Research on central sensitization of endometriosis-associated pain: a systematic review of the literature

Pengshen Zheng, W Zhang, J Leng, J Lang
In: Journal of Pain Research, Vol Volume 12, Pp 1447-1456 (2019) · 2019 · W4401475455
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This systematic review of 15 articles examined the mechanisms of endometriosis-associated pain, including central sensitization, to identify targets for improved treatment strategies.

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This systematic review evaluated evidence for central sensitization as a mechanism underlying endometriosis-associated pain by searching PubMed, Web of Science, Embase, and the Cochrane Library for English-language studies published from 2008 onward using terms combining endometriosis-related pain outcomes with “central sensitization.” From the identified records, 15 articles met eligibility criteria, comprising 6 reviews, 6 human studies (including one conference abstract only), and 3 animal studies, which the authors organized into four lists to synthesize proposed mechanisms. The review highlights multiple contributing domains—innervation, vascularization, local inflammation, cross-correlated visceral sensitization, and central sensitization—and concludes that further work is needed to map key signaling pathways, gene targets, and biomarkers using new techniques. This paper is centrally about endometriosis — it specifically reviews literature on central sensitization mechanisms in endometriosis-associated pain.

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Abstract

Ping Zheng*, Wen Zhang*, Jinhua Leng, Jinghe LangDepartment of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China*These authors contributed equally to this workAbstract: Endometriosis-associated pain afflicts an enormous number of women who suffer from endometriosis. There is an urgent need to explore the pathogenesis of endometriosis-associated pain to identify targets for treatment of hyperalgesia. A search was conducted in PubMed, Web of Science, Embase, and the Cochrane Library using the search terms “endometriosis” AND (“pain” OR “hyperalgesia” OR “nociception” OR “allodynia”) AND “central sensitization”. The search was limited to articles published in English from 01/01/2008 to the present. Among the search results, 15 articles were eligible for systematic review, including 6 reviews, 6 human studies (one in the form of a conference abstract only), and 3 animal studies. The articles were classified into 4 lists to describe the mechanism of endometriosis-associated pain and synthesize different aspects of research on it. In conclusion, there is a need to explore the mechanism of endometriosis-associated pain in terms of innervation, vascularization, local inflammation, cross-correlated visceral sensitization, and central sensitization to identify the target molecules and signaling pathways of key genes and relevant biomarkers through new techniques, all with the goal of developing a more comprehensive treatment strategy for endometriosis than is currently available.Keywords: endometriosis-associated pain, neurogenic inflammation, mechanism, central sensitization
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Journal of Pain Research (May 2019) Research on central sensitization of endometriosis-associated pain: a systematic review of the literature Abstract Ping Zheng*, Wen Zhang*, Jinhua Leng, Jinghe LangDepartment of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China*These authors contributed equally to this workAbstract: Endometriosis-associated pain afflicts an enormous number of women who suffer from endometriosis. There is an urgent need to explore the pathogenesis of endometriosis-associated pain to identify targets for treatment of hyperalgesia. A search was conducted in PubMed, Web of Science, Embase, and the Cochrane Library using the search terms “endometriosis” AND (“pain” OR “hyperalgesia” OR “nociception” OR “allodynia”) AND “central sensitization”. The search was limited to articles published in English from 01/01/2008 to the present. Among the search results, 15 articles were eligible for systematic review, including 6 reviews, 6 human studies (one in the form of a conference abstract only), and 3 animal studies. The articles were classified into 4 lists to describe the mechanism of endometriosis-associated pain and synthesize different aspects of research on it. In conclusion, there is a need to explore the mechanism of endometriosis-associated pain in terms of innervation, vascularization, local inflammation, cross-correlated visceral sensitization, and central sensitization to identify the target molecules and signaling pathways of key genes and relevant biomarkers through new techniques, all with the goal of developing a more comprehensive treatment strategy for endometriosis than is currently available.Keywords: endometriosis-associated pain, neurogenic inflammation, mechanism, central sensitization

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