Understanding the mechanisms that underpin the transition from acute to chronic pain is critical for the development of more effective and targeted treatments. There is growing interest in the contribution of glial cells to this process, with cross-sectional preclinical studies demonstrating specific changes in these cell types capturing targeted timepoints from the acute phase and the chronic phase. In vivo longitudinal assessment of the development and evolution of these changes in experimental animals and humans has presented a significant challenge. Recent technological advances in preclinical and clinical positron emission tomography, including the development of specific radiotracers for gliosis, offer great promise for the field. These advances now permit tracking of glial changes over time and provide the ability to relate these changes to pain-relevant symptomology, comorbid psychiatric conditions, and treatment outcomes at both a group and an individual level. In this article, we summarize evidence for gliosis in the transition from acute to chronic pain and provide an overview of the specific radiotracers available to measure this process, highlighting their potential, particularly when combined with ex vivo/in vitro techniques, to understand the pathophysiology of chronic neuropathic pain. These complementary investigations can be used to bridge the existing gap in the field concerning the contribution of gliosis to neuropathic pain and identify potential targets for interventions.

中文翻译：

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慢性神经病理性疼痛神经胶质增生的正电子发射断层扫描成像的最新进展和挑战。

了解从急性疼痛转变为慢性疼痛的机制对于开发更有效、更有针对性的治疗方法至关重要。人们对神经胶质细胞对此过程的贡献越来越感兴趣，横断面临床前研究证明了这些细胞类型的特定变化，捕获了急性期和慢性期的目标时间点。对实验动物和人类这些变化的发展和进化进行体内纵向评估提出了重大挑战。临床前和临床正电子发射断层扫描的最新技术进步，包括神经胶质增生特异性放射性示踪剂的开发，为该领域带来了巨大的前景。这些进步现在允许跟踪神经胶质随时间的变化，并提供将这些变化与疼痛相关症状、共病精神疾病以及群体和个体水平的治疗结果联系起来的能力。在本文中，我们总结了从急性疼痛向慢性疼痛转变过程中神经胶质增生的证据，并概述了可用于测量这一过程的特定放射性示踪剂，强调了它们的潜力，特别是与离体/体外技术相结合时，以了解病理生理学慢性神经性疼痛。这些补充研究可用于弥合该领域关于神经胶质增生对神经性疼痛的影响的现有差距，并确定潜在的干预目标。