The unique features of visceral pain
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Many aspects of visceral (i.e. organ) pain are fundamentally different than pain in skin, skeletal muscle, bone and joints (somatic pain). Most obviously, many common analgesics are not particularly effective for visceral pain, illustrating that the underpinning biology must be distinctive. We study the functional anatomy, signalling properties and molecular properties of visceral nociceptors and their connections in the central nervous system to develop new neurobiological frameworks for understanding and developing treatments for clinical conditions such as bladder pain syndrome/interstitial cystitis and endometriosis. Many of these pelvic pain conditions are more prevalent in women, so our studies also investigate the basis of sex differences and steroid signalling mechanisms in these circuits. The range of clinical comorbidities also suggests strong relevance to autonomic circuits, so we also study the sacral spinal cord where autonomic control and pain pathways collide. These projects are being expanded to bioinformatics approaches to identify signalling networks relevant to particular pain states.
Figure 1: Cryosection of sacral spinal cord showing sensory and autonomic neural pathways that express nitric oxide synthase (green) and nociceptor nerves expressing the receptor for glial cell line-derived neurotrophic factor (blue).
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