Advanced Discovery of Visceral Analgesics via Neuroimmune Targets and the Genetics of Extreme human phenotype (ADVANTAGE)

Visceral pain is pain that comes from the inside of our bodies. For example, from the gut, kidneys, uterus, and bladder. Such pain affects intimate aspects of everyday living. It can be very difficult to live with visceral pain and it constitutes a third of all chronic pain and is disabling in 5% of the UK population.

There are many conditions associated with visceral pain including:

Chronic pancreatitis Chronic prostatitis and chronic pelvic pain syndrome (CP/ CPPS) Endometriosis Inflammatory bowel disease (IBD) Irritable bowel syndrome (IBS) Painful bladder syndrome or interstitial cystitis (IC) Polycystic kidney disease (PKD) Vaginal mesh complication

The ADVANTAGE visceral pain consortium aims to improve how we treat people with visceral diseases, focusing on their pain rather than just their underlying disease.

One in twenty individuals in the UK are disabled by visceral pain - approximately as many people as live in the entire country of Wales. The condition is a terrible burden for those who suffer from it: causing pain not only during the most intimate moments of their lives, but also frequently triggering unpredictable episodes of pain ‘flares’ that can need hospital admission.

Our consortium will set up a UK-wide database of visceral pain patients to address these questions. We will also study those nerves connecting inner organs to the brain to ultimately cause pain, as their exact identity is unknown.

Our ultimate aim is to improve our understanding of visceral pain from the perspective of people living with the condition, so that the NHS can develop and offer patients more effective interventions and support to address the diverse nature of their symptoms and help improve their quality of life.

The purpose of the ADVANTAGE consortium is to catalyse a step change in the care of people with severe visceral pain through an APDP National Visceral Pain Resource. The ADVANTAGE consortium will unite cross-cutting clinical expertise in pain and visceral disease with patients, psychologists, basic pre-clinical pain scientists and industrial collaborators to achieve the following objectives:

Set up phenotyped disease cohorts including pain from the bladder, vagina, pelvis, pancreas, kidney and gut

Identify the genetic, autoantibody and psychological drivers of visceral pain

Study sensory nerve mechanisms underlying chronic visceral pain

Professor Geoff Woods (University of Cambridge)

Dr Michael Lee Professor Ewan St John Smith Professor George Malliaras

Professor Amanda Williams

Dr Thanasis Tsanas Professor Andrew Horne Professor Philippa Saunders

Dr David Andersson Dr Franziska Denk

Professor David Bennett Professor Nathalie Vergnolle Professor Stacey Missmer Professor Ted Price

Dr Karen Guerrero

Dr Ian Arnott

Dr Paul Phelan Dr Voula Granitsiotis Mr Ammar Alhasso

Mr Chris Harding

Dr Richard Sandford

Dr Sibu Varghese Mr Mohamed Mabrouk Mr Nikesh Thiruchelvam Professor James Nathan Professor Miles Parkes Professor Stefan Marciniak

Patient and Public Involvement (PPI) is vital in today's research. The ADVANTAGE consortium aims to work with and draw upon the valued input and feedback from the Patient & Charity Advisory Board (PCAB) members to improve the overall experience for research participants both now and in the future.

The charities involve include:

Advanced Discovery of Visceral Analgesics via Neuroimmune Targets and the Genetics of Extreme human phenotype (ADVANTAGE)

Our consortium aims to improve the treatment of people with visceral diseases, such as endometriosis, colitis and kidney disease, focusing on their pain rather than just their underlying disease.

Key aims