ASOD scientists team up with Duke on TMD pain research

Researchers have been awarded $2.3 million from the National Institutes of Health for a collaborative study between Adams School of Dentistry and the Duke Center for Translational Pain Medicine. ASOD’s Pei Feng Lim, BDS, MS, and Roger Moreira, DDS, PhD, MD, MS, worked with Yong Chen, PhD, and Andrea Nackley, PhD, from Duke, combining the Duke scientists’ interests in basic neuroscience with the clinical expertise of ASOD’s orofacial pain team.

The study, titled “Identification and validation of LPA/LPAR signaling as a target for the treatment of Temporomandibular Disorder pain” will be conducted during the next five years and will determine the contribution of elevated lysophosphatidic acid (LPA) to Temporomandibular Disorder (TMD) pain, the most common form of chronic orofacial pain.

“Our previous TMD research focused on epidemiology and identification of the risk factors associated with TMD onset and persistence. This funding allows us to take our research to the next level by investigating the contribution of specific molecules and receptors to the maintenance of chronic TMD pain, and subsequently bring the bench discoveries to the bedside. The translation of basic science research to clinical therapeutics will broaden the scope of treatment options for patients suffering from chronic TMD,” Lim said.

Our previous TMD research focused on epidemiology and identification of the risk factors associated with TMD onset and persistence. This funding allows us to take our research to the next level by investigating the contribution of specific molecules and receptors to the maintenance of chronic TMD pain, and subsequently bring the bench discoveries to the bedside. The translation of basic science research to clinical therapeutics will broaden the scope of treatment options for patients suffering from chronic TMD.”

Pei Feng Lim, BDS, MS

Recent evidence suggests that LPA/LPA receptor (LPAR) signaling is a promising target for dorsal root ganglion-mediated pain. However, its contribution to trigeminal ganglion-mediated pain is unknown. Using mouse models, researchers found increased LPA levels in both peri-temporomandibular joint (TMJ) tissues and plasma. In TMD patients, elevated plasma levels of LPA correlated with pain severity. Systemic and local inhibition of LPA and LPAR in the mouse models reduced pain, identifying LPA/LPAR signaling as a TMD pain target for the research team. The researchers hope to confirm the importance of LPA in TMD pain to develop mechanism-based therapeutics for patients with TMD pain.

The ultimate goal of the study is to help TMD patients with their pain and identify better treatments for them, including personalized medicine approaches that may go beyond just TMD pain to include other pain conditions.

“Identification of the subset of TMD patients who will benefit from such treatments brings us a step closer to personalized pain medicine. Since chronic TMD is comorbid with chronic widespread bodily pain (such as fibromyalgia, irritable bowel syndrome, and chronic low back pain), the discoveries from this study may also impact the management of other complex persistent pain,” Lim said.

Lim said the collaboration between the two teams was key to the success of the study, as each group brings different perspectives – both basic and clinical science.

“That collaborations continue despite the differences in institutional affiliation allows us to complement and share resources and build upon each other’s expertise to solve a piece of the complex chronic pain puzzle. The ultimate goal is to reduce suffering and improve the quality of life of chronic pain sufferers,” Lim said.