European Pain School® at the University of Siena
Siena | Italy • 9-15 June 2024
Background
The European Pain School (EPS), founded at the University of Siena (Italy) in 2002, is the first and still the premier school intended for students working on basic science and clinical topics related to acute and chronic pain. EPS has an interdisciplinary perspective and a distinct research orientation. Young scientists at the Ph.D. or postdoctoral levels (or equivalent) in all fields of pain science and pain medicine are encouraged to apply.
Mission and Overview
In the past the basic mechanisms of pain and the neural pathways involved were explored through research on animals and human subjects using well defined noxious stimuli and observing neurophysiological, behavioral and subjective sensory responses. This straightforward approach, however, is not sufficient to understand most of the real-life spontaneous and prolonged pain states that occur in human patients and animals. Rather, chronic pain involves complex and nonlinear functioning of neural and extraneural systems resulting in the maintenance of the pain process.
Long known are inflammatory mechanisms that can induce a prolonged pain state mediated by pain-producing substances of multiple origin including the immune system, with cytokines stimulating peripheral nociceptors or neurons of the central somatosensory system. Prolonged and enhanced activation of the central pain system may also be due to failure of inhibitory controls in the CNS, a likely mechanism in neuropathic pain. Control by both GABA and endogenous opioids may be affected, causing persistent pain and allodynia. Altered control may also be mediated by cytokines released from activated astrocytes and microglia in the CNS.
The mammalian pain system shows a clear sexual dimorphism that may depend on hormonal influences during peri- and postnatal nervous system development, among other causes. This sexual dichotomy has consequences for pain expression and for psychosocial and medical consequences of pain in males and females, including e.g. the process of pain chronification. Recognition of this dichotomy is resulting in developments in pain medicine that take gender into account.
The European Pain School believes in the advancement of interdisciplinary programs for the ultimate benefit of pain patients, disseminating this vision especially among junior investigators interested in basic and clinical research on pain.
2024 Edition: Pain and the immune system
The scientific programme will include general lectures on pain and chronic pain as well as lectures more focussed on neuro-immune interactions in pain. We have a balanced mixture of pre-clinical and clinical lectures as well as industrial perspective on neuro-immune interactions as a source of novel targets. We also cover biopsychological aspects of pain, including ethics in pain and placebo and nocebo effects. A total of 16 lectures including basic, clinical, and industrial research around the issue of chronic inflammatory and neuropathic pain, sex dimorphism in pain, fibromyalgia, and musculoskeletal pain. We will emphasise the significant role played by immune cells (e.g. macrophages, meningeal cells, and microglia) in neuronal mechanisms underlying peripheral and central sensitisation. We will consider interactions in the nociceptive neuro-axis at the periphery (skin, nerve, meninges) and in the CNS (spinal cord). Scholars will be guided through the issue of “chronic pain” by the aid of solid lectures on general topics and exposed to cutting-edge topics that should inspire the new generation of pain scientists.
Our social programme includes guided tours of Siena and Val D’Orcia including wine tasting and visit to a thermal SPA..
Topics
Neuro-immune interactions in
rheumatoid arthritis
fibromyalgia
meninges and headaches
painful neuropathies
painful autoimmunity
Placebo/nocebo: pain modulation by psychosocial factors
Transfer of power: how macrophages control pain
Ethics in pain: pain in babies
Local and systemic inflammatory mediators
Crosstalk between immune cells and sensory neurons
Sex and pain: differences and similarities
Central microglia and peripheral macrophages: targets for pain treatment
Faculty 2024
Anna Maria Aloisi, Siena, Italy
Carlo V. Bellieni, Siena, Italy
Fabrizio Benedetti, Turin, Italy
Giancarlo Carli, Siena, Italy
Thiago Cunha, Ribeirão Preto, Brazil
Niels Eijkelkamp, Utrecht, Netherlands
Pierangelo Geppetti, Florence, Italy
Marzia Malcangio, London, United Kingdom
Peter Reeh, Erlangen, Germany
Mike Salter, Toronto, Canada
Emanuele Sher, Eli Lilly, United Kingdom
Shafaq Sikandar, London, United Kingdom
Camilla Svensson, Stockholm, Sweden
Nurcan Üçeyler, Würzburg, Germany