Chronic Pain: Mechanisms and putative novel treatments

Chronic pain remains one of the most under-recognized and under-treated medical problems of the 21st century affecting on average 20% of the adult population. Chronic pain has an enormous impact on modern society, due to loss of productivity and health care costs. Pain, hyperalgesia and allodynia are common symptoms experienced in chronic pain syndromes and are thought to depend on sensitization of the sensory nervous system at different levels such as sensory neurons, spinal cord and brain. Sensitization of sensory neurons that relay pain signals, so-called nociceptors is one of the major factors that drives pathological pain. Current therapies to treat pain are at best moderately effective and their effectiveness shows great variability between patients. Although many efforts have been undertaken to elucidate the underlying molecular pathways driving sensitization, understanding of the mechanisms leading to chronic pain is limited, hindering the development of new therapeutic approaches to treat debilitating chronic pain conditions.
In this presentation I will discuss potential peripheral mechanisms leading to chronic pain. In addition, I will briefly discuss two main studies we are currently working on. Firstly, we developed a fusion protein of the anti-inflammatory cytokines IL4 and IL10 which has potential as treatment for persistent inflammatory pain. Secondly, we found a genetic variation nearby the FAM173b gene in patients with chronic pain. We identified the function of FAM173B, a hitherto uncharacterized protein, and demonstrated how this unknown protein regulates pain.