Table 1.
Phases | Description | Main Involved Structures | Chemical Mediators | References |
---|---|---|---|---|
1. Transduction | Transforming harmful stimuli into an electrical impulse (action potential) |
|
5-HT, BK, H, H+, K+, LT, NT, NY, PAG, PG, ROS, TNF-α, TX | [50,53,54,55,56,57,58,59] |
2. Transmission | Electrical impulse travels to the DRG and spinal cord interneurons |
|
GLU, SP, CGRP | [57,58,59,60,61] |
3. Modulation | Facilitate or inhibit nociceptive transmission |
|
ASP, BK, CA, CGRP, EOP, IL, LT, PC, PG, SP | [54,61,62,63] |
4. Projection | Carry nociceptive inputs from the spinal cord to supraspinal structures |
|
GLU, SP | [62,63] |
5. Perception | Integration of the conscious recognition of pain |
|
GLU, SP | [51,55] |
AMPAr: AMPA receptor; ASP: aspartate; BK: bradykinin; CA: catecholamines; CGRP: calcitonin-gene-related peptide; DRG: dorsal root ganglion; EOP: endogenous opioid peptides; GLU: glutamate; H: histamine; H+: hydrogen; IL: interleukin; K+: potassium; LT: leukotrienes; NMDAr: NMDA receptor; NT: neurotrophins; PAF: platelet-activating factor; PC: prostacyclin; PG: prostaglandin; ROS: free radicals; SP: substance P; TNFα: tumoral necrosis factor; TRP: transient receptor potential; TX: thromboxane; 5-HT: serotonin.