Patapoutian: “the door has been opened to tackle chronic pain”

This year’s Nobel Prize in Medicine has advocated, in an interview with EL MÉDICO INTERACTIVO, for promoting basic sciences, “because they offer extraordinary surprises for applications against diseases”

October 13, 2021. 10:00 am

In all cultures and in all religions the pain linked to human existence itself appears. Valley of tears, you will give birth with pain, pain as redemption. Only in recent years has pain been seen as a disease with its own pathological personality, and many doctors and researchers dedicate themselves to fighting it. For this reason, the Nobel Prize to Ardem Patapoutian and David Julius for contributing to know how to combat it acquires an unusual relevance for our society.

“With the discovery of ion channel proteins and cell membranes, an immense field of possibilities opens up for us to apply it in medicine, among them that of pain”, explained to THE INTERACTIVE DOCTOR, this year’s Nobel Prize in Medicine, Ardem Patapoutian, awarded together with his colleague David Julius, for the Karolinska Institute in Stockholm.

Basic science

“Research in basic sciences gives rise to fascinating inquiries,” argued Patapoutian, who a week earlier was awarded by the BBVA Foundation Frontiers of Knowledge in the Biomedicine category.

The discovery of the capsaicin receptor gene was published in 1997 by Dr. David Julius and opened the way to know how the physical processes of pressure and temperature are related to electrochemical nerve impulses, which is the way in which the that sensory information is transmitted from the sense organs to the central nervous system.

While the investigations by Julius sand focused on membrane receptor proteins for temperature and how they transform the perception of cold or heat into electrochemical messages that our neurons transport and our brain is able to understand, Ardem Patapoutian – an Armenian immigrant who came to the United States fleeing the war in Lebanon – who had arrived with the intention of becoming a doctor, quickly “fell in love with basic research” and he also began to study the molecular bases of sensory perception, in his case of pressure.

Membrane proteins

Patapoutian and Julius agreed at the University of California, San Francisco during a Patapoutian postdoctoral stay that “he identified the genes for receptors that are activated by tension,” the mechanical force of stretching. These proteins are called Piezos and “are responsible for the perception of pressure in the skin and blood vessels, so its importance for health goes beyond the sense of touch ”.

The proteins found by Ardem, the so-called Piezo1 and Piezo2, are found in the cell membrane and are responsible for capturing the sensations of nociception and changes in physical pressure, transforming them into electrochemical modifications, which are the way in which our neurons transmit messages and our brain receives and analyzes information.

“The molecular receptors with which we perceive pressure stimuli help us distinguish between a gentle breeze and the prick of a cactus and also tell us when our blood pressure rises or when we have a full bladder,” explained the now Nobel. This discovery puts in our hands the possibility not only of differentiating between acute punctual pain and chronic pain, but to act in one or the other in a specific way.

While maintaining acute pain capacity is good as a pathological warning sign and defense, reducing or even eliminating chronic pain has been a historic battle for humanity now closer to winning.

This year’s Nobel Prize in Medicine, Ardem Patapoutian.

Practical effect

The importance of their discovery on a practical level for citizens can be easily summarized: they have discovered the key if not to eliminate completely, then at least to reduce chronic pain in a very significant way. And it is likely that in a relatively short time it will be applied in clinical protocols.

Pain is a complex notion something very important for survival and that is why we should not inhibit acute pain. The interesting thing is that we have shown, both in animal and human models, that although Piezo2 it is required for touch, acute pain is not affected by it ”, added the Nobel.

However, when a clinically relevant form of pain appears and the touch becomes painful, in that case it does depend on the Piezo2 and thus block this Piezo2 it could be useful in individuals suffering from neuropathic pain or persistent chronic pain or even pathologies such as malaria.

On the target of their investigations

Diseases with insidious pathologies and ongoing pain could benefit from this discovery: osteoporosis, arthritis, hypertension, and even malaria are the target of the application of the discovery of the new Nobel Prize.

“Initially, we researchers look for knowledge for the sake of knowledge, what is called basic science; but precisely this passion research can lead us to practical applications of maximum interest in our daily lives, such as in chronic pain“He added to THE INTERACTIVE DOCTOR. That humanity has in its hands to be able to free itself, even if only in part, from a biblical curse like pain, well deserves a Nobel recognition.

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Patapoutian: “the door has been opened to tackle chronic pain”

Hank Gilbert