Nociceptor sensory neurons are specialized to detect potentially damaging stimuli, protecting the organism by initiating the sensation of pain and eliciting defensive behaviours. Bacterial infections produce pain by unknown molecular mechanisms, although they are presumed to be secondary to immune activation. Here we demonstrate that bacteria directly activate nociceptors, and that the immune response mediated through TLR2, MyD88, T cells, B cells, and neutrophils and monocytes is not necessary for Staphylococcus aureus-induced pain in mice. Mechanical and thermal hyperalgesia in mice is correlated with live bacterial load rather than tissue swelling or immune activation. Bacteria induce calcium flux and action potentials in nociceptor neurons, in part via bacterial N-formylated peptides and the pore-forming toxin α-haemolysin, through distinct mechanisms. Specific ablation of Nav1.8-lineage neurons, which include nociceptors, abrogated pain during bacterial infection, but concurrently increased local immune infiltration and lymphadenopathy of the draining lymph node. Thus, bacterial pathogens produce pain by directly activating sensory neurons that modulate inflammation, an unsuspected role for the nervous system in host–pathogen interactions.

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Microarray data are deposited at the NCBI GEO database under accession number GSE46546.


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We thank L. Barrett, V. Wang, N. Andrews, C. Melin, Y. Wang, K. Duong, E. Cobos del Moral, O. Babanyi and G. Bryman for technical help. We thank Y.-C. Cheng and R. Becker for technical advice; J. Sprague and A. Yekkirala for developing whole-well imaging; I. Inoshima for recombinant αHL; R. Malley, J. Steen and Q. Ma for discussions; J. Chiu for moral support; S. Liberles, B. Xu and V. Kuchroo for mentoring. This work was supported by NIH PO1AI078897, 5RO1AI039246 (M.C.C.), R37NS039518, 5P01NS072040 (C.J.W.), 5F32NS076297 (I.M.C.), FACS, and microarrays at Boston Children’s Hospital IDDRC facilities (NIH-P30-HD018655).

Author information


  1. Kirby Neurobiology Center, Boston Children’s Hospital, and Department of Neurobiology, Harvard Medical School, Boston, Massachusetts 02115, USA

    • Isaac M. Chiu
    • , Nader Ghasemlou
    • , Christian A. Von Hehn
    • , Johnathan Tran
    • , Brian Wainger
    • , Amanda Strominger
    • , Sriya Muralidharan
    • , Sun Wook Hwang
    •  & Clifford J. Woolf
  2. Boston Children’s Hospital, Program in Cellular and Molecular Medicine, and Harvard Medical School, Boston, Massachusetts 02115, USA

    • Balthasar A. Heesters
    •  & Michael C. Carroll
  3. Medical Microbiology, University Medical Center, Utrecht, Utrecht 3584 CX, The Netherlands

    • Balthasar A. Heesters
  4. Department of Chemistry, Quantitative Biology Program, Brandeis University, Waltham, Massachusetts 02454, USA

    • Fan Zhao
  5. Department of Microbiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA

    • Alexander R. Horswill
  6. Departments of Pediatrics and of Microbiology, University of Chicago, Chicago, Illinois 60637, USA

    • Juliane Bubeck Wardenburg
  7. Korea University Graduate School of Medicine, Seoul 136-705, South Korea

    • Sun Wook Hwang


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I.M.C. and C.J.W. designed the study. I.M.C. and B.A.H.: infection and immune analysis; I.M.C. and N.G.: behavioural analysis; N.G. and A.S.: cytokine profiling; I.M.C. and S.M.: microscopy; I.M.C., C.A.V.H. and J.T.: neuronal culture, calcium imaging; S.W.H.: electrophysiology; F.Z.: peptide synthesis and chemistry; B.W.: multielectrode arrays. J.B.W. and A.R.H.: generation of bacterial strains; J.B.W.: recombinant αHL; J.B.W., M.C.C. and C.J.W.: supervision and expertise. I.M.C. and C.J.W. wrote the manuscript.

Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Clifford J. Woolf.

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