Dr. Maixner Named President of American Pain Society

William Maixner, DDS, PhDOn March 6, the board of directors elected Duke Anesthesiology’s William Maixner, DDS, PhD, president of the American Pain Society (APS). It’s a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.

Dr. Maixner, professor in anesthesiology and director of the Center for Translational Pain Medicine (CTPM), is a world-renowned pain researcher who has dedicated his career to unraveling the mysteries of chronic pain. His research focuses on biological, environmental, and genetic factors involved in pain transmission and modulation.

In his new role, Dr. Maixner will help the APS achieve its goal of advancing the care of people in pain by ensuring access to treatment, removing regulatory barriers, increasing funding for pain research and educating practitioners and policy makers in all settings about advances and economics of effective treatment.

“This is a wonderful opportunity to help further shape the society’s activities in the area of pain research and pain management,” says Dr. Maixner. “This is one of the most established pain-oriented societies, and it’s such an honor to be recognized by my peers and to be part of the opportunity to further the mission of the APS which falls in line with the same mission statement that we have at the CTPM at local, state and federal levels for pain patients.”

Dr. Maixner was a key leader in establishing Duke Anesthesiology’s Center for Translational Pain Medicine in January of 2016, which brings together basic scientists, clinicians and clinical researchers who have a common core mission of transforming the way painful conditions are diagnosed and treated. He also helped develop Duke Innovative Pain Therapies, a first-of-its-kind multispecialty pain practice in Raleigh that opened in September of 2016. Learn more about these initiatives in the 2016 edition of the department’s BluePrint magazine.

Chris KeithDr. Maixner Named President of American Pain Society
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Postdoctoral Fellow Receives APS Award

Xin Zhang, PhDThe American Pain Society (APS) has awarded Duke Anesthesiology’s Xin Zhang, MD, PhD, the Young Investigator Travel Award for its 36th Annual Scientific Meeting!

Funding from this award will allow Dr. Zhang the opportunity to travel to Pittsburgh and present his poster abstract, titled “Sustained Activation of β2- and β3ARs Leads to Phosphorylation of Neuronal MAPKs and Activation of Glial Cells in Spinal Cord and DRG.” Co-authors of this project include director of The Nackley Lab, Dr. Andrea Nackley, and undergraduate researchers in the lab, Harrison Ballard and Julia Kozlowski. The APS  acknowledges the National Center for Complementary and Integrative Health (NCCIH) for support of the Young Investigator Travel Award program.

As noted in the abstract, functional pain syndromes, such as fibromyalgia and temporomandibular disorder, are associated with enhanced catecholamine tone and decreased catechol-O-methyltransferase (COMT; an enzyme that metabolizes catecholamines) activity. Consistent with clinical syndromes, The Nackley Lab has shown that sustained 14-day delivery of the COMT inhibitor OR486 in rodents results in pain at multiple body sites that persists for three weeks following OR486 cessation.

Results of this study suggest that treatments targeted towards βAR and MAPK signaling pathways may prove useful in the management of functional pain syndromes.

Dr. Zhang is a postdoctoral fellow with The Nackley Lab, part of Duke Anesthesiology’s Center for Translational Pain Medicine which is dedicated to unraveling the causes of painful conditions to better improve patient care.

Chris KeithPostdoctoral Fellow Receives APS Award
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Undergraduate Researcher Awarded Fellowship

Katie KanterDuke’s Summer Neuroscience Program (formerly known as NPR) has awarded Katie Kanter, a researcher with Duke Anesthesiology’s The Nackley Lab, a fellowship for her project, titled “Effects of MOR-1K Genetic Variation on Cellular Activity.”

Opioid-induced hyperalgesia manifests as increased pain sensitivity due to acute or chronic opioid administration. A truncated variant in the mu opioid receptor, MOR-1K, has been linked to pain in human genetic studies, and shown to produce cellular excitation, resulting in hyperalgesia rather than analgesia. The Nackley Lab has identified a candidate single nucleotide polymorphism (SNP) within the enhancer box regulatory motif on MOR-1K exon 13 in CXB7/ByJ mice, that is predicted to contribute to the increased pain sensitivity observed in this variant compared to 129S6 mice.

The proposed work will continue a previously unpublished study by The Nackley Lab to elucidate alterations to MOR-1K receptor function related to this SNP using a cAMP assay, and ultimately examine changes to transcriptional regulation via a luciferase assay.

The Nackley Lab is part of Duke Anesthesiology’s Center for Translational Pain Medicine. The main objectives of this lab’s research include: 1) To determine the factors that put some people, but not others, at risk for maladaptive chronic pain conditions, 2) to elucidate the mechanism(s) whereby genetic, biological, and environmental factors drive chronic pain, and 3) to improve pharmacologic management of pain.

Chris KeithUndergraduate Researcher Awarded Fellowship
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A Breath of Fresh Air for Eucalyptus Research

Left to Right: The researchers who work in Dr. Jordt’s lab: Maya Kaelberer, BS; Satya Achanta, DVM, PhD; Dr. Sven-Eric Jordt; Anabel Caceres, PhD; and Boyi Liu, MD

Left to Right: The researchers who work in Dr. Jordt’s lab: Maya Kaelberer, BS; Satya Achanta, DVM, PhD; Dr. Sven-Eric Jordt; Anabel Caceres, PhD; and Boyi Liu, MD

A new study by Dr. Sven-Eric Jordt’s Chemical Sensing, Pain and Inflammation Research Laboratory at Duke Anesthesiology identifies the mechanism through which eucalyptol, the active ingredient in eucalyptus oil, suppresses inflammation.

Eucalyptol, a cooling natural product, is licensed as an over-the-counter treatment in some countries, either as a pill, in lozenges, as an oil for inhalation, or as a cream for pain treatment. Eucalyptol is also found in sage, rosemary and tea tree oil, all used for treatment of inflammation. Clinical trials suggested that eucalyptol is effective as a supportive treatment in bronchitis and chronic obstructive pulmonary disorder, a lung disease caused by smoking. However, eucalyptol’s mechanism of action has remained unclear, and studies in mice and rats required much higher amounts of eucalyptol to be effective than in the human studies.

This study, titled “TRPM8 mediates the anti-inflammatory effects of eucalyptol,” is published in the February 2017 issue of the British Journal of Pharmacology. It identifies a target for eucalyptol and explains why eucalyptol might be more effective in humans.

“We identified TRPM8 as eucalyptol’s target to treat skin and lung inflammation” says Dr. Jordt. “TRPM8 is a sensor for cooling in temperature-sensing nerves in the body. Eucalyptol mimics the sensation of cooling that is known to have anti-inflammatory effects. We also found that TRPM8 in humans is more sensitive to eucalyptol than in the mouse or rat. This may explain why lower amounts of eucalyptol were effective in the published human trials.”

This Duke study provides a rationale for additional human studies testing this widely-used natural product in other inflammatory conditions, and for the development of novel eucalyptol-based drugs. Duke Anesthesiology researchers, Ana Caceres, Boyi Liu, Sairam Jabba and Satya Achanta, contributed to the study. Dr. Jordt is an associate professor in anesthesiology and a faculty member of the department’s newly established Center for Translational Pain Medicine. His research interests focus on the mechanisms that enable humans and animals to sense touch, pain and irritation.

Chris KeithA Breath of Fresh Air for Eucalyptus Research
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Aspiring Physician-Scientist Awarded Prestigious Fellowship

Alexander ChamessianThe Grass Foundation has awarded Alexander Chamessian, an MD/PhD candidate working in the labs of Duke Anesthesiology’s Drs. Ru-Rong Ji and Thomas Van de Ven, a Grass Fellowship for his project, titled “Deciphering Pain and Itch Circuitry in the Spinal Dorsal Horn using Permanent Activity-Dependent Labeling, Electrophysiology, and Single-Cell Transcriptomics.”

The Grass Fellowship Program is the hallmark program of The Grass Foundation which supports research and education in neuroscience. It supports investigator-designed, independent research projects by scientists early in their careers. Thanks to this award, Chamessian will spend 14 weeks this summer at Woods Hole working on his project.

Chamessian’s research focuses on understanding the molecular and cellular mechanisms of nociception, with an emphasis on chronic pain. He is currently pursuing his PhD jointly with Dr. Ji in the Pain Signaling and Sensory Plasticity Laboratory and Dr. Van de Ven in the Nerve Injury and Pain Mechanism Laboratory. Both labs are part of Duke Anesthesiology’s Center for Translational Pain Medicine which represents a novel entity that is transforming the way painful conditions are diagnosed and treated.

Chris KeithAspiring Physician-Scientist Awarded Prestigious Fellowship
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Acupuncture Proves to be Integrative Therapy for Bell’s Palsy

Jongbae Jay Park, PhD, LAcBell’s palsy is a nerve disorder that causes sudden paralysis of unilateral facial muscles. Studies show that 70 percent of those affected will completely recover, but 15 percent will go on to experience permanent damage. This prolonged paralysis and asymmetry can affect psychological and social behaviors which can undermine patients’ quality of life.

Duke Anesthesiology’s Dr. Jongbae Jay Park is a co-author of a newly published study in the February 2017 issue of Complementary Therapies in Clinical Practice, titled “A close look at an integrative treatment package for Bell’s palsy in Korea.”

As the study notes, Bell’s palsy patients experience significantly higher degrees of distress and report that they feel helpless when doctors don’t acknowledge problems other than facial disfigurement. While clinical guidelines in conventional medicine don’t yet recommend acupuncture treatment for Bell’s palsy due to poor study design and reporting, acupuncture is one of the most sought after treatments for this condition in many Asian countries.

The authors conclude that the lack of awareness, dearth of knowledge in patient needs, and shortage of treatment options available during the recuperation months increase the need and significance of an integrative treatment program for a well-rounded overall recovery. While rigorous research is warranted, they highly suggest that it is worth applying integrative medicine, such as acupuncture, to Bell’s palsy patients.

Dr. Park is the director of acupuncture and Asian medicine for Duke Anesthesiology’s Center for Translational Pain Medicine and a pain specialist at Duke Innovative Pain Therapies, located in Raleigh, North Carolina. Learn more about this first-of-its-kind pain practice in Duke Anesthesiology’s 2016 edition of BluePrint magazine.

Chris KeithAcupuncture Proves to be Integrative Therapy for Bell’s Palsy
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