The Force Awakens: How Pain And Inflammation Take Their Toll In Arthritis

Professor Nidhi Sofat works on the causes of pain and inflammation in musculoskeletal diseases using a bench-to-bedside experimental approach.

Musculoskeletal conditions are a major cause of pain and disability worldwide. In conditions such as rheumatoid arthritis and osteoarthritis, pain is a major symptom. Pain can be triggered by local damage to the joint, which is caused by molecules produced in the body including prostaglandins and cytokines. The human response of pain and inflammation is often an early warning system to prevent further damage and harm. However, in arthritis, several molecular pathways are switched on continuously, which causes symptoms. A major question in arthritis is how to switch off these pain and inflammation pathways.

Professor Sofat and her group have established the importance of different characteristics of pain in arthritis using a variety of techniques including sensory testing and imaging of the joint by magnetic resonance imaging (MRI). Her group has shown how the brain is activated during arthritis pain (in collaboration with Professor Franklyn Howe). Professor Sofat’s group have tested drugs to combat pain in arthritis patients from her rheumatology clinics which target pain sensitisation.

As well as carrying out clinical studies, Professor Sofat’s group investigates how different parts of the joint trigger pain and inflammation. Her group performed the first gene expression study of bone marrow lesions in arthritis. Ultimately, a better understanding of the mechanisms inducing pain and inflammation could be used to develop improved diagnostic tools and treatments for arthritis.

Publications

• Kuttapitiya A, Assi L, Laing K, Hing CB, Mitchell P, Whitley G, Harrison A, Howe FA, Ejindu V, Heron C, Sofat N. Microarray analysis of bone marrow lesions in osteoarthritis demonstrates upregulation of genes implicated in osteochondral turnover, neurogenesis and inflammation. Annals of the Rheumatic Diseases, 2017; 76(10): 1764-1773.

• Fuggle NR, Smith TO, Kaul A, Sofat N. Hand to Mouth: A Systematic Review and Meta-Analysis of the Association between Rheumatoid Arthritis and Periodontitis. Front Immunol 2016; 7: 80; doi: 10.3389/fimmu.2016.00080

• Sofat N, Harrison A, Russell M, Ayis S, Kiely PD, Baker EH, Barrick TB, Howe FA. The effect of pregabalin or duloxetine on arthritis pain: a clinical and mechanistic study in people with hand osteoarthritis. J Pain Research 2017, 10: 2437-2449.