Doorways to Discovery
November 11, 2014
Although pain serves a purpose to let us know when we have been injured, in many patients, the pain signaling system is somehow broken, resulting in chronic pain.
The Neurosurgery Pain Research Institute at Johns Hopkins was developed using a generous gift from an anonymous donor to fundamentally transform our understanding of pain and to develop new and effective strategies to treat it.
This mission is being accomplished through an unprecedented collaborative effort that brings together scientists across Johns Hopkins who study pain. Experts across diverse fields are now working in concert so that the whole is greater than the sum of its parts to achieve the institute’s mission.
More than seven collaborative efforts have been established in areas ranging from the identification of novel molecules responsible for pain initiation to measurement of pain in postoperative patients and the implementation of “comfort menus” aimed at individualizing patient pain management.
As one example, Michael Caterina, the institute’s director, has worked with investigators from the departments of Neuroscience and of Anesthesiology and Critical Care Medicine to demonstrate that keratinocytes, the cells that cover our skin surface, can act as a “first line of defense” for the body by communicating with nearby sensory neurons and triggering the sensation of pain. This discovery provides the rationale for the development of novel pain therapies aimed at interfering with the communication between keratinocytes and nerves to disrupt pain signaling.
In another collaboration, Allan Belzberg, the institute’s clinical co-director, has worked with scientists in the Department of Neurology to uncover why some patients with peripheral nerve tumors experience excruciating pain, whereas others do not. By isolating the tumor cells from these patients, the team has discovered a number of pain-related genes that are expressed at higher levels in tumors from patients with pain compared with those whose tumors are not painful. Further analysis of these genes will provide an invaluable handle with which to better understand and ultimately treat pain in these patients.
Doorways to Discovery: Neurosurgical Pain Research Institute-To Control, Prevent, and Eliminate Pain
Challenge: To better understand chronic pain in order to develop new and effective treatment strategies.
Approach: Bringing together scientists from disparate fields across Johns Hopkins to collaborate on novel solutions that will fundamentally transform our understanding of pain and how to treat it.
Progress: In one collaboration, scientists have identified keratinocytes, the cells that cover our skin surface, as a target for novel pain therapies to disrupt pain signaling. In another, researchers have found genetic clues as to why some patients with peripheral nerve tumors experience excruciating pain, opening the door for better treatments.