Dr. Terrando Awarded Core Specific Voucher

Niccolo Terrando, PhDDuke University’s Mouse Behavioral and Neuroendocrine Core Facility has awarded Duke Anesthesiology’s Niccolo Terrando, PhD, a $5,000 voucher to evaluate the effects of vagal nerve stimulation on cognitive function.

His project, titled “Vagal Nerve Stimulation as a Therapy for Postoperative Cognitive Dysfunction,” will analyze the efficacy in protecting or ameliorating cognitive decline after surgery using this novel intervention. This project relates to the 2016-2017 funded Duke Institute for Brain Sciences Research Incubator Award, titled “Bioelectronic Medicine and Cholinergic Regulation of Postoperative Cognitive Dysfunction.”

Dr. Terrando is the director of the department’s Neuroinflammation and Cognitive Outcomes Laboratory and a collaborator with the Center for Translational Pain Medicine which represents a novel entity aimed at driving the discovery of new and innovative pain therapies to improve patient outcomes.

Chris KeithDr. Terrando Awarded Core Specific Voucher
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Dr. Ji’s Lab Makes Local Headlines for Autism-Pain Discovery

Ru-Rong Ji, PhDAbnormal pain sensitivity is often associated with autism spectrum disorders which can affect the quality of life of those individuals. New research from two Duke University labs, Dr. Ru-Rong Ji’s Pain Signaling and Plasticity Laboratory and Dr. Yong-Hui Jiang’s autism research lab, reveals a potential mechanism underlying pain insensitivity in autism. According to an article published by Duke Today on December 1 titled, “Autism-Linked Protein Crucial for Feeling Pain,” this finding is the first to connect autism to one of the most well-studied pain receptors, TRPV1 (transient receptor potential ion channel subtype V1).

This research was published in the December 2016 issue of the journal, Neuron, in an article titled, “SHANK3 Deficiency Impairs Heat Hyperalgesia and TRPV1 Signaling in Primary Sensory Neurons.” The manuscript describes how SHANK3 (a prominent autism gene), expressed by peripheral primary sensory neurons, regulates TRPV1 function and heat hyperalgesia after inflammation and nerve injury, offering a mechanistic insight into pain dysregulation in autism. The co-first authors of this paper are Qingjian Han, PhD, Yong-Ho Kim, PhD (both with Dr. Ji’s lab), and Xiaoming Wang, PhD. Co-investigators with Duke Anesthesiology include Dr. Ji, Zhi-Jun Zhang, Di Liu, Mark Lay, Wonseok Chang, Temugin Berta and Yan Zhang.

As explained in the Duke Today article, Dr. Ji’s lab put SHANK3-dificient mice through several sensory tests which found that animals had lower sensitivity than normal mice to heat and heat-related pain, similar to that of a sunburn. Their research found 1) that not only is the SHANK3 protein present in the brain, but also in a cluster of pain-sensing neurons called the dorsal root ganglion in mice, 2) SHANK3 in the same types of cells from human donors who did not have autism, 3) that SHANK3 is expressed on the sending sides of the synapse. Dr. Ji was surprised to find that SHANK3 is expressed in the peripheral nervous system and notes that this is the first study where researchers looked for it outside of the brain – a study that could shape how effective treatments for autism are developed.

Co-expression of SHANK3 (red) and TRPV1 (green) in primary sensory neurons in mouse dorsal root ganglion in the peripheral nervous system.

Co-expression of SHANK3 (red) and TRPV1 (green) in primary sensory neurons in mouse dorsal root ganglion in the peripheral nervous system.

Dr. Ji is the chief of pain research at Duke Anesthesiology, a distinguished professor of anesthesiology in the Duke University School of Medicine, a faculty member of Duke Anesthesiology’s Center for Translational Pain Medicine, and a member of the Duke Institute for Brain Sciences. His lab focuses on identifying molecular and cellular mechanisms that underlie the genesis of chronic pain and developing novel pain therapies that can target those mechanisms.

Chris KeithDr. Ji’s Lab Makes Local Headlines for Autism-Pain Discovery
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Dr. Maixner Makes National Headlines About Surgeon General’s Report

William Maixner, DDS, PhDThe surgeon general released a landmark report about drug addiction and abuse on November 17 which prompted both praise and critique from pain specialists across the nation, including a world-renowned pain researcher with Duke Anesthesiology, Dr. Bill Maixner.

According to an article by Duke Today and an interview posted on YouTube by Duke Health, he commends the report for outlining ways to deal with an overt problem around addiction and substance abuse, and providing full recognition that this is a disease rather than a character flaw. But he adds that it missed an opportunity to call for research and development of additional medical alternatives to opiates for pain management.

The report serves as a call to action and tackles what Dr. Maixner calls “the hidden epidemic” of chronic pain in America which affects more than 100 million adults and costs society more than $635 billion each year. “The cost of treating chronic pain is greater than the combined costs of diabetes, cancer and heart disease,” notes Dr. Maixner. “Yet we spend just four cents per pain patient annually on research, while pain patients consume about 15 percent of health care costs annually. That’s a big imbalance.”

Dr. Maixner was also featured in an NBC News article about the report, which he believes could have gone even further. He says, “There’s very little language regarding the need for discovery of new treatments, discovery of new therapies for chronic pain — which is another epidemic. One of the reasons we have this hidden epidemic in chronic pain is the fact that we don’t have good therapies, and many physicians rely on the use of opioids.” He adds, “We find, unfortunately, that a large number of these individuals are treated by opioids by well-intended individuals who have very little option but opioids to go to.”

Following the release of the surgeon general’s report, MedPage Today formed a panel of experts in addiction, pain and emergency medicine (including Dr. Maixner) to begin a national dialogue about the crisis of addiction. Click here to watch the panel discussion.

As highlighted earlier this year in the cover story of Duke Anesthesiology’s annual magazine, BluePrint, Dr. Maixner says one-tenth of chronic pain patients are suffering from opioid addiction and abuse due to excessive exposure to opioids which are often misappropriated. He believes the only way to deal with the abuse and addiction is to discover new medications and innovative pain therapies which require research.

Dr. Maixner is the director of Duke Anesthesiology’s Center for Translational Pain Medicine. This center further expands the department’s existing clinical and research program in innovative pain therapies by bringing together, under one umbrella, leading basic scientists, clinicians and clinical researchers who have a common core mission of unraveling the causes of painful conditions to better improve patient care. He also played a key role in the opening of a first-of-its-kind pain practice, Duke Innovative Pain Therapies, located in Raleigh.

Chris KeithDr. Maixner Makes National Headlines About Surgeon General’s Report
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Dr. Ji Published in Special Issue of Science

Ru-Rong Ji, PhDChronic pain is a rising health issue affecting as many as 30 percent of adults, worldwide, with an annual cost of more than $600 billion in the United States alone. Chronic pain after arthritis, nerve injury, cancer, and chemotherapy is typically associated with chronic neuroinflammation. Dr. Ru-Rong Ji, the chief of pain research at Duke Anesthesiology, is featured in a special “Pain Research” issue of the journal, Science, for his work that investigates the role non-neuronal cells play in pain regulation and inflammation.

Dr. Ji is the senior author of the review article, “Pain regulation by non-neuronal cells and inflammation,” published in the journal’s November 14, 2016 issue. Co-investigators include Alexander Chamessian (staff member of Dr. Ji’s Pain Signaling and Plasticity Laboratory) and Yu-Qiu Zhang.

Science JournalAccording to the authors, accumulating evidence suggests that non-neuronal cells such as immune cells, glial cells, keratinocytes, cancer cells, and stem cells play active roles in the pathogenesis and resolution of pain. They studied how non-neuronal cells interact with nociceptive neurons by secreting neuroactive signaling molecules that modulate pain, revealing that “non-neuronal cells can communicate with nociceptive neurons by ‘listening’ and ‘talking’ to neurons.” The authors add that recent studies suggest that bacterial infections regulate pain through direct actions on sensory neurons, and specific receptors are present in nociceptors to detect danger signals from infections. Their study also discusses new, therapeutic strategies to control neuroinflammation for the prevention and treatment of chronic pain.

Dr. Ji is a distinguished professor of anesthesiology at Duke University’s School of Medicine and a faculty member of Duke Anesthesiology’s Center for Translational Pain Medicine where he and other researchers are devoted to understanding the epigenetic processes and signatures of what causes acute pain to become chronic, and reducing the burden of chronic pain by developing innovative, non-opioid pain therapies to improve patient care (highlighted in the cover story of Duke Anesthesiology’s 2016 edition of BluePrint magazine).

Chris KeithDr. Ji Published in Special Issue of Science
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2016 FAER Inductees Announced

Drs. William Maixner and Paul WischmeyerDuke Anesthesiology’s William Maixner, DDS, PhD, and Paul Wischmeyer, MD, have been appointed as members of the Foundation for Anesthesia Education and Research (FAER) Academy of Research Mentors in Anesthesiology.

They received this honor for their contributions as mentors for anesthesia residents, fellows and faculty. The FAER Academy’s objective is to recognize mentors who have not only committed their career to the development and advancement of academic anesthesiologists and others in research, but promoted mentoring among colleagues in the specialty – all in effort to increase the quality of research and advance the scope of academic anesthesiology. The main criterion for membership of the academy is the number of individuals whom the mentor has supported and the quality of work accomplished by those individuals.

Dr. Maixner is a world-renowned pain researcher and the director of Duke Anesthesiology’s newly established Center for Translational Pain Medicine. Dr. Wischmeyer is recognized internationally for his interdisciplinary research and translational approach to challenges in perioperative and critical care medicine. He is the associate vice chair for clinical research and the co-director of the Academic Career Enrichment Scholars (ACES) Resident Research Program within Duke Anesthesiology. Additionally, Dr. Wischmeyer is the director of perioperative research at the Duke Clinical Research Institute (DCRI), the largest clinical research institute in the world.

Chris Keith2016 FAER Inductees Announced
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National Media Features Dr. Jordt Lab Study

Drs . Jordt and LiuDuke Anesthesiology’s Drs. Sven-Eric Jordt and Boyi Liu, along with scientists at Zhejiang Chinese Medical University, have discovered a strategy to stop the uncontrollable itch caused by an oily sap, common to poison ivy, poison sumac, poison oak and mango trees.

According to a news release from Duke Health, the research team found that by blocking an immune system protein in the skin with an antibody, they could halt the processes that tell the brain the skin is itchy. The research was done in mice and is described in the November 7, 2016 issue of Proceedings of the National Academy of Sciences.

This cutting-edge research, which could lead to treatments for those allergic to poison ivy (an estimated 80 percent of the population), made national headlines on CBS NewsU.S. News & World Report, HealthDay, STAT, Scientific American, and Univision.

Dr. Jordt is the senior author of the study and director of the Chemical Sensing, Pain and Inflammation Research Laboratory at Duke Anesthesiology. This research was supported with funding from Dr. Liu’s 2015 DREAM Innovation Grant. These grants support innovative high-risk and potentially high-reward investigations to accelerate anesthesia and pain management research – a key component of Duke Anesthesiology’s DREAM Campaign.

Chris KeithNational Media Features Dr. Jordt Lab Study
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