Chronic pain is highly prevalent and burdensome, affecting millions of people worldwide. Although it emerges at any point in life, it often manifests in adolescence. Given that adolescence is a unique developmental period, additional strains associated with persistent and often idiopathic pain lead to significant long-term consequences. While there is no singular cause for the chronification of pain, epigenetic modifications that lead to neural reorganization may underpin central sensitization and subsequent manifestation of pain hypersensitivity. Epigenetic processes are particularly active during the prenatal and early postnatal years. We demonstrate how exposure to various traumas, such as intimate partner violence while in utero or adverse childhood experiences, can significantly influence epigenetic regulation within the brain and in turn modify pain-related processes. We provide compelling evidence that the burden of chronic pain is likely initiated early in life, often being transmitted from mother to offspring. We also highlight two promising prophylactic strategies, oxytocin administration and probiotic use, that have the potential to attenuate the epigenetic consequences of early adversity. Overall, we advance understanding of the causal relationship between trauma and adolescent chronic pain by highlighting epigenetic mechanisms that underlie this transmission of risk, ultimately informing how to prevent this rising epidemic.

中文翻译：

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关键窗口：探索围产期创伤、表观遗传学和慢性疼痛之间的关联。

慢性疼痛非常普遍且令人难以忍受，影响着全世界数百万人。虽然它出现在生活的任何阶段，但它往往表现在青春期。鉴于青春期是一个独特的发育时期，与持续且通常是特发性疼痛相关的额外压力会导致重大的长期后果。虽然疼痛慢性化没有单一原因，但导致神经重组的表观遗传修饰可能支持中枢敏化和随后的疼痛超敏反应表现。表观遗传过程在产前和产后早期特别活跃。我们展示了如何暴露于各种创伤，例如在子宫内的亲密伴侣暴力或不良的童年经历，可以显着影响大脑内的表观遗传调节，进而改变与疼痛相关的过程。我们提供了令人信服的证据表明，慢性疼痛的负担很可能在生命早期就开始了，通常会从母亲传给后代。我们还强调了两种有前途的预防策略，催产素给药和益生菌使用，它们有可能减轻早期逆境的表观遗传后果。总的来说，我们通过强调这种风险传播背后的表观遗传机制，推进了对创伤与青少年慢性疼痛之间因果关系的理解，最终告知如何预防这种不断上升的流行病。我们还强调了两种有前途的预防策略，催产素给药和益生菌使用，它们有可能减轻早期逆境的表观遗传后果。总的来说，我们通过强调这种风险传播背后的表观遗传机制，推进了对创伤与青少年慢性疼痛之间因果关系的理解，最终告知如何预防这种不断上升的流行病。我们还强调了两种有前途的预防策略，催产素给药和益生菌使用，它们有可能减轻早期逆境的表观遗传后果。总的来说，我们通过强调这种风险传播背后的表观遗传机制，推进了对创伤与青少年慢性疼痛之间因果关系的理解，最终告知如何预防这种不断上升的流行病。