From pain control to infection control: the evolutionary case for promiscuity

Pain is an adaptive protective response to threat that is critical for survival. It is highly context sensitive. The brain contains multiple evolutionarily conserved parallel systems for regulating nociceptive sensory input that appear to fail in chronic pain. I will describe our rodent and matched human imaging studies that have explored the noradrenergic and endorphinergic systems that provide moment by moment control of pain and describe how they may be better harnessed for therapies. I will also briefly digress into how society deployed adaptive protective responses to threat during the recent COVID pandemic. Some of these adaptations were believed to be critical for the survival of healthcare practitioners and dramatically changed clinical practice. I will describe our recent investigations into aerosol generating procedures and explain why this is also highly context sensitive and in many cases a maladaptive response. We have found that principles of pain neuroscience and infection control practice have some surprising parallels that have only been uncovered through enforced research promiscuity.


Tony is a Geordie expat, exiled in the South-West. He is a practicing anaesthetist and pain clinician. He leads the Anaesthesia, Pain and Critical Care research group at The University of Bristol. His research investigates the brainstem and spinal cord organisation of mission-critical control circuits regulating key sensory and autonomic functions. His team uses genetic circuit manipulation approaches to define the operating principles of these evolutionarily ancient systems in rodents and seeks to apply this knowledge in human neuroscience experimental medicine investigations and clinical trials.