Professor Susan Brain
Susan Brain is professor of pharmacology at King’s College London.
What does your work involve?
Our work involves studies of the biology of nerves that transport pain signals from the inflamed joint to the brain. We know that the activation of a mechanism called TRPV1 on painsensitive nerves is involved in arthritis. TRPV1 is stimulated by capsaicin, which is found in extracts from chilli peppers. Capsaicin has been used for many treatments, including rheumatism, in folk medicine. There are also creams available that include capsaicin and are applied to the skin to treat the aches and pains, but they are associated with a burning sensation.
Our present project was designed to learn more precisely how capsaicin works to combat the effects of one of the best-known inflammatory substances, TNF-alpha, and in turn work towards the possibility that agents without the burning side effects of chilli peppers may be useful in the treatment of arthritis. The TRPV1 channel works in a similar manner to a door lock. If the correct key (stimulant) is put into it the lock will open to allow entry of traffic (calcium in this case) into the nerves. This can act to start, amplify or prolong the inflammation and pain. We believe that blocking the actions of TRPV1 will act to combat the pain and hopefully reduce the swelling and tissue damage that occurs during the disease and its flare-ups. Indeed, TRPV1 blockers are in development for use as painkillers. However, we need to do more research to fully understand all the steps involved in the pain and inflammation as we now realise that other TRP channels may also be involved in arthritis.
How long has Arthritis Research UK been funding you?
I've been funded via various grants since the early 1990s. Some have enabled me to combine my expertise as a pharmacologist with others such as biochemists and neurochemists.
What’s the most important thing you've found out in the past 12 months? Why?
We've recently obtained evidence that another TRP channel is highly likely to be also involved in mediating pain in arthritis. We need to understand how this new channel impacts on the disease and if interaction with TRPV1 occurs.
What do you hope or expect to achieve as a result of your Arthritis Research UK funding?
This group carried out research at a pre-clinical level to learn more about the role of pain-sensitive nerves and their activity in inflammatory models. We aim to provide mechanistic evidence for feasible and relevant targets for new drugs in arthritis.
What do you do in a typical day?
My day starts by using the quiet time before I get to work to read and write. I travel by train and this provides excellent facilities, as long as I get a seat! Once I enter King’s my day revolves around research, teaching and administration. I like teaching and do my best to be an effective administrator by developing systems so that it can be done as swiftly as possible. This allows me to spend as much time as possible with my research group.
What's your greatest research achievement?
During the 1980s, the research team that I was working with were given a powder, an extract from the thyroid tissue of patients with thyroid cancer. I learnt that it had very potent effects on blood flow in tissues that include the joint. This small protein was CGRP. Excitingly, CGRP blockers have been shown to be beneficial in the treatment of migraine and these new drugs are now in the very last stages of clinical trials. Their role in arthritis is still unclear. However, our research with the TRP channels involves CGRP.
Why did you choose to do this work?
I went to university to do a joint biology and chemistry degree but realised that I seemed to understand and do well in pharmacology. I spent a year of my degree working in a pharmacology department and from then I was hooked.
Do you ever think about how your work can help people with arthritis?
Severe arthritis, albeit in different forms, has affected several of my family and friends. I have no clinical training but I do have a good understanding of the treatments available and the help that is available from Arthritis Research UK. Last year I was involved in trying to help a sufferer understand why their nurse wanted them to take a course of a different drug and what was meant by the literature that she was given to read. I feel strongly that better painkillers are needed. There's an urgent need to learn more about how the joints and nerves work together.
What would you do if you weren’t a scientist/researcher?
I believe that I'd still be involved in the university system, either teaching or administrating. Even though the research is the thing that I love to do, I also enjoysome of the different types of challenges that these other parts of my job offer.
I enjoy walking, gardening and generally being outdoors.
This article first appeared in Arthritis Tiday Autumn 2009, issue 146.