They're national - and excellent
Published on 01 January 2010
Arthritis Research UK has now awarded funding for its first three new national centres of research excellence. All receive £2.5 million over five years. Arthritis Today reports on their progress to date.
Our newest centre is Arthritis Research UK's National Pain Centre at Nottingham University, which aims to improve treatments for arthritis – the most common cause of chronic pain.
As the world’s first national centre for research into understanding pain in arthritis, with further £3 million from the university, it will be officially opened in spring.
The centre represents an ambitious bid to tackle chronic pain involving a multi-disciplinary, integrated approach to clinicians and scientists from different research fields including rheumatology, neuro-imaging and psychology.
The researchers’ aims over the next five years will be to gain a better understanding of how people experience pain, to use that knowledge to fully understand the biological basis of pain in osteoarthritis, to develop new drugs to treat pain more effectively and to target existing drugs more effectively at individual patients.
Director Dr David Walsh from the School of Clinical Science’s Division of Academic Rheumatology said the centre offered a “wonderful opportunity” to produce more effective pain treatments. “There is a huge unmet need for better pain relief for people with arthritis,” he said.
“Current treatment can help some people, but the future holds huge potential for developing new and better treatments for the millions who suffer from chronic pain. Bringing together a team like this, of world experts in their fields, to look at the problem from completely different angles presents us with a wonderful opportunity.”
Professor Alan Silman, Arthritis Research UK medical director said: “Pain is the number one concern for all patients with arthritis, and there have been too few recent advances in how to manage it. Several million people suffer both day and night, with only conventional painkillers helping to keep the pain at bay.
“Our new centre is charged with a truly innovative approach; covering the basic pathways of pain perception and the changes in the tissues caused by arthritis to identify completely new targets for developing effective, safe and acceptable treatments.”
Current drug treatments to relieve the pain of osteoarthritis are unsatisfactory, and although exercise, weight loss and self-management help some sufferers, many more people struggle to find adequate, side-effect-free pain relief. Joint replacement surgery is available for people with severe, unremitting pain, but even this is not a solution for everyone. Many osteoarthritis sufferers turn to unproven supplements, but few have been shown to work.
Dr Walsh and his team will use osteoarthritis of the knee as an initial model for their research, although it is expected that their work will help people with other types of arthritis pain over time.
“It is well recognised that the experience of osteoarthritic pain involves the interplay between the way that the nerves present in the joint (the peripheral nerves) detect changes in the joint tissues that occur in osteoarthritis, how these nerve signals from the joint are processed by the spinal cord and brain and translated into feelings of pain, and how this is influenced by the way a patient thinks and feels about their pain,” explained Dr Walsh.
"However, our understanding of the relative contributions of each of these factors to the final experience of pain is incomplete – which is our great challenge.”
A full-length feature on the new pain centre will follow in Arthritis Today in April.
Arthritis Research UK Biomechanics and Bioengineering Centre at Cardiff University was officially opened by His Royal Highness the Duke of Gloucester in September.
The Duke met researchers, arthritis sufferers, clinicians and fundraisers during the opening ceremony. The centre is dedicated to world-leading research to find bioengineering solutions to arthritis, and brings together biomedical scientists, medics, engineers, rheumatologists, physiotherapists and orthopaedic surgeons.
One exciting new aspect of the research is to relate molecular changes in the joint to pain and inflammation, to then show how overworked joints are linked to pain and disease development. This should lead to better drugs and physical therapies, as well as improvements to joint replacement techniques and, further in the future, to identify novel alternatives to orthopaedic surgery.
Welsh First Minister Rhodri Morgan described the new centre as “a real feather in the cap for Welsh science.”
The first of our national research centres, Arthritis Research UK National Primary Care Centre was officially opened by the then health Minister Lord Darzi in December 2008 and has enjoyed a productive first 12 months.
One of the centre’s main aims is to have a direct impact on the way people with common musculoskeletal problems such as osteoarthritis and back pain are treated and to increase the status of research in the primary care setting (ie the GP surgery) where most people with arthritis receive their care.
Centre director Professor Peter Croft is enthusiastic: “Our first year has been an exciting one,” he says. “The stability and the resource provided by the charity’s investment in centre of excellence status has given tremendous impetus, energy and sense of purpose to our staff and our NHS partners in the research, and to the patients and public who support our studies, the local community and Keele University as a whole.”
One main objective of the charity’s investment strategy was to provide the centre with the basis to mount strong bids for external funds from sources which have often not prioritised musculoskeletal illness in the past. During the centre’s first year, it was awarded two of the Department of Health’s National Institute of Health Research (NIHR) programmes of £4 million over five years: to investigate optimal care for osteoarthritis in primary care and how to enhance the treatment of patients with low back pain.
Adds Professor Croft: “These awards directly recognise the framework for applied health research supported by Arthritis Research UK. They provide evidence of the expansion of applied health research into common musculoskeletal syndromes and of support for individuals to carry out and lead such research.”
The Primary Care Sciences Research Centre, where the Arthritis Research UK centre is based, is also due to receive the prestigious Queen’s Anniversary Prize for Higher and Further Research, a national honour awarded every two years for work of outstanding excellence, at a ceremony at Buckingham Palace in February.