The Notable Nine
Leading Pain Researchers Call Dental School Home
By Salwa Choucair
One of the best kept secrets of UT Health San Antonio may be that its School of Dentistry is recognized across the United States as a leader in pain research. In fact, an unprecedented number of highly skilled and trained clinicians and scientists in the school are actively working to battle America’s addiction to pain meds and reduce the number of chronic pain diagnoses.
“We are home to a nationally recognized group of clinician scientists and basic scientists who are working to solve the problem of pain,” says Kenneth M. Hargreaves, D.D.S., Ph.D., professor and chair of the Department of Endodontics. “This is an extraordinary group of innovative, creative and very well-funded individuals.”
Today, more than ever, the country, which is gripped by headlines concerning America’s opioid crisis, is looking for solutions. The Centers for Disease Control and Prevention estimates the economic burden of prescription opioid misuse alone in the U.S. is $78.5 billion a year; every day, more than 130 people die from overdose.
Dr. Hargreaves and his colleagues have been effectively using a two-pronged approach in order to solve this crisis. The first approach impacts patient care through educating dental students and dentists on the best ways to treat pain.
“We have developed strategies to treat dental pain with very minimal or no use of opioids at all,” Dr. Hargreaves explains. “We published dozens of papers and given probably hundreds of presentations over the last 20 years. We have taught every class of dental students the proper way of treating moderate to severe pain with minimal or no use of opioids.”
The second approach, research and work in the lab, is where this team is developing the next generation of pain killers that are non-opioid with non-addictive properties.
The Notable Nine
The clinicians and scientists in the dental school conducting pain research are Dr. Hargreaves; Armen Akopian, Ph.D.; Vanessa Chrepa, D.D.S.; Anibal Diogenes, D.D.S. Ph.D; Nathaniel Jeske, Ph.D.; Asma Khan, B.D.S., Ph.D.; Yu Shin Kim, Ph.D.; Nikita Ruparel, D.D.S., Ph.D., and Shivani Ruparel, Ph.D.
Dr. Akopian, associate professor with tenure of endodontics, researches pain management as it relates to the difference in men, women and the elderly.
Dr. Chrepa, director of undergraduate studies and assistant professor of endodontics, also researches stem cell biology and regenerative endodontics, molecular biology and endodontic microbiology.
Dr. Diogenes, associate professor of endodontics, performs stem cell clinical trials on endodontic regeneration. He led the first clinical study that proved children’s oral stem cells could regenerate their teeth. The discovery contributed to the definition of the term “regenerative endodontics” and national guidelines.
Dr. Jeske, director of research and associate professor of oral and maxillofacial surgery, focuses on biochemical signaling molecules and pathways unique to pain-sensing neurons in the periphery that can be targeted to reduce pain, increase analgesia and improve the quality of life for pain patients.
Dr. Khan, associate professor of endodontics, is conducting research on strategies for the diagnosis and management of acute odontogenic pain, the evaluation of new analgesics and anesthetics, and the development of new diagnostics for the detection of cracks in teeth.
Dr. Kim, assistant professor of oral and maxillofacial surgery, and his team are studying the molecular and cellular mechanism of pain, itch and touch sensation. He is particularly interested in looking at in vivo cellular imaging of messengers such as calcium, cAMP and others to study chronic pain and itch.
Dr. Nikita Ruparel, assistant professor of endodontics, focuses on pain and stem cells including the development of non-opioid drugs using human tissues and stem cells to treat inflammatory pain; the study of sexually dimorphic pain mechanisms mediated by serotonin on nociceptive neurons; and the study of the role and function of stem cells in tooth regeneration.
Dr. Shivani Ruparel, director of research and assistant professor of endodontics, is investigating the peripheral mechanisms of how oral tumors regulate activities of surrounding pain-sensing neurons by using tools such as orthotopic tongue cancer pain models in mice, behavioral assays as well as single-fiber electrophysiology.
Much of the school’s national acclaim is due to Dr. Hargreaves, who has devoted most of his almost 40-year career to pain research.
While he has received numerous accolades for his research, Dr. Hargreaves believes his greatest accomplishment lies in his years of teaching and mentoring students and collaborating with colleagues both within his profession and outside of his profession.
“UT Health has been an amazing place for an academic home,” he says. “There are opportunities for collaboration, education and training all along the clinical-translational spectrum. In my view, the ‘secret sauce’ of UT Health is the open culture of collaboration that exists across labs, clinics and schools.”