Story at a glance
- Chronic pain affects about 20 percent of adults in the U.S.
- Painkillers can be addictive, and overdoses lead to tens of thousands of deaths each year.
- Funding from the NIH aims to help develop monoclonal antibodies for chronic pain, which could be a non-addictive alternative to opioids.
A group of researchers based out of University of California Davis recently received a $1.5 million grant from the National Institutes of Health (NIH) to develop monoclonal antibodies for use against chronic pain.
“It’s a challenge to be able to develop safe and effective drugs to treat pain,” said Vladimir Yarov-Yarovoy at University of California Davis School of Medicine.
Opioid painkillers like oxycodone (OxyContin) can be addictive for some people, and others like fentanyl have played a large part in the opioid misuse and overdose crisis.
Monoclonal antibodies are already being used as treatments for some types of cancer. A few types of monoclonal antibodies were also given emergency use authorization from the U.S. Food and Drug Administration (FDA) to fight COVID-19.
In a similar vein as chronic pain, the FDA has already approved a monoclonal antibody treatment for migraine headaches. The novel therapy targets a specific signaling molecule called CGRP. The antibodies block CGRP, which researchers think plays a role in the nerves linked to the blood vessels in the brain, according to Nature.
Although it only works for a subset of patients, this is a step forward for migraine treatment because of how effective it is for the people it does work for. In addition, patients on the migraine treatment have had minimal side effects, and that could also be true for other monoclonal antibody treatments.
Complications from a monoclonal antibody treatment will depend on if the antibodies are specific enough, meaning that they bind well to their targets and not much else.
For Yarov-Yarovoy and collaborators, this is where the high resolution imaging and computational tools come in. Based on past research, the team are focused on three ion channels in the membranes of nerve cells. Ion channels allow molecules to pass into and out of the cell based on if they are activated or deactivated. This kind of movement of molecules is the basis for many types of signaling in the body, including pain.
The receptors where an antibody can bind to on the membrane channels are highly complex structures. Yarov-Yarovoy says that the imaging and computational techniques have become much more powerful in recent years and hopes that will help the team develop these new antibodies.
If they do develop the right antibodies, this treatment could be given as an intravenous injection. The antibodies could circulate in the bloodstream for up to a month before getting broken down, meaning that patients could potentially get this shot and feel the benefits for weeks.
The team think that if this research works out that a monoclonal antibody treatment for chronic pain could be a good alternative to opioids because it would not be addictive and could have few side effects.
The Centers for Disease Control and Prevention estimates that 20 percent of adults have chronic pain and 8 percent of adults in the U.S. experience high impact chronic pain. In the ongoing opioid epidemic, tens of thousands of people die from overdoses each year.
The White House recently announced $1.5 billion initiative to combat addiction and opioid misuse. If a monoclonal antibody treatment for chronic pain were to receive FDA approval, that could provide another option for doctors to prescribe and could prevent people from becoming addicted to or dependent on opioids.
This would all depend on years of extensive research and clinical trials before it could get into regular use, and it could end up being a very expensive treatment.
“We’ll see how broad the actual usefulness of these antibodies in the future,” said Yarov-Yarovoy. “We don’t think there is one magic, basic treatment for all the patients with chronic pain, but what we hope is that it will help some patients with chronic pain.”
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