. A HANDFUL OF STUDIES HAVE EMERGED IN THE FIELD OF PAIN EPIGENETICS; HOWEVER, THE FIELD IS STILL VERY MUCH IN ITS INFANCY. THIS CHAPTER DRAWS UPON OTHER SPECIALITIES WHICH HAVE EXTENSIVELY INVESTIGATED EPIGENETIC MECHANISMS, SUCH AS LEARNING AND MEMORY AND ONCOLOGY. AFTER DEFINING EPIGENETICS AS WELL AS THE RECENT FIELD OF "NEUROEPIGENETICS" AND THE MAIN MOLECULAR MECHANISMS INVOLVED, THIS CHAPTER DESCRIBES THE ROLE OF THESE MECHANISMS IN THE SYNAPTIC PLASTICITY SEEN IN LEARNING AND MEMORY, AND ADDRESS THOSE EPIGENETIC MECHANISMS THAT HAVE BEEN LINKED WITH THE DEVELOPMENT OF ACUTE AND PROLONGED PAIN STATES. FINALLY, THE IDEA THAT LONG-LASTING EPIGENETIC MODIFICATIONS COULD CONTRIBUTE TO THE TRANSITION FROM ACUTE TO CHRONIC PAIN STATES BY SUPPORTING MALADAPTIVE MOLECULAR CHANGES IS DISCUSSED. 2015