Folic Acid in Pain: An Epigenetic Link

Abstract

Pain, due to its variability and lack of clear definition, forms one of the biggest challenges being faced by the physicians globally. The current therapeutic interventions being used to treat or reduce pain seem to be insufficient to solve the problem. Although the mechanisms underlying pain and associated with “killing pain” have been in limelight since time immemorial, the exact mechanisms have not yet been delineated. The genetic and epigenetic basis of pain and its treatment are emerging as potential answers to the unsolved queries associated with pain. Folic acid (vitamin B9) has been reported to show a potential role in treatment of various types of pains including joint pain (rheumatoid arthritis), myofascial pain, and cancer-associated pain. This pharmacological property displayed by folic acid could rightly be linked to the epigenetic alterations associated with folic acid administration. This review attempts to link the analgesic effect of folic acid with its deoxyribonucleic acid (DNA) methylation property (a major epigenetic alteration), which may help us understand the molecular basis of analgesic effect of folic acid in a more appropriate manner.