Funded Projects

Rheumatoid arthritis is an autoimmune disease characterized by episodes of joint inflammation and pain. There are currently no safe and effective treatments that achieve long-term remission of the condition or the associated pain. Many patients use opioid medications to manage the pain and are at increased risk of developing opioid use disorder; therefore, additional treatment options are needed. In rheumatoid arthritis, pain-triggering sensory neurons interact with immune cells in the joints. This project aims to dissect the neuroimmune crosstalk underlying pain and inflammation in arthritic joints and uncover novel therapeutic avenues for this painful condition.

Neuropathic pain—a debilitating form of chronic pain affecting millions of people—responds poorly to current analgesic treatment approaches. By better understanding the cellular mechanisms and compounds involved in neuropathic pain, researchers will be able to develop more targeted therapeutic approaches. This project will investigate the role that two proteins—Ly6e and Lynx1—play in various processes involved in the development of neuropathic pain, such as the activity of pain-triggering sensory neurons, interactions between neurons and immune cells, and the activity of an ion channel that has been implicated in the generation of pain signals.

Chronic pain remains a significant global heath challenge. Development of novel safe and effective treatments requires a deeper understanding of the molecular and cellular mechanisms that underlie the development of chronic pain. One protein that has been implicated in controlling the transition from acute to chronic pain is N-acylethanolamine acid amidase (NAAA). This project will evaluate how NAAA controls pain susceptibility after an acute insult and how this affects the emergence of chronic pain.

Endometriosis is a gynecologic disorder characterized by severe pelvic pain, affecting 10% of reproductive aged women and adolescents worldwide. These individuals are at an increased risk for chronic opioid use, dependence, and overdose. Adolescents and young adults in particular are understudied in endometriosis research. This project will conduct a longitudinal study of adolescent endometriosis. The research will identify novel biomarkers and biological pathways involved in the transition of acute to chronic pain. The research aims to improve non-surgical endometriosis diagnosis, risk, and treatment. 

This project provides protected time for training and research activities that are required for an independent scientific career in delivering evidence-based treatments for people with opioid use disorder. The increasing presence of fentanyl in the drug supply creates challenges for the use of buprenorphine, because both patients and physicians want to avoid causing withdrawal. This research will interview both patients and physicians to understand their concerns and experiences and work with them to develop a buprenorphine induction toolkit to help balance the advantages of buprenorphine treatment against concerns about the potential presence of unknown fentanyl. 

The Interagency Pain Research Coordinating Committee has identified a need for organized opportunities for early-stage pain researchers to meet and learn from more experienced pain researchers and mentors – who are exiting the field at a faster rate than they are being replaced. This project will create a coordinating center for early-stage pain researchers, with an online networking platform to encourage interactions and collaboration among these scientists. The research will also develop a training curriculum and make it accessible to NIH funded, early-stage pain scientists.

Current evidence indicates that chronic pain after a traumatic injury is influenced by the body’s response to stress. This project will conduct a comprehensive analysis of gene expression after traumatic stress exposure in a range of animal models in various body regions including the brain (amygdala, hippocampus, hypothalamus) and spinal cord, as well as nerves and immune cells throughout the body. These studies will be conducted in animals with no stress exposure as well as in animals treated with a molecule (FKBP51) known to block the stress response. This research will enhance understanding of how FKBP51 and post-injury stress affect pain processes.

The Early Phase Pain Investigation Clinical Network (EPPIC-Net) conducts comprehensive analyses of observable traits (deep phenotyping) and aims to identify molecular and physiological signatures to help characterize specific pain conditions. To achieve these goals, researchers collect complex data using technologies such as magnetic resonance imaging of the brain, actigraphy, and electroencephalography. There is a need to train researchers to be able to extract key information from high-powered computing resources now widely available.  This research will complement the goals of EPPIC-Net by enhancing development of novel statistical methods to analyze complex data generated by EPPIC-Net pain studies.

An important step for identifying new, non-addictive chronic pain treatments is the search for new, non-opioid molecular targets that reflect the human condition. Recent findings show an increase in levels of two proteins (calcium channel alpha-2delta-1 subunit and thrombospondin) in sensory and spinal cord neurons after nerve injury. This increase is associated with the development of neuropathic pain. This project will determine if chronic injury to key nerve fibers involved in pain cause changes in rat behavior that indicate altered mood. These nerve fibers include the trigeminal nerve that communicates pain, touch, and temperature sensations from the face to the brain and the L5/6 spinal nerves often associated with back and leg pain. This research will also test whether small protein-like molecules (peptides) that block calcium channel alpha-2delta-1 subunit and thrombospondin also block the mood-related behaviors.

Few integrated treatments are available that simultaneously address the fundamental causes of chronic pain and opioid misuse/opioid use disorder and focus on well-being among individuals with chronic pain and opioid misuse/opioid use disorder. This research will inform development of patient-centered interventions that increase quality of life and engagement in valued activities, are culturally appropriate for use by diverse patient populations, and reduce stigma related to chronic pain and opioid misuse/opioid use disorder. The results of this project will be used to inform future research focused on developing mobile health treatments for individuals with chronic pain and opioid use disorder, and for developing culturally appropriate treatments for chronic pain and opioid use disorder in Hispanic/Latino individuals.

Acute and chronic pain vary widely across patients, due in large part to genetic differences between individuals. The same variation occurs in preclinical animal models with diverse genetic backgrounds. The development of automated mouse “pain scales” using high-speed videography, machine learning, and custom software allows pain to be assessed in a quantitative manner in nonverbal animals. This technology will be used to identify genetically different mice with high or low pain sensitivity, which will facilitate the development of new therapeutic strategies to treat pain and reduce reliance on opioids.

Current treatments for chronic pain, including opioids, are not effective for many individuals. Much remains unknown about genes, circuits, and cells that contribute to chronic pain, including how chronic pain changes across the lifespan in certain populations, including infants, children, older people, and pregnant women. This project will develop technology to map the genes, circuits, and cells associated with pain across ages, sexes, and during pregnancy. The technologies will guide the search for new biomarkers for chronic pain diagnosis and treatments.

There are significant and persistent gaps in knowledge about effective pain management for acute and chronic sickle cell pain. This is an area of relevant interest for the NIH HEAL Initiative's Early Phase Pain Investigation Clinical Network (EPPIC-Net). In order to provide guidance for hospital-based administration of the medication ketamine, this project will conduct a cross-sectional survey study of healthcare professionals within EPPIC-Net who provide care for people with sickle cell disease. This information can be used to design a clinical protocol for a multisite, randomized clinical trial of sub-anesthetic (low) doses of ketamine for challenging vaso-occlusive episodes (“pain crises”) in people with sickle cell disease.