A neurological boost
by Rosanne Fohn and Lety LaurelPain is a growing epidemic. More than 116 million Americans suffer from chronic pain, and the numbers are expected to rise as the population ages.
It comes at a cost. The Institute of Medicine estimates the annual cost of pain management is around $600 billion a year. So Kenneth M. Hargreaves, D.D.S., Ph.D., and his team are trying to understand how changes in the way genes are expressed, or epigenetics, might lead to chronic pain. That knowledge might help develop a new class of nonaddictive painkillers.
"This could change how we diagnose and manage chronic pain in many conditions besides burns. This is such a major problem," said Dr. Hargreaves, professor and chair of the Department of Endodontics in the School of Dentistry and professor in the departments of Pharmacology, Physiology and Surgery in the School of Medicine.
Kenneth M. Hargreaves, D.D.S., Ph.D.
Dr. Hargreavesí research is just one neuroscience project benefiting from a $1 million gift from the J.M.R. Barker Foundation. The gift also funds the UT Health Science Centerís South Texas ALS Clinic, and preliminary research involving humans and the drug rapamycin for dementia and Alzheimerís disease.
"The Health Science Center is an outstanding gem," said Ben Barker, a member of the Presidentís Development Board who helped arrange the foundationís support. "The neurosciences research being conducted here has the potential to yield a future Nobel Prize. I anticipate that efforts such as these will help to attract the next generation of bright, aspiring doctors and researchers to the Health Science Center."
Dr. Hargreavesí research will receive $600,000 from the gift. Developing new nonaddictive painkillers is critical, he said, because more Americans suffer from chronic pain than those with diabetes, heart disease and cancer combined, according to Institute of Medicine research.
By studying chemicals that give chili peppers their burning sensation, Dr. Hargreavesí team has discovered a major class of pain mediators released when an injury occurs. The mediators are the "go-betweens" communicating the pain message from the site of an injury though the nervous system to the brain.
The researchers have identified the molecule released at the site of the injury. They understand how the pain signal is transmitted to the brainóand how to block it. Dr. Hargreavesí team will use the Barker Foundation funds to create a screening method to develop and optimize new drugs that can be used to alleviate pain at its source.
"This gift is the catalyst for our research," said Dr. Hargreaves, who holds The USAA Foundation Presidentís Distinguished University Chair in Neurosciences. "This is a rocket booster in terms of research because this is allowing us to rapidly and dramatically focus on developing new types of nonaddictive analgesics in a way we could not have fathomed last year."
Pain is not the only area of neuroscience that causes significant human suffering and costs millions of dollars to treat.
The worldwide cost of dementia was $604 billion in 2010. The World Alzheimerís Report 2010 notes that the number of people affected by dementia was 35.6 million and projects that number will rise 85 percent by 2030 and another 75 percent by 2050.
The Barker Foundation gift is providing $65,000 to Veronica Galvan, Ph.D., and Tyler J. Curiel, M.D., M.P.H., for preliminary research involving humans and the drug rapamycin for dementia and Alzheimerís disease.
Rapamycin is approved by the U.S. Food and Drug Administration as an anti-rejection drug for organ transplants, but has shown promise as an anti-aging drug that can increase healthy life spans in mice.
Veronica Galvan, Ph.D.
Barker Foundation funding will permit the doctors to collaborate in studies evaluating whether rapamycin could be a useful and safe treatment for Alzheimerís disease or other age-related neurological diseases in humans.
"This is really encouraging for us," said Dr. Galvan, assistant professor in physiology at the Health Science Centerís Sam and Ann Barshop Institute for Longevity & Aging Studies. "With this important funding, we can gather the data we need to push therapy forward."
As a person ages, vascular dysfunction occurs. It can range from mild to severe, but when it affects the brain, it can shut down blood vesselsí ability to carry necessary amounts of oxygenated blood to the brain. Areas of the blood-starved brain start to shut down, which can contribute to dementia and Alzheimerís disease.
"Blood flow in the brain is precisely controlled," Dr. Galvan said. "You can have changes in blood pressure and perfusion elsewhere in the body with no major implications. However, if a change of the same magnitude happens to the brain, this can have serious consequences. The brain is critically sensitive to changes in perfusion, that is why much smaller changes such as the ones we study have a major impact on brain function."
The rate of occurrence of dementia and Alzheimerís disease is increasing, she said.
"This problem is extremely urgent. This is not going to stop anytime soon," Dr. Galvan said. "This funding will allow us to find out more about how [rapamycin] works to restore brain blood flow in Alzheimerís. The more we know about how the drug works, the more options become available to achieve the same beneficial effect. Countless possibilities open up with greater understanding."
A less common but equally debilitating disease, amyotrophic lateral sclerosis, also known as ALS or Lou Gehrigís disease, affects about 5,600 people each year, according to the ALS Association. About 30,000 Americans may have the disease at any given time.
ALS is a progressive disease that impacts nerve cells in the brain and spinal cord. As these nerve cells die, patients have difficulty controlling muscle movement and eventually become paralyzed. There is no cure.
The Barker Foundation gift allocates $335,000 to continuing support for operations of the Health Science Centerís South Texas ALS Clinic, led by Carlayne Jackson, M.D. The clinic is part of UT Medicine San Antonio, the clinical practice of the School of Medicine.
"We offer treatment, education and opportunities to participate in clinical trials, but the most important thing we may offer our patients is hope," said Dr. Jackson, professor in the departments of Neurology and Otolaryngology, assistant dean for ambulatory services in the School of Medicine and chief medical officer at UT Medicine. "My patients, and the hope that through our work here we can make their lives better in the future, are what drive me every day."
Offering 10 different disciplines to treat patients, the ALS Clinic is accredited by the National ALS Association and is an ALS Association Certified Center of Excellence. Patients are seen at the Medical Arts & Research Center in San Antonio.
Carlayne Jackson, M.D..
Health Science Center President William L. Henrich, M.D., MACP, said all three research areas are significant because they have far-reaching impact.
"All three of these areas cause significant human suffering and cost millions of dollars to treat," he said. "We thank the Barker Foundation for believing in our groundbreaking research and clinical care that will improve the human condition."
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