Primers on molecular pathways - Pain and opioid receptors, I

The conquest of pain would be in our mind, perhaps, the most important discovery in medicine to impact on patient suffering. In our specialty, several pancreatic diseases are characterized by severe discomfort. For instance, pancreatic cancer is one of the most painful diseases from which a human being can suffer. Chronic pancreatitis is similarly debilitating. Therefore, the field of pain research and management is of paramount importance to pancreatologists. Certainly, this area is very extensive and growing. However, as applied to pancreatic diseases, we are still in our infancy. The major problem is that, beyond the anecdotal publication, we do not know how pancreatic pain is originated and maintained. Therefore, significant efforts must be made to improve our understanding of the mechanisms of both acute and chronic pain, as well as of how we can provide our patients with a more dignified life and sometimes a more peaceful end stage of life. Thus, it is in this spirit that we are developing several articles on 'molecular pathways' focused on describing the molecular machinery underlying pancreatic pain, with the objective of both creating a better understanding of this problem as well as of generating enthusiasm for outstanding investigators to come to this emerging and critical field of pancreatology. Here, the first article will focus on the mechanism underlying the effect of morphine and opioids. It is our dearest goal that the basic scientist gets very excited about dissecting this problem, and that the clinician not only has simple, one-stop reading material, but that this reading will help him/her understand work published on pancreatic pain and hopefully also initiate clinical trials targeting this pathway.