# Transient Vanilloid Receptors and Vulvar Pain: New Therapeutic Targets for Vulvodynia

> **NIH NIH R01** · UNIVERSITY OF ROCHESTER · 2024 · $575,316

## Abstract

The Focus: Localized provoked vulvodynia (LPV) is the most common cause of chronic dyspareunia (painful
intercourse) in premenopausal women, and it remains a poorly understood disease. Existing therapies do not
target the underlying causes, treatment is trial and error, and intervention typically escalates to cutting away
the painful tissue surrounding the vaginal opening, the vestibule. This proposal aims to identify new targets to
treat LPV pain in alignment with the missions of at least two NIH institutes by aiming to 1) improve women’s
health care (NICHD) and 2) identify non-addictive targets for pain therapy (NIDA).
The Premise: We discovered a non-classical inflammatory response in the vestibule of LPV patients that is a
key contributor to LPV pain. The vestibule of LPV patients is hypersensitive to inflammatory stimuli, causing a
response when one would not otherwise occur, which is characterized by high levels of proinflammatory
mediators. There is a direct association between proinflammatory mediator levels and pain; fibroblasts taken
from sites of exquisite pain produce the highest levels of these mediators, indicating the vestibule could be
uniquely vulnerable and could be specifically targeted to resolve pain. We subsequently identified several
candidates for therapeutic intervention (e.g. Dectin-1, Nuclear kappa factor B). However, targeting these would
not completely alleviate proinflammatory signaling or might compromise host defenses. Our goal is to identify
and validate new therapeutic targets for LPV pain therapy. Our supporting data strongly suggest that transient
receptor potential vanilloid receptor 4 (TRPV4) and members of its signaling pathway represent promising and
innovative therapeutic targets. We will confirm TRPV4’s role in LPV, validate the likely therapeutic targets, and
in the process, enhance our mechanistic understanding of vulvodynia.
Organizing Hypothesis: We hypothesize that targeting the TRPV4 pathway will reduce pro-nociceptive
signaling in human fibroblasts and tissue and impart analgesia in mice
Specific Aim 1: Elucidate the role of site-specific TRPV4 signaling differences to identify new therapeutic
targets for LPV.
Specific Aim 2: Explore the relationship between inflammation, TRPV4, and alterations in lipid profiles in LPV
patients.
Specific Aim 3: Validate TRPV4 and other identified targets using 3D tissue culture and an in vivo LPV model.
Impact on the field: We plan to accomplish three goals: 1) identify and validate new targets for desperately
needed non-invasive and efficacious vulvodynia therapies, 2) improve understanding of the vulvodynia
mechanism, and 3) identify mechanisms likely conserved in other pain conditions by focusing on a ubiquitous
signaling pathway (TRPV4) suspected to play a role in pain syndromes, targeting of which would be unlikely to
result in adverse sequelae, including drug dependence disorders.

## Key facts

- **NIH application ID:** 10932844
- **Project number:** 5R01HD108173-02
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Megan Lindsay Falsetta Wood
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $575,316
- **Award type:** 5
- **Project period:** 2023-09-21 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932844

## Citation

> US National Institutes of Health, RePORTER application 10932844, Transient Vanilloid Receptors and Vulvar Pain: New Therapeutic Targets for Vulvodynia (5R01HD108173-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10932844. Licensed CC0.

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