Trigeminal and spinal acute/chronic pain systems

Rationale for the work - The socio-economic burden of chronic pain is substantial.  Over 40% of chronic pain sufferers state that their pain significantly impairs their quality of life, leading to depression and suicidal tendencies. A major re-evaluation of chronic pain as a disease in its own right has directed future research towards ‘causes’ rather than ‘symptoms’. It is likely that different types of pain relating to specific conditions e.g. cancer, diabetes, arthritis will be more effectively treated using specific classes of drugs that target an identified cause rather than the current ‘one-size-fits-all’ approach.

Summary of work - There is a high prevalence of oro-facial chronic pain conditions, collectively referred to a ‘trigeminal pain’, that include migraine, post-herpetic neuralgia or dental pain.  Effective treatments are limited.  Our studies are aimed at providing a much better understanding of these types of pain conditions.  The most typical causes involve either inflammation (inflammatory pain) or nerve damage (neuropathic pain).  In the past, these two types of pain have effectively been considered as being equivalent and assumptions have been made about developing generic analgesics that would be effective in both types of pain.  But recent studies show that this is incorrect and is a gross over-simplification of the two systems which, whilst having commonality display unique characteristics.  Each type of pain must be understood in its own right.

Animal Welfare – All of our studies comply with the highest ethical standards, in line with our duty of care and are approved by both the Animal Welfare and Ethical Review Committee and the Home Office.

Reduction, replacement & refinement - Pain is generated by complex networks in brain and spinal cord which cannot yet be replicated in a dish or in non-sentient models so a requirement for relevant models remains.  As part of our 3Rs strategy, our studies mainly utilize isolated tissues such as brain/spinal cord slices or cultured cells.  We are also applying in silico computational modelling approaches in attempt to simulate neuronal activity. Recently, we have begun to develop studies using brain EEG recordings to provide insight into sensory-cognitive aspects of human pain.

Implications for our findings - Our work will provide data on potential future targets for the development of effective analgesics to treat chronic pain that originates within the oro-facial trigeminal system.

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