Pain remains one of medicine’s most enduring contradictions. The body relies on pain as a warning signal when something is wrong, yet for millions of people, that warning can continue long after the original injury has healed. U.S. data found that 24.3% of adults experienced chronic pain, while 8.5% reported pain that frequently interfered with their everyday life or work activities.
The enormous scale of the problem is prompting researchers and regulators to reconsider how pain should be addressed. In May 2026, the U.S. Food and Drug Administration issued draft guidance focused specifically on developing non-opioid analgesics for chronic pain, highlighting the ongoing demand for new treatment strategies in an area where effective options remain limited. This regulatory movement follows a broader evolution in pain medicine, including the 2025 approval of Journavx, the first medication in a new class of non-opioid treatments for moderate to severe acute pain. Yet chronic pain remains a more difficult challenge, with existing medications often addressing symptoms only partially and ineffectively.
Acute and chronic pain involve very different biological processes. Acute pain can serve as a protective mechanism, prompting a person to avoid additional injury while damaged tissue repairs itself. Chronic pain, by contrast, can persist because of changes within the nervous system that allow pain signals to continue and cause normally harmless sensations to become painful. This can be understood as a breakdown in the regulation of the pain system, where inflammation and increased neuronal activity can reinforce each other.
This phenomenon is known as central sensitization, and it creates a particularly complex therapeutic problem because multiple biological pathways can become interconnected. Persistent pain signaling can stimulate immune cells known as microglia, which release inflammatory substances that influence neuronal behavior. As a result, neurons may become increasingly sensitive and excitable, creating a system where pressure, temperature, or even ordinary touch can produce pain. The effects extend far beyond physical discomfort, potentially limiting a person’s ability to work and participate in everyday activities. CDC data links chronic pain to reduced quality of life and significant additional health burdens.
This biological challenge is the focus of Dr. David Bravo, CEO and co-founder of Pannex Therapeutics, a New York-based biopharmaceutical company developing small-molecule therapies aimed at Pannexin-1, or Panx1, as a potential treatment target for chronic pain. Dr. Bravo, who has spent more than a decade researching the target, believes the field needs to look more closely at the mechanisms that allow pathological pain to continue after the original injury has disappeared.
“We’re not trying to just stop pain; we’re trying to control the cause of that pain,” Dr. Bravo says. “What is generating this pain, and how can we change the biology that is generating this pathological pain? The answers to these questions are the core of our technology.”
Pannexin-1 is a membrane channel that plays a role in cellular communication. According to Dr. Bravo and other researchers, abnormal activation of the channel may contribute to the release of ATP outside cells, activation of immune cells, and inflammatory signaling, while also increasing neuronal excitability. Dr. Bravo says Pannex Therapeutics has developed a small molecule known as PX004 that blocks the channel and, in animal models, affects multiple components of the pain process through a single biological target.
The company’s preclinical research has raised another important question: how long can a biological response continue once a drug has left the body? Dr. Bravo points to animal studies showing that PX004 has a relatively short half-life, while the biological effects observed following repeated treatment have continued for substantially longer. He considers this durability an important part of the scientific proposition and its potential clinical relevance, while emphasizing that the evidence remains at the preclinical stage.
“The compound is not only durable in relieving pain, but it also shows superior efficacy compared to the standard of care,” Dr. Bravo notes.
The question of evidence, however, makes the research more challenging. Pannexin-1 is still a relatively new therapeutic target, and Dr. Bravo acknowledges that its role in normal human physiology needs further investigation before conclusions can be drawn about its potential in patients. He reports that Pannex Therapeutics has carried out studies examining locomotor activity, sedation, coordination, and organ health, including extended high-dose animal testing, without observing side effects to date.
“These findings are part of our preclinical program, and they cannot establish human safety yet. That is our next step,” Dr. Bravo states.
The broader importance of the research comes from the question it poses about how persistent pain should be treated. If chronic pain is partly maintained by biological changes within the nervous system, future therapies may need to target those mechanisms rather than simply suppressing the symptoms. FDA action in 2025 and 2026 demonstrates that the development of safer non-opioid approaches remains an important priority, while emerging therapeutic targets are expanding the scientific search for new solutions.
For people living with chronic pain, the importance of this research ultimately comes down to the possibility of better and longer-lasting relief.
“We’re not trying to just stop pain,” Dr. Bravo says. “We’re trying to control the cause of that pain to bring hope to people suffering from it.”
For him, the potential significance of the work is not about promising an immediate cure. It is about discovering whether changing the underlying biology of pain can eventually provide persistent relief that continues even after the drug itself is no longer present in the body.
