About this Research Topic

Background

It has been estimated that ~40% of population experience a chronic or persistent pain from internal organs. Chronic pelvic pain is pain in the area below the belly button and between the hips that lasts six months or longer. It can be a symptom of another disease, or it can be a condition in its own right. Pelvic pain is the cardinal symptom of either gastrointestinal, gynaecological or urological diseases. Patients with chronic pelvic pain manifest physical and psychiatric comorbidities which amplify pain creating a vicious circle highly impacting on patients’ quality of life. The current pharmacotherapy remains unsatisfactory because of the low efficacy and the side effects. Understanding the molecular mechanisms disturbing the complex network of communication between the viscera and the brain might be the key to understand the pathophysiology of chronic pelvic pain and help to tailor new pharmacological treatments.

The multifactorial nature of pelvic pain makes both the diagnosis and the therapy challenging. The lack of effective and safe therapies able not only to alleviate pelvic pain and comorbidities, but also modifying the underlying mechanisms in patients affected by gastrointestinal, gynaecological and urinary diseases, requires many efforts for the medical community to study novel targets and develop new pharmacological strategies for ameliorating patient’s quality of life. The bidirectional communication between the brain and the viscera passes through various pathways and is highly integrated and regulated by either neuronal or non-neuronal factors, namely neuron-glia networks, neuro-immune interactions, hypothalamus-pituitary axis, emotional inputs, autonomic responses, endocrine regulation, and the local microbial environment. In this context, whether the therapy of pelvic pain should be aimed at the organs, the neural pathways controlling viscera functions and sensitivity, or the central processing mechanisms of symptoms and behaviour, is still unclear. Interdisciplinary research approaches investigating the viscera-brain axis and its disorders at the interface of psychology, gastroenterology/gynaecology/urology and the neurosciences are currently considered best suited to address this topic. It is thus conceivable that a multi-target approach might result more effective in the management of pelvic pain and related diseases than a single therapy.

In this Research Topic, which will comprise both Original Research Articles (preclinical or clinical studies) and Reviews, we invite researchers to discuss innovative and suitable pharmacological approaches for the management of pelvic pain, along with functional and psychiatric comorbidities, exploring the pathways involved in the physiology of viscera-brain axis and identifying novel therapeutic targets. In particular, the contributes should address the following specific themes:

- Peripheral and central pathological mechanisms for pelvic pain.

- Identification of new targets for treating gastrointestinal pain, gynaecological pain, urologic pain.

- Multitarget pharmacological approaches to pelvic pain.

Keywords: Pelvic, Pain, Pharmacology, Gastrointestinal, Gynaecological, Urological

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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