Author: Alice McCarthy

Overcoming pain by tackling the fear factor

chronic regional pain syndrome
Grace Cahners prior to fear-based therapy (photos: Leigh Cahners)

When 11-year old Grace Cahners broke her foot in July 2015, she received the usual support boot, then casting and several weeks of physical therapy (PT). But instead of getting better, her pain intensified over the course of five months, forcing her to miss the first 54 days of sixth grade. She lost her normally sunny disposition and became crippled by fear.

Grace was diagnosed with complex regional pain syndrome (CRPS), a chronic pain condition in which the brain sends an over-abundance of pain signals to the affected limb. Not a newcomer to pain – Grace was diagnosed with psoriatic arthritis at the age of 13 months – she was using a wheelchair by December.

Leigh Cahners, Grace’s mother, knew that full-day narcotic pain medications and traditional PT would not restore Grace’s ability to walk. “I knew we needed another approach,” she says.

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DIY pain relief with light-activated local nerve blocks

light-activated liposomes
Injected, gold-coated liposomes could release painkillers on demand when heated with NIR light. (Shutterstock)

You’ve just had a root canal or knee surgery — both situations that will likely require some sort of local pain medication. But instead of taking a systemic narcotic with all its side effects, what if you could medicate only the part of your body that hurts, only when needed and only as much as necessary?

That concept is today’s reality in the laboratory of Daniel Kohane, MD, PhD, professor of anesthesia at Harvard Medical School and a senior associate in pediatric critical care at Boston Children’s Hospital.

The Kohane laboratory is developing a patient-triggered drug delivery system — but not a simple time-release mechanism or one tethered to ports or pumps. Instead, around the time of an intervention, pain medication would be injected into the site, or around a nerve leading to that site. Whenever pain relief is needed, the patient triggers release of the drug with a laser-like light-emitting device. “It’s like carrying the pharmacy in your body,” explains Kohane.

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A biomarker for Rett syndrome: Measuring hand movements

Rett syndrome stereotypies bracelet Q-sensor curveRett syndrome, a neurodevelopmental disorder affecting mostly girls, takes away the ability to speak, and this makes the condition hard to reliably measure and assess. But children with Rett syndrome also display distinctive hand movements or stereotypies, including hand wringing, clasping and other repetitive hand movements, visible in many of these videos. With help from a grant from Boston Children’s Hospital’s Innovation Acceleration Program, researchers are transforming these hand movements into an assessment tool.

Until now, there has been no quantitative measure for monitoring Rett hand movements. Adapting commercially available wearable sensor technology, biomedical engineering researcher Heather O’Leary has created a bracelet-like device not unlike Fitbit, another wearable accelerometer used to monitor exercise activity levels.

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Leveraging bacteria biofilms for vaccines

biofilm vaccine cholera
Through genetic engineering, this Vibrio cholerae biofilm can be loaded with extra antigens, creating a super-charged but inexpensive vaccine.

Malaria. Cholera. Now Ebola. Whatever the contagion, the need for new, or better, vaccines is a constant. For some of the most devastating public health epidemics, which often break out in resource-poor countries, vaccines have to be not only medically effective but also inexpensive. That means easy to produce, store and deliver.

Paula Watnick, MD, PhD, an infectious disease specialist at Boston Children’s Hospital, has a plan that stems from her work on cholera: using a substance produced by the bacteria themselves to make inexpensive and better vaccines against them.

Cells do all the work

Bacteria produce biofilms—a sticky, tough material composed of proteins, DNA and sugars—to help them attach to surfaces and survive.

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