Cytokines are small proteins with a molecular mass lower than 30 kDa. They are produced and secreted on demand, have a short life span and only travel over short distances if not released into the blood circulation. In addition to the classical interleukins and the chemotactic chemokines, growth factors like VEGF or FGF and the colony stimulating factors are also considered cytokines since they have pleiotropic actions and regulatory function in the immune system. Despite the redundancy and pleiotropy of the cytokine network, specific actions of individual cytokines and endogenous control mechanisms have been identified. Particular local profiles of the classical proinflammatory cytokines are associated with inflammatory hypersensitivity and suggest an early involvement of TNFα, IL-1ß and IL-6. An increasing number of novel cytokines and the more recently discovered chemokines are being associated with pathological pain states. Besides acting as pro-or anti-inflammatory mediators increasing evidence indicates that cytokines act on nociceptors. Neurons within the nociceptive system express neuronal receptors and specifically bind cytokines or chemokines which regulate neuronal excitability, sensitivity to external stimuli and synaptic plasticity. A first step towards a more mechanistic and individual pain therapeutic strategy could be avoidance of hypersensitive pain processing by either neutralization strategies for the proalgesic cytokines or by shifting the balance in favour of antialgesic members of the cytokine-chemokine network.Keywords: Hypersensitivity, inflammatory pain, unrepathic pain, neuroimmune interaction.
HYPERSENSITIVITY AND NOCICEPTOR SENSITI-ZATIONTissue injury and inflammation commonly cause hypersensitivity of the affected body region, so that normally painful stimuli become more painful (hyperalgesia), and those usually associated with nonnoxious sensations evoke pain (allodynia). The neural bases for these sensory phenomena have been explored most extensively using heat injury and experimental arthritis as models. Heat and/or mechanical hypersensitivity is observed after burns, inflammation, nerve lesion and malignant tumour growth. In models of peripheral inflammation hypersensitivity has been attributed to sensitization of myelinated (Adelta) and unmyelinated (C) primary sensory neurons [1] that normally respond to potentially tissue damaging (noxious) stimuli. Since the first report on primary afferent fibres that responded only to damaging stimulation of the skin and therefore were termed nociceptors [2] our knowledge on the function of these fibres and their association with pain has increased substantially. Detailed analyses of nociceptor function have been performed and strict criteria are available for phenotyping distinct classes of nociceptors in mice, rats and men [1,[3][4][5][6]. Nociceptors occupy a prominent functional position in fast information detection, transduction and transmission of potentially noxious stimuli. They can undergo plastic changes and nociceptor ...