Open AccessThe Guts of the Opioid Crisis
Author(s) -
Karan H. Muchhala,
J. Jacob,
Minho Kang,
William L. Dewey,
Hamid I. Akbarali
Publication year - 2021
Publication title -
physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.14
H-Index - 125
eISSN - 1548-9213
pISSN - 1548-9221
DOI - 10.1152/physiol.00014.2021
Subject(s) - opioid , homeostasis , immune system , analgesic , opioid peptide , intestinal epithelium , chronic pain , biology , medicine , neuroscience , immunology , epithelium , microbiology and biotechnology , pharmacology , receptor , pathology
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.