We’re gradually coming to understand, as one scientist put it, that “the immune cells, glia and neurons form an integrated network in which activation of an immune response modulates the excitability of pain pathways:” in other words, that microglia getting over-zealous play a key role in the continuation and formation of chronic pain of both neuropathic and inflammatory kinds.
And this is particularly important because there’s a group that’s more likely to experience chronic pain than any other: women. The likelihood of chronic pain is higher among women than men; studies have repeatedly borne this out. Perversely, women’s pain is often treated less seriously than men’s, thanks to cultural expectations about male stoicism and female emotionality, so female chronic pain sufferers may face the double whammy of lack of responsiveness to medication and lack of response from doctors.
The microglia add to a range of factors that we already know may shift the ways in which women respond differently to drugs. I’ve written before about the problems of not acknowledging gender when it comes to medication testing; our metabolisms, body fat ratios, hormonal cycles, and smaller size all affect how we absorb and respond to medication as a gender, and now it seems that the microglia activation in our immune systems have been playing havoc without being noticed. Until now. Continue…
The microglial revolution is relatively young; Nature only reported in 2012 that they were being discovered to be more than “passive sentinels.” But it’s moving fast. We now have regular experiments in which they’re being knocked out in mice, and a method by which the same experiment could be performed on human microglia is likely not far behind. Once that happens, microglia knock-out or alteration therapies could be part of normal treatment for chronic pain, particularly in women, and microglial reaction could help construct better pain responses for various medications. Good news indeed.