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Endogenous Opioid Dynorphin Is a Potential Link between Traumatic Brain Injury, Chronic Pain, and Substance Use
Kaitlin M Best1,2, Marissa M Mojena3, Gordon A Barr3,4,5
1Department of Nursing and Clinical Care Services, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Journal of Neurotrauma
|November 9, 2021
Summary
Dynorphin and its receptor (KOR) are dysregulated after traumatic brain injury (TBI). This review suggests dynorphin may play a role in chronic pain and substance use disorder (SUD) following TBI.
Area of Science:
- Neuroscience
- Neuropharmacology
- Traumatology
Background:
- Traumatic brain injury (TBI) is a major public health issue linked to physical and neuropsychiatric problems.
- Chronic pain and substance use disorder (SUD) are common after TBI, but their mechanisms remain unclear.
- Dynorphin, an endogenous opioid, and its receptor (KOR) are implicated in pain and SUD.
Purpose of the Study:
- To review the roles of dynorphin and KOR in chronic pain and SUD.
- To synthesize this information with TBI pathophysiology.
- To propose dynorphin's potential role in TBI's long-term consequences.
Main Methods:
- Literature review of dynorphin/KOR in pain and SUD.
- Synthesis of findings with TBI research.
- Identification of mechanistic parallels.
Main Results:
- Dynorphin/KOR activation has complex effects on pain (antinociceptive or pro-nociceptive).
- Dynorphin signaling pathways overlap with chronic pain development.
- The dynorphin/KOR system regulates negative affective states in SUD, mirroring TBI pathophysiology.
Conclusions:
- Dynorphin dysregulation after TBI may contribute to chronic pain and SUD.
- Further research is needed to elucidate the dynorphin/KOR system's role in TBI sequelae.
- Hypotheses proposed for future investigation into dynorphin's role post-TBI.
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