“…7,11,13,43 In addition, astrocytosis and microglia activation, internalization of the substance P receptor, c-Fos expression and proinflammatory cytokine interleukin-1 (IL-1) beta, tumor necrosis factor-alpha, 26 IL-18, 56 IL-33, 59 and IL-6 which are the cellular and neurochemical characteristics of chronic pain, can be detected in the spinal dorsal horn or DRG. 7,10,26,43,56,59 Our previous report describes the effect of endogenous MOR ligands in the spinal cord and indicates that downregulated spinal endomorphin 2 is an important contributor to the neuropathological process of bone cancer pain. 4 Neuroinflammation appears to be involved in the peripheral nerves, DRG and the spinal cord, all of which contribute to the complex properties of bone cancer pain.…”