Epigenetics and Chronic Pain in Children

Chronic pain, or reoccurring pain lasting longer than three months, is frequently co- morbid with other chronic conditions. Physiological health problems such as overall general health, immune function, inflammation, stress, and sleep, as well as psychological problems like depression and anxiety are all associated with chronic pain. Previous studies have also shown evidence for the heritability of chronic pain, indicating a genetic factor for chronic pain in children. However, few studies have investigated potential epigenetic processes involved in childhood chronic pain. DNA methylation and other epigenetic processes are highly susceptible to changes during crucial developmental periods in children, and they are heavily influenced by psychosocial factors and environmental factors. During an immune response, various cytokines such as TNFα, IL-6, and CRP are released. Cytokines are involved in the production of pain through their pro-inflammatory properties. Additionally, there is evidence to believe they increase pain sensitivity acutely by acting directly on nociceptors. Previous studies have shown that higher levels of inflammatory cytokines are associated with more pain because the inflammatory response from our immune cells activates pain pathways. A constant or prolonged activation of the immune response may consequently result in chronic pain. In many cases of chronic pain, there is an increase in the circulating pro-inflammatory cytokines in the blood that also leads to hypersensitivity.