Background: The management of pain in patients with rheumatoid arthritis (RA) is a
complex subject due to the autoimmune nature of the pathology. Studies have shown that chemical
mediators play a fundamental role in the determination, susceptibility and modulation of pain at
different levels of the central and peripheral nervous system, resulting in interesting novel molecular
targets to mitigate pain in patients with RA. However, due to the complexity of pain physiology in
RA cand the many chemical mediators, the results of several studies are controversial.
Objective: The aim of this study was to identify the chemical mediators that are able to modulate
pain in RA.
Method: In this review, a search was conducted on PubMed, ProQuest, EBSCO, and the Science
Citation index for studies that evaluated the expression of chemical mediators on the modulation of
pain in RA.
Results: Few studies have highlighted the importance of the expression of some chemical mediators
that modulate pain in patients with rheumatoid arthritis. The expression of TRPV1, ASIC-3, and
TDV8 encode ionic channels in RA and modulates pain, likewise, the transcription factors in RA,
such as TNFα, TGF-β1, IL-6, IL-10, IFN-γ, IL-1b, mTOR, p21, caspase 3, EDNRB, CGRPCALCB,
CGRP-CALCA, and TAC1 are also directly involved in pain perception.
Conclusion: The expression of all chemical mediators is directly related to RA and the modulation
of pain by a complex intra and extracellular signaling pathway, however, transcription factors are
involved in modulating acute pain, while the ionic channels are involved in chronic pain in RA.