Ward rounds to the lab and back again: the life of a WADDP clinician/researcher
- Beth Amato
Dr Motsamai Khumalo is pioneering targeted drug delivery to tackle chronic post-operative pain, aiming to improve outcomes while reducing reliance on high-dose
When Dr Motsamai Khumalo, an emerging researcher at the Wits Advanced Drug Delivery Platform and a busy anaesthesiologist at the Charlotte Maxeke Johannesburg Academic Hospital, observed that patients were suffering from chronic, often debilitating post-operative pain, he wondered how pain medicines could be more effective.
“Doctors often rely on high-dose systemic drugs, some of which can be addictive. I wondered how we could deliver pain meds in more efficient ways to solve ongoing pain. Drug delivery systems that target specific pain sites at an effective dose are a missing piece in the pain puzzle,” said Dr Khumalo.
He is also a member of Pain SA, which is a chapter of the International Association for the Study of Pain.
Driven by nerve injury and structural changes in tissue, post-operative pain significantly affects a person’s quality of life. While chronic pain is common, there is only one dedicated pain clinic in Johannesburg, for example. “When you’re in pain, you can’t do or think about much else. The burden doesn’t end there. It affects your productivity and mental health. Pain has many ripple effects on families and communities. It affects others, too,” says Khumalo.
He adds that chronic post-operative pain is more common in procedures like hysterectomies and orthopaedic surgeries involving the spine, hips and knees.
So far, Khumalo’s work uses in vitro and in vivo models to simulate nerve injury and examines how different formulations influence healing and regeneration. His ultimate aim would be to intervene early, at the site of injury, to reduce inflammation, support proper nerve repair, and prevent the cascade that leads to chronic pain.
Khumalo presented his work at the World Congress of Anaesthesiologists in Morocco and described how his microneedle system can deliver gabapentin (a drug widely used for neuropathic pain) directly to the surgical site for up to 4 weeks. This could potentially reduce the need for systemic analgesics and their associated side effects.
“Gabapentin has anti-inflammatory and anti-neuropathic properties,” he explains. “But in current practice, it is given orally at relatively high doses. We are looking at how to deliver it in a more targeted way, and at lower doses.”
This approach could reduce systemic side effects while improving outcomes, aligning with WADDP’s work in engineering the formulation and delivery of existing and emerging drugs to achieve more effective treatment.
Says WADDP Senior Researcher, Prof. Pradeep Kumar, “Dr Khumalo brings something distinctive to WADDP as he deals with patients every day and can observe where current treatment approaches fall short.”
Dr Divesha Essa, Research Fellow at WADDP, notes that translating biomedical research requires meaningfully and appropriately reflecting real human systems. “Dr Khumalo’s research can elevate our already scientifically rigorous lab models into clinical relevance,” says Essa.
Laboratory work at WADDP, in turn, refines appropriate dosing, blood volume considerations, and toxicity thresholds.
“We want our innovation and research to be grounded in patient reality from the beginning. Having Dr Khumalo with us shows how important combining clinical insights into pharmaceutical innovation is,” says Professor Yahya Choonara, WADDP’s director.
Khumalo explains that his attraction to research began with curiosity and seeing the real hardships in his patients’ lives. “I wanted to do something about it. I wanted to improve their lives tangibly, and my work at WADDP is allowing me the space to do so.”