Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum
Chronic pain is highly prevalent in the pediatric population. Many factors are involved in the transition from acute to chronic pain. Currently, there are conceptual models proposed, but they lack a mechanistically sound integrated theory considering the stages of child development. Objective biomar...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/16/5176 |
| _version_ | 1797584347376648192 |
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| author | Irina T. Duff Kristen N. Krolick Hana Mohamed Mahmoud Vidya Chidambaran |
| author_facet | Irina T. Duff Kristen N. Krolick Hana Mohamed Mahmoud Vidya Chidambaran |
| author_sort | Irina T. Duff |
| collection | DOAJ |
| description | Chronic pain is highly prevalent in the pediatric population. Many factors are involved in the transition from acute to chronic pain. Currently, there are conceptual models proposed, but they lack a mechanistically sound integrated theory considering the stages of child development. Objective biomarkers are critically needed for the diagnosis, risk stratification, and prognosis of the pathological stages of pain chronification. In this article, we summarize the current evidence on mechanisms and biomarkers of acute to chronic pain transitions in infants and children through the developmental lens. The goal is to identify gaps and outline future directions for basic and clinical research toward a developmentally informed theory of pain chronification in the pediatric population. At the outset, the importance of objective biomarkers for chronification of pain in children is outlined, followed by a summary of the current evidence on the mechanisms of acute to chronic pain transition in adults, in order to contrast with the developmental mechanisms of pain chronification in the pediatric population. Evidence is presented to show that chronic pain may have its origin from insults early in life, which prime the child for the development of chronic pain in later life. Furthermore, available genetic, epigenetic, psychophysical, electrophysiological, neuroimaging, neuroimmune, and sex mechanisms are described in infants and older children. In conclusion, future directions are discussed with a focus on research gaps, translational and clinical implications. Utilization of developmental mechanisms framework to inform clinical decision-making and strategies for prevention and management of acute to chronic pain transitions in children, is highlighted. |
| first_indexed | 2024-03-10T23:50:37Z |
| format | Article |
| id | doaj.art-8e37e0d07f144be088669aecda493203 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T23:50:37Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8e37e0d07f144be088669aecda4932032023-11-19T01:38:55ZengMDPI AGJournal of Clinical Medicine2077-03832023-08-011216517610.3390/jcm12165176Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age SpectrumIrina T. Duff0Kristen N. Krolick1Hana Mohamed Mahmoud2Vidya Chidambaran3Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21218, USADepartment of Anesthesia, Cincinnati Children’s Hospital, Cincinnati, OH 45242, USADepartment of Anesthesia, Cincinnati Children’s Hospital, Cincinnati, OH 45242, USADepartment of Anesthesia, Cincinnati Children’s Hospital, Cincinnati, OH 45242, USAChronic pain is highly prevalent in the pediatric population. Many factors are involved in the transition from acute to chronic pain. Currently, there are conceptual models proposed, but they lack a mechanistically sound integrated theory considering the stages of child development. Objective biomarkers are critically needed for the diagnosis, risk stratification, and prognosis of the pathological stages of pain chronification. In this article, we summarize the current evidence on mechanisms and biomarkers of acute to chronic pain transitions in infants and children through the developmental lens. The goal is to identify gaps and outline future directions for basic and clinical research toward a developmentally informed theory of pain chronification in the pediatric population. At the outset, the importance of objective biomarkers for chronification of pain in children is outlined, followed by a summary of the current evidence on the mechanisms of acute to chronic pain transition in adults, in order to contrast with the developmental mechanisms of pain chronification in the pediatric population. Evidence is presented to show that chronic pain may have its origin from insults early in life, which prime the child for the development of chronic pain in later life. Furthermore, available genetic, epigenetic, psychophysical, electrophysiological, neuroimaging, neuroimmune, and sex mechanisms are described in infants and older children. In conclusion, future directions are discussed with a focus on research gaps, translational and clinical implications. Utilization of developmental mechanisms framework to inform clinical decision-making and strategies for prevention and management of acute to chronic pain transitions in children, is highlighted.https://www.mdpi.com/2077-0383/12/16/5176chronic painchronification of painmolecular markersbiomarkersmechanismspediatric pain |
| spellingShingle | Irina T. Duff Kristen N. Krolick Hana Mohamed Mahmoud Vidya Chidambaran Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum Journal of Clinical Medicine chronic pain chronification of pain molecular markers biomarkers mechanisms pediatric pain |
| title | Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum |
| title_full | Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum |
| title_fullStr | Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum |
| title_full_unstemmed | Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum |
| title_short | Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum |
| title_sort | current evidence for biological biomarkers and mechanisms underlying acute to chronic pain transition across the pediatric age spectrum |
| topic | chronic pain chronification of pain molecular markers biomarkers mechanisms pediatric pain |
| url | https://www.mdpi.com/2077-0383/12/16/5176 |
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