Better understanding the transition from acute to chronic pain

Researchers at the Institut des neurosciences de Montpellier (Université de Montpellier/Inserm) have demonstrated the key role played by the FLT3 receptor in the chronicization of post-surgical pain. By inhibiting this receptor with therapeutic antibodies, the scientists could offer promising avenues for the prevention of chronic pain. Their findings are to be published in the journal Progress in neurobiology.  

Chronic pain is severe pain that persists for more than three months. Around 30% of surgical patients will develop this type of pain following surgery. In this study, led by Cyril Rivat, a teacher-researcher at the University of Montpellier, the scientists shed light on the mechanisms behind the onset of chronic post-operative pain, and suggest ways of alleviating it.  

According to the results of this work, carried out on an animal model, repeated exposure to pain (repetition of the same surgery one week apart) creates a long-term vulnerability that translates into increased sensitivity to pain and the onset of anxiety-depressive pathologies. The FLT3 receptor expressed by certain so-called sensory neurons plays a key role in this phenomenon. In concrete terms, surgery induces activation of the FLT3 receptor in the affected nerve fibers, leading not only to an increase in initial pain, but also to its chronicization.

Antibodies to FLT3

In collaboration with the Montpellier Cancer Research Institute and Biodol Therapeutics, therapeutic antibodies directed against the FLT3 receptor have been generated. These antibodies inhibit FLT3 activation, thereby considerably reducing pain intensity and halting the transition to chronic pain. The principle is simple: unlike morphine or any other type of painkiller, these antibodies do not penetrate the brain, but target damaged nerves in the peripheral nervous system. FLT3 is therefore a promising target not only for the management of post-operative pain, but also for the prevention of its chronicization.

" These results are still preliminary, but if they are confirmed, they could help many patients suffering from chronic pain, especially as some 300 million surgeries are carried out worldwide every year ," explains Cyril Rivat.

Practical information:

 " Activation of neuronal FLT3 promotes exaggerated sensorial and emotional pain-related behaviors facilitating the transition from acute to chronic pain " is already available in full in its English version, and will appear in the scientific journal "Progress in Neurobiology", volume 222 in March 2023, 102405.

Authors: Adrien Tassou, Maxime Thouaye, Damien Gilabert, Antoine Jouvenel, Jean-Philippe Leyris, Corinne Sonrier, Lucie Diouloufet, Ilana Mechaly, Sylvie Mallié, Juliette Bertin, Myriam Chentouf, Madeline Neiveyans, Martine Pugnière, Pierre Martineau, Bruno Robert, Xavier Capdevila, Jean Valmier, Cyril Rivat.

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