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The Guts of the Opioid Crisis
Karan H Muchhala1, Joanna C Jacob1, Minho Kang1
1Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia.
Abstract:
Bidirectional interactions of the gut epithelium with commensal bacteria are critical for maintaining homeostasis within the gut. Chronic opioid exposure perturbs gut homeostasis through a multitude of neuro-immune-epithelial mechanisms, resulting in the development of analgesic tolerance, a major underpinning of the current opioid crisis. Differences in molecular mechanisms of opioid tolerance between the enteric and central pain pathways pose a significant challenge for managing chronic pain without untoward gastrointestinal effects.
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