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Europain consortium receives EU and industry funding and begins five year research into better treatments for chronic pain Europain, a public-private consortium funded by the Innovative Medicines Initiative (IMI), announced today the launch of a five-year research project to understand and improve treatment of chronic pain. The project will receive 6M€ from the IMI as well as 12.5M€ in kind contribution from the European Federation of Pharmaceutical Industries and Associations (EFPIA) over the coming five years.

One in five adults suffers from chronic pain. This constitutes a major cause of long-term sick leave and forced early retirement, placing a great financial burden on both individuals and healthcare systems. Despite extensive research programmes by biopharmaceutical companies and academia, there remains a need for treatments that are more effective and with fewer side-effects.

Europain has established an international team of leading researchers and clinicians from both academia and industry to undertake multidisciplinary translational research. This team aims to increase the understanding of chronic pain mechanisms, help to develop novel analgesics, and develop better biomarkers for pain. Their ultimate goal is to improve the lives of people suffering from chronic pain.

During the five-year project, Europain will undertake a large number of preclinical and clinical studies. The program will be delivered through collaboration between laboratories in the Europain network, sharing resources to improve the value derived from the budget. Results will be made public during and after the project, ensuring that the knowledge created can be widely applied to the development of better therapies for patients suffering from chronic pain.

King’s College London, the managing entity of Europain and the academic lead institution will contribute to both the pre-clinical and clinical aspects of the project. One role will be to study the expression of potential pain mediators in both animal models of pain and samples from patients suffering from chronic pain. The role of novel pain mediators will then be investigated using an array of techniques ranging from cell culture to quantitative sensory testing in humans.

Professor Steve McMahon, who along with Dr Dave Bennett will be running the project at King’s, comments: ‘There are some big questions facing the pain field at the moment and this consortium, drawing on the skills and expertise of both academia and industry, is in a unique position to address them’.

The consortium network involves scientists representing 12 renowned European Universities: King’s College London (Academic lead), University College London, Imperial College London, the University of Oxford, the Christian-Albrechts-University of Kiel, the Medical Faculty Mannheim/Heidelberg University, the Technische Universität München, the Goethe University of Frankfurt, the BG University Hospital Bergmannsheil/Ruhr University Bochum, the University Hospitals of Aarhus, Rigshospitalet Copenhagen, University of Southern Denmark, the SME Neuroscience Technologies from Barcelona, and the research resources and expertise of Europe’s most active pharmaceutical companies working in the field of analgesics, including AstraZeneca (co-ordinator), Boehringer-Ingelheim, Eli Lilly, Esteve, Pfizer, Sanofi-Aventis, UCB Pharma.

About the Innovative Medicines Initiative

IMI is a unique Public-Private Partnership (PPP) between the pharmaceutical industry represented by the European Federation of Pharmaceutical Industries and Associations (EFPIA) and the European Union represented by the European Commission.
Summer School, June 2009 Photos from the London Pain Consortium Summer School, held 21st-26th June 2009 in El Escorial, Madrid, Spain.

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Past Research
Rodent model of Zoster-associated pain
Varicella-Zoster virus (VZV) is a neurotropic virus, which causes varicella (chickenpox) as the primary infection. Following the acute illness, the virus establishes latency within sensory ganglia in the peripheral nervous system (PNS). VZV may be reactivated years later and present as herpes zoster (shingles). Although mechanisms of reactivation from ganglia have not been fully identified, dysfunction of cellular immunity is thought to be involved. Shingles may be followed by the development of post-herpetic neuralgia (PHN), a common neuropathic pain syndrome that persists even when the virus becomes latent within the sensory ganglia of the affected dermatomes and long after the disappearance of skin lesions.

Clinical relevance
PHN is characterised by the development of persistent hyperalgesia and allodynia, accompanied by spontaneous pain typically of a burning or aching nature. It responds poorly to classical analgesics and as such is associated with significant morbidity. The treatments with the strongest evidence base are opioids, tricyclic antidepressants and gabapentin but these are only effective in 30-50% of patients and are
associated with unacceptable adverse effect profiles. This presents a need for the investigation of the mechanisms involved in the establishment of post-herpetic neuralgia and in the development of effective drugs for its treatment. An animal model of zoster-associated pain would increase our understanding of the pathophysiology of this condition and provide a pre-clinical screen for novel analgesic drugs.

Proposed Experiments
A well established rodent model of latent VZV infection will be refined [Fleetwood-Walker et al., 1999] to investigate whether rats infected with VZV display behavioural and electrophysiological features, which reflect the clinical picture of human PHN. These behavioural tests will initially include simple reflex withdrawal to mechanical, thermal and cold stimuli. More complex measures of integrated pain behaviour and spinal electrophysiological observations will then be examined. The pharmacological profile of the rodent model to analgesics known to have a degree of efficacy in human neuropathic pain conditions will also be examined. Finally, the association of viral latency with DRG gene correlates of neuropathic pain will be investigated using the Consortium?s microarray facility.