Universitetslektor vid Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin
- BMC, Husargatan 3
- Box 564
751 22 UPPSALA
Jag är legitimerad läkare sedan 1997, specialist i allmänmedicin sedan 2006 samt specialist i smärtbehandling sedan 2009. Sedan min disputation 2011 har jag fortsatt mitt forskningsfokus på diagnostik och behandling av smärta och är sedan 2019 anställd som universitetslektor vid Institutionen för folkhälso- och vårdvetenskap vid Uppsala universitet kombinerat med en anställning vid en Akademisk vårdcentral i Region Uppsala. Sedan 2021 är jag docent i allmänmedicin.
Akademiska meriter: leg. läk. spec i allmänmedicin
Nyckelord: allmänmedicin smärta folkhälsa
Detta stycke finns inte på svenska, därför visas den engelska versionen.
I am a general practitioner with additional training as specialist in pain management. I defended my thesis at the Departments of Public Health and Caring Sciences, Section of General Medicine and Preventive Medicine, November 2011. In my research, I have focused on long-term pain, with a special focus on soft tissue pain, which is a common and costly problem for both society and healthcare and one of the most common reasons for consultation in primary care. The mechanisms behind long term pain are still incompletely known and treatment is mostly symptomatic. In primary care, pain is the most common cause for consultation, but despite this, only about half of all patients seeking help undergo adequate examination and treatment. Many treatments are inadequate and incompletely evaluated.
My thesis had focus on a common type of soft tissue pain (chronic tennis elbow) where I researched treatment practice for this conditione and evaluated a new type of physiotherapeutic treatment (eccentric training) that had gained popularity but lacked scientific evaluation. The project was carried out with support from the Swedish Research Council. In addition, a research grant from the Amersham Foundation at Uppsala University allowed us to perform studies on chornic tennis elbow using positron emission tomography (PET) and how this method can be used to visualize physiological processes in peripheral soft tissue with association to pain. The work on PET and the signal substance "substance P" and its receptor NK1 received a great deal of media attention as this was the first time that the method was used to image tissue processes related to pain outside the central nervous system in humans in vivo. This work, together with similar PET studies on the inflammation marker Deprenyl at the research group at the pain center, Uppsala, was named one of the ten most innovative works at the science fair in San Diego in 2014. In collaboration with Harvard Medical School, we later analyzed how the same mechanism regulated and can be visualized in the central nervous system.
Following the dissertation, a three-year grant from AFA Insurance in 2015 provided the opportunity to continue studies with immunohistochemistry and autoradiography with the aim of developing new PET markers to visualize tissue processes associated with pain. The project was carried out as a collaboration between the Department of Public Health and Caring Sciences, the Department of Medical Biochemistry and Microbiology (IMBIM) Uppsala University, the Preclinical PET Platform, the Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet and the Department of Clinical and Experimental Medicine ( IKE) Linköping University. Within the framework of this project, a doctoral student could be hired (Abdul Alim), who completed his dissertation in 2019.
The project also provided interesting findings about the role of mast cells in tissue healing, where we were able to go further and show how the mast cells participate and are activated in the healing of ruptured Achilles tendon. As a result, we have also (as the first research group) been able to demonstrate that the mast cells possess receptors for the neuropeptide glutamate and respond to it. This work demonstrates how mast cells (similar to other inflammatory cells) can respond to signaling peptides released from peripheral nerve endings, a pre-requisite for so-called neurogenic inflammation.
We are now continuing this work by studying how mast cells respond to hyperglycemia. Our preliminary findings suggest that altered function of the mast cells in hyperglycemia may lead to increased inflammatory activity, which in turn could help to explain the slowed tissue healing seen in people with diabetes, including chronic foot / leg ulcers. An increased understanding of these mechanisms, and how we can pharmacologically modify the function of mast cells, could be beneficial for improving wound healing in people with type 2 diabetes, for whom primary care has the main responsibility for diagnosis and treatment.
In 2017, physiotherapist Kent Jonsson could also be registered as a doctoral student in collaboration with the Center for Clinical Research (CKF) in Sörmland, for a project that maps respiration and work capacity in the pain condition fibromyalgia.
In addition, I have acted as co-supervisor to physiotherapist Thomas Torstensson (PhD 2013) on studies of long-term pelvic pain in women who have given birth, MD Mikko Aarnio (PhD 2018) on PET-studies of Whiplash-associated disorder and to nurse Susanne Hellerstedt-Börjesson (PhD 2018) for studies on pain in chemotherapy for breast cancer. I am currently co-tutor to the physiotherapist Kerstin Ahlkvist on studies of long-term pelvic pain in women who have given birth.
Since 2019, I have been employed as a senior lecturer in general medicine at the Department of Public Health and Caring Sciences, Uppsala University with combined service at Nära vård och hälsa, Region Uppsala. In this position I also supervise other research projects, primarily on pain associated with the musculoskeletal system.
Since 2021 I am Docent in General Medicine.
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