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Dental School
Could your body be the best source of pain relief?

By Aileen Salinas

Pain – it’s the most common complaint triggering patients to seek health care. Whether it’s a toothache, headache, arthritis or worse, health care professionals continually are looking for ways to help ease their patients’ pain.

"Pain serves an important protective function," said Kenneth Hargreaves, D.D.S., Ph.D., professor and chairman in the Dental School’s department of endodontics. "If we injure our hand by touching a hot fire, then the perception of pain initiates reflexes to withdraw the hand while sending signals to the brain letting us know injury has occurred." Over time, the body should recover from this type of injury.

However, persistent pain (pain lasting well beyond the time of actual injury) involves suffering and requires treatment. Fortunately, Dr. Hargreaves and his team are on the verge of developing a new class of pain-relieving analgesics using a substance already in our bodies.

"Almost all of the pain-relieving drugs we have today are derived from plants," Dr. Hargreaves said. "Using tools we have now, we are looking into how the body’s pain system works, to develop a new class of pain relievers that can help people."

Dr. Hargreaves is investigating Neuropeptide Y (NPY) and its role in the human body to relieve persistent inflammatory pain. "NPY is of interest because it is one of the body’s natural substances," Dr. Hargreaves said.

In January, Jennifer Gibbs, a joint D.D.S./Ph.D. student in her third year at the Health Science Center and a member of Dr. Hargreaves’ team, proved through animal models that NPY truly is an analgesic, or pain-relieving compound. Her research showed NPY works to inhibit pain fibers in our nerves from activating.

"Jennifer’s work is important because it recognizes the NPY system’s involvement in regulating pain, and that suggests drugs that alter the NPY system could represent a whole new class of pain relievers," Dr. Hargreaves said. "We wanted to see whether NPY was good for relieving inflammatory pain. The answer is yes."

Now that NPY is a proven analgesic, scientists believe a synthetic form of it can be administered to patients with persistent pain. Clinical studies already are under way. Studying subjects with severe toothaches, which is inflammatory pain, Karl Kaiser, D.D.S., assistant professor of endodontics, and Linc Conn, D.D.S., associate professor of general dentistry, are helping test NPY’s effects on patients.

But this is just the beginning. Exciting news for people at higher risk for pain, including the elderly and people with diabetes, could be on the horizon. In fact, neuropathic pain (pain often described as a burning numbness from nerve damage) is the next frontier in the pain management research. Dr. Hargreaves believes he and his team are starting to understand how NPY also works to relieve neuropathic pain. This is important information for people in pain. Although common pain relievers can be helpful in treating minor pain, people who suffer from some sort of painful neuropathy find little respite in over-the-counter aspirin-like drugs.

"We know the NPY system is dramatically altered when nerves are injured. It’s one of the most profound changes in the body. We think NPY also could be mediating neuropathic pain," Dr. Hargreaves said. "If so, this one natural peptide our body makes could be equally important for both kinds of pain."

Dr. Hargreaves and his team will continue their pain research at the Health Science Center because of funding from the National Institutes of Health. Their work has received a merit award, and Jennifer Gibbs is working under an NIH training grant to continue her studies as a clinician scientist.

"Pain crosses all areas of health care. It’s important in dentistry, medicine, nursing and allied health. As a dentist, I want to help people be more at ease at their appointments. People think of dental visits and pain as synonymous. Our goal is to make dentistry much more comfortable for patients," Dr. Hargreaves said. "The knowledge we find, fortunately, will be helpful for all health care professions."

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