The following is a summary of the “Perturbations in Neuroinflammatory Pathways Are Associated With a Worst Pain Profile in Oncology Patients Receiving Chemotherapy,” published in the January 2023 issue of Pain Management by Shin, et al.

Around 55% of people with cancer experience chronic, unbearable agony. Identifying the underlying biological causes of pain may reveal novel treatment avenues. This study aimed to compare cancer patients with and without acute pain to identify differences in neuroinflammatory pathways. About 6 times during 2 cycles of chemotherapy, the worst pain was reported using a numeric rating scale from 0 to 10. Using latent profile analysis, we could classify patients based on their unique pain characteristics. Gene expression data from RNA sequencing (n = 192) and microarray (n = 197) technologies were used to conduct pathway impact assessments in 2 separate samples. 

Significantly altered pathways between the None and Severe pain groups were identified using Fisher’s combined probability test. Of those who participated in the RNA sequencing and microarray studies, 62.5% and 56.3% were classified as having Serious pain. In nine cases, the underlying neuroinflammatory systems were disturbed (i.e., retrograde endocannabinoid signaling, gamma-aminobutyric acid synapse, glutamatergic synapse, Janus kinase-signal transducer and activator of transcription signaling, phagosome, complement and coagulation cascades, cytokine-cytokine receptor interaction, chemokine signaling, calcium signaling). 

This is the first study to investigate the link between severe pain and disruptions in neuroinflammatory pathways in people seeking cancer treatment. The results point to complicated neuroimmune interactions as a possible contributor to the upkeep of chronic pain disorders. About 9 altered neuroinflammatory pathways were found by comparing oncology patients with no pain to those with significant pain. The results raise the possibility that intricate neuroimmune interactions contribute to the upkeep of chronic pain states.