When doctors prescribe Vicodin or Percocet to treat pain after a car accident or surgery, that’s because the drugs work. Of course, opioids–which bind to parts of the brain that control both pain and emotions, producing euphoria as they dull pain–also pose the risk of addiction. In 2016, more than 11 million Americans misused painkillers, and more than 13,000 people overdosed.
One biotech startup is working on an alternative that it believes could treat pain as well or better than opiates, without addiction. “You don’t get high from our drug,” says Paul Blum, a biological sciences professor at the University of Nebraska-Lincoln and one of the founders of the startup, called Neurocarrus. “There is no addiction based on becoming dependent on that high.”
The treatment injects a protein from a class of bacteria called Clostridium botulinum, which is also used in Botox. The protein is naturally good at delivering material into cells; the researchers engineered it to target sensory nerve cells that send pain signals to the brain. “What we’re doing is selectively turning down the sensory neurons in the peripheral nervous system, so that the signals don’t ever reach the brain,” says Neurocarrus co-founder Ben Pavlik.
Unlike opiates, the protein molecules are too large to cross the blood-brain barrier. The treatment only affects sensory nerve cells, without side effects, like the loss of balance or cognitive function, that come from other pain control drugs. Two proteins work together: one targets the nerve cell and delivers the second protein, which works to reduce electrical signaling and the perception of pain. And because there is no pleasure–only a lack of pain–people won’t want to take continually larger doses.
“We’re capitalizing on something very natural, but we have repurposed it to something different, and that is pain control,” says Blum.
They say the treatment, called Neurotox, could be used both for short-term pain and for chronic pain from diseases like arthritis, multiple sclerosis, or cancer. In animal studies, where the researchers have tested Neurotox against opioids, it appears to control pain as well as or better than the addictive drugs. The team plans to apply for a permit to test it in people within 18-24 months. Once approved, it could be used both to treat people experiencing pain for the first time–so they might never need to use opioids–or for addicts, to manage pain while they get treatment to get off the drugs.
The startup is part of the new class of companies at San Francisco-based IndieBio, a four-month-long accelerator for early-stage biotech startups. The accelerator focuses on companies that use biology and technology to solve large problems, and saw Neurocarrus as an obvious fit, both to replace addictive painkillers and to help people better manage pain.
“Long-term pain, even if you’re not taking opioids, is crippling and debilitating for a huge number of people, whether it’s osteoarthritis or some pain that just can’t be managed in any other way,” says IndieBio founder Arvind Gupta. “When we saw Neurocarrus’s technology, we saw a very novel and interesting approach to using biology to solve this . . . This is a solution that if it’s approved by the FDA, and if it’s proven to work, it’s going to be a gamechanger for pain management for millions of people.”