Research out of the UK is pointing toward a new direction in the quest to treat osteoarthritis. A team from the Arthritis Research UK Pain Centre at the University of Nottingham has discovered a new way to potentially block the chronic pain affecting osteoarthritis sufferers.
Study: How to Block OA Pain
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In this study, published by the journal Annals of the Rheumatic Diseases and highlighted by Nature Reviews Rheumatology, scientists studied a protein (‘receptor’) called TRPV1, which is produced by nerve cells in the human body that are responsive to pain, including those that respond to stimulation of joints.
Dr. Sara Kelly, a lecturer in neuroscience at the university, and one of the lead researchers on the project, says that previous research has suggested that TRPV1 could be an important contributor to osteoarthritis pain and that drugs that ‘block’ TRPV1 (TRPV1 antagonists) have the potential to reduce it.
“The success of recent clinical trials in osteoarthritis patients of TRPV1 antagonists has been hampered by adverse effects on body temperature resulting in hyperthermia (or overheating of the body), ” explained Dr Kelly in the February 26, 2014 news release.
By blocking TRPV1 within the joint, Dr. Kelly and the pain centre research team were able to reverse the pain responses in the osteoarthritis pain model.
“By targeting the joint directly, we did not see the side effect of hyperthermia, which is thought to be generated outside of the joint at the level of abdominal organs, ” added Dr. Kelly.
This latest discovery suggests that injecting TRPV1 antagonists directly into the diseased joint could potentially maximize the effectiveness of the pain relief without producing undesirable side effects. This approach will potentially be used to help treat the pain caused by osteoarthritis in the future. However, the effectiveness of TRPV1 antagonists in reducing osteoarthritis pain following locally delivery to the joint needs to be tested in clinical trials in patients first.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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