Pancreatic Pain-Knowledge Gaps and Research Opportunities in Children and Adults: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop.

Aliye Uc, Dana K Andersen, A Vania Apkarian, Melena D Bellin, Luana Colloca, Asbjørn M Drewes, Ellyn K Dunbar, Christopher E Forsmark, Marc T Goodman, Leonardo Kapural, George F Koob, Tonya M Palermo, Stephen J Pandol, Pankaj Pasricha, Anna E Phillips, Daniele Piomelli, Jami L Saloman, Sarah Jane Schwarzenberg, Vikesh K Singh, Gwendolyn Sowa, Thomas Strouse, Glenn J Treisman, John A Windsor, Dhiraj Yadav

Journal: Pancreas 2022;50(7):906-915

PMID: 34643606

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Abstract

A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to focus on research gaps and opportunities in pancreatic pain. The event was held on July 21, 2021, and structured into 4 sessions: (1) pathophysiology; (2) biomarkers, mediators, and pharmacology of pain; (3) pain assessment; and (4) pain treatment challenges and opportunities. The current state of knowledge was reviewed; many knowledge gaps and research needs were identified that require further investigation. Common themes included the need to better understand the underlying mechanisms of pain in pancreatic diseases, the relationship of visceral neural pathways and central pain centers, the role of behavioral factors and disorders on the perception of pain, and differences in pain perception and processes in children when compared with adults. In addition, the role of genetic risk factors for pain and the mechanisms and role of placebos in pain treatment were discussed. Methods of pain assessment including quantitative sensory testing were examined, as well as the process of central sensitization of pain. Finally, newer approaches to pain management including cognitive behavioral therapy, nerve stimulation, experimental (nonopioid) drugs, and cannabinoid compounds were covered.

Address: From the Division of Gastroenterology, Hepatology, Pancreatology and Nutrition, Stead Family Department of Pediatrics, The University of Iowa, Iowa City, IA.; Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.; Departments of Physiology, Anesthesiology, Physical Medicine and Rehabilitation, and Center for Translational Pain Research, Northwestern University, Feinberg School of Medicine, Chicago, IL.; Departments of Pediatrics and Surgery, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.; Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.; Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, FL.; Cancer Prevention and Control Program, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA.; Carolinas Pain Institute, Charlotte, NC.; National Institute on Alcohol Abuse and Alcoholism and Intramural Research Program, National Institute on Drug, National Institutes of Health, Bethesda, MD.; Division of Gastroenterology, Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA.; Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.; Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine.; Departments of Anatomy and Neurobiology, Biological Chemistry, and Pharmacology, University of California, Irvine School of Medicine, Irvine, CA.; Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.; Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA.; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA.; Department of Psychiatry and Behavioral Sciences, Department of Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.; Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

DOI: 10.1097/MPA.0000000000001899

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MeSH Terms: Abdominal Pain, Adult, Biomedical Research, Child, Humans, National Institute of Diabetes and Digestive and Kidney Diseases (U.S.), Pain Management, Pancreatic Diseases, United States