At the IASP 2021 Virtual World Congress on Pain, to take place June 9-11 and June 16-18, the International Association for the Study of Pain (IASP) will present awards to honor the achievements of up-and-coming as well as more established investigators (these awards were originally to be presented at the 2020 World Congress on Pain in Amsterdam, which was canceled due to the COVID-19 pandemic). In advance of the meeting, PRF spoke with each of the winners. In this interview, we chat with Jan Vollert, PhD, winner of the Ronald Dubner Research Prize. This is a trainee award that honors the best clinical or basic science research paper, series of papers, or doctoral thesis in the field of pain, published or in press while training as a student, intern, resident, predoctoral fellow, postdoctoral fellow, or equivalent.
Vollert is a biostatistician working at Imperial College London, UK, and the University of Heidelberg, Germany. His research focuses on the application of statistical and computational models to pain research, mainly to quantitative sensory testing. He has made significant contributions to the German Research Network on Neuropathic Pain and the EU-funded EuroPain network, particularly his work in unifying and managing the largest sensory phenotype database in the world. Here, Vollert speaks with Lincoln Tracy, PhD, a researcher and freelance writer based in Melbourne, Australia, to discuss how he entered the pain research field, his work on sensory phenotypes, and who he’d want at the table with him for his ideal dinner party. What follows is an edited transcript of the conversation.
What was your path to pain research?
When I was at school, I was rather set on studying literature. But in the last few years of my schooling I had some great biology teachers who really sparked my interest in genetics; they made it such an interesting and compelling area. From that point on, I started to see the value in studying something that can improve the quality of health and life. So when I got to university, I started studying molecular biology. There was a strong bioinformatics branch at the university, and one day a professor sat me down and said, “You seem to be really good at these computer things.” I thought about how clumsy I was in the lab, how many Coomassie blue stains I had left on the bench, and I thought, “Okay, maybe these computer techniques are a good field for me.” That’s how I got into statistics and bioinformatics.
After I had been working in bioinformatics for a while, I started looking for a summer job. I ended up working with Professor Christoph Maier, who would become my first mentor in pain research. After a few weeks I was considering a different job offer, but he sat me down and told me how well he thought I was doing and that I could potentially do a PhD if I stayed in his research group. This was an interesting offer, and as I thought that he was a very interesting person to work with, it was a great environment, and I was really enjoying the work, I accepted his offer. That was the point at which I really transitioned into pain research.
What is the overall aim of your research?
The overall aim is twofold. The first aim is to give patients more targeted access to the range of currently available treatments for neuropathic pain. At the moment, we are basically just trying multiple medications and hoping that one of them works at some point. I want to get to a point where we can use sensory phenotyping to at least make an educated guess about the order in which we should try the medications, rather than just trying randomly. The second aim is to use sensory phenotyping and other related methods to bring more new medications into the market. A lot of neuropathic pain medications have failed over the last 20 years, many of them because they would have only been effective in a subgroup of patients. This means if you test the medication in a broader population, the effect in the relevant subgroup drowns in the larger study population.
How did you develop an interest in researching sensory phenotypes?
There were two European networks [the German Research Network on Neuropathic Pain and the EU-funded EuroPain network] that had spent a lot of time working in this area before I came onto the scene. My initial contribution to this area of work was that, in a field of medical people, I was someone who could run a large-scale database because of my bioinformatics background. We then went on to develop quality control measures for sensory testing protocols, and then started showing that centers across Europe could produce reliable and comparable data, across borders and languages.
We now have more than 2,000 datasets from patients with neuropathic pain in our central database. Through our analyses we have found that there are three emerging phenotypes: one of mainly sensory loss, one of thermal hyperalgesia, and one of mechanical hyperalgesia that has associated hypoesthesia in the thermal parameters.
What does winning the Ronald Dubner Research Prize mean to you?
In short, it means a lot. It shows there is a lot of recognition within the pain community for the work I completed during my PhD, which is certainly a big honor. Just over two years ago, when I was writing up my thesis, I won a similar prize from the German chapter of the IASP. I thought that was the highest honor I could receive for my PhD work. Then, last year, my university singled out my PhD thesis as one of the best five theses submitted in 2018, out of all of the theses submitted to the university. Having my work singled out at a local and international level is one thing; getting international recognition for a prize that is only awarded biennially is a very, very big honor. I hope that I can live up to these expectations in the future by continuing to produce great work over the next few years.
In your area of research, what do you hope to know in five to 10 years that we don’t currently know?
One of the best things to come out of my work and the work of my European colleagues is that it is now possible to conduct phenotype-stratified trials based on the different sensory profiles of patients. This means that, for the first time, companies can seek regulatory approval to target a subgroup of neuropathic pain patients. I know that companies are now starting their pipelines up again, trying out new drugs to target specific subtypes of neuropathic pain. I hope that this will lead to the development of some new medications.
However, if we want to bring some of these sensory phenotyping methods into routine practice, we will need to simplify them. The current protocols are very comprehensive, the equipment is expensive, and really good training is required to produce comparable results. We need to find some cheaper devices and produce some protocols that anyone can use, to give each and every hospital the ability to at least screen patients for their sensory phenotype.
What are some of the challenging aspects in your area of pain research?
One of the biggest challenges is convincing people that our work is important, but this is certainly something that affects the whole pain field. With sensory testing, we often feel that our work is seen as something that is based more in the psychological realm; it’s seen as less objective than any blood-based biomarker. This is one of the reasons why we have gone to such lengths to standardize it and keep showing that our work can be highly reliable – and be even more reliable than tests that use big machines and computers, in most cases. One of the questions I often get from the audience when I present the sensory testing protocol is, “Can’t you just ask people how they feel? Why can’t you just ask people, ‘where does it hurt, and how does it hurt?’” We have good reasons for doing our sensory profiling, but at times it is difficult to make those points to people.
What is it like being an early career researcher in the pain field?
I honestly think it’s a great scene to be working in. In a short period of time I have met many wonderful colleagues across Europe, and now across the world. I hope it is an area that will get more public attention and funding in the future, because pain has been ignored publicly, to some degree; it’s such an important topic that we should look at more, as a society.
Despite this, it’s a great field to build a career in – at least I hope so. Otherwise, I should have left a while ago [laughs]. But I don’t think I would be in the same kind of position I am now if I had stayed in bioinformatics or genetics.
What are the key pieces of advice you give to trainees?
Learn to write, and learn that soon. I know that in European countries medical and scientific trainees are never really taught how to write properly. However, writing will quickly become one of the most crucial skills in your career, as it allows you to communicate your work. You need to try to be articulate and not be too harsh on yourself while you are learning.
Apart from that, my other piece of advice would be to network at meetings. Go to the congresses and the young scientist meetings whenever possible. If you see a professor who you have always wanted to talk to, just go and talk to them. They will probably enjoy it if you tell them you have marveled at their wonderful career.
If you could have a dinner party with anyone from history, who would you want at the table with you and why?
How big is the table [laughs]? There would certainly be a few writers. Vladimir Nabokov wrote some of my favorite books. While Lolita, his most famous book, is also infamous because it was forbidden for a while, it is a wonderful book that I would recommend that everyone read. Maybe also Immanuel Kant, because I like his idea of how to structure a society. I would want a few famous politicians to be there, as I would love to listen in on some conversations. I’m pretty sure Barack Obama must be great company; he seems like such an eloquent and funny person. In Germany we have Otto von Bismarck, who constructed a lot of European politics from 1850 to 1900. That was a very formative time in Europe, so it would be very interesting to listen in on how he constructed all those parts of European foreign policy.
So it might be a very intellectual dinner party [laughs]; maybe I should invite the [guys from] Monty Python as well.
Lincoln Tracy, PhD, is a researcher and freelance writer based in Melbourne, Australia. Follow him on Twitter @lincolntracy.