Malin Ernberg

Malin Ernberg

Professor/Senior Dentist

Research about mechanisms behind chronic pain Translational research including both basic and clinical research Subcontracted PI for NIH projekt phenotyping masseter muscle nerve distribution

Telephone: +46852488236
Visiting address: Alfred Nobels Allé 8, 14104 Huddinge
Postal address: OF Odontologi, OF Oral rehabilitering, 171 77 Stockholm

About me

  • I am since 2012 Professor in Clinical Oral Physiology and Senior Consultant at the Department for Dental Medicine. Since 2024 I am Senior Professor with 20% employment and subcontracted PI for a projekt within the NIH-project "Comprehesive functional phenotyping of trigeminal neurons innervating the temporomandibular joint (TMJ) tissues in male, female and aged mice, primates, and humans with and without TMJ disorders (TMJD)."

    I received my dental degree (DDS) at Karolinska Institutet 1979 and Specialist Diploma in Orofacial Pain/TMD in 1995. In 1999 I defended my PhD thesis and in 2004 I was appointed Associate Professor at KI. Between 2004 and 2006 I was guest researcher at the Department of Orofacial Pain at Aarhus University, Denmark during a total of 1 year. From 2009 to 2014 I had a 50% clinical research position financed by the Swedish Research Council and was 2012 appointed Professor in Clinical Oral Physiology at KI. 

    Within the Department I have had various leadership assignments. I was Head of the undergraduate dental clinic for adults between 2006 and 2009, Head of the Division of Oral Diagnostics and Rehabilitation 2018-2023, and Head of Research at the Department and member of the Management team 2014 and 2022.

    During 2011 and 2012 I was the President of the Neuroscience Group of the International Association for Dental Research (IADR) and between 2013 to 2016 the President of the Swedish Pain Society, the national chapter of the International Association for the Study of Pain (IASP). At the same time I was a member of the European Pain Federation’s (EFIC) Council. Presently I am the President of the European Academy of Orofacial Pain and Dysfunction (EAOPD) and of the American Dental Society Sweden (ADSS), and member of the recently started KI Pain Network’s stearing group.

    I have co-authored a vast number of original papers, review papers and book chapters.

Research

  • My research group focuses on increasing our knowledge concerning the mechanisms behind chronic orofacial pain, emphasising jaw muscle pain and its sex differences. The research is translational, spanning from basic research conducted in patients and matched pain-free controls via human experimental studies where pain is experimentally induced to clinical intervention studies. We study potential algesic and inflammatory peripheral biomarkers.

    The current project I am Swedish PI for is led by Professor Armen Akopian, University of Texas, San Antoniand includes four PIs at different universities. I am the only PI outside USA. The projektet is in turn, part of a larger consortium, RE-JOIN, including five larger project groups within the NIH HEAL initiative, aiming at finding new drugs that can replace opioids.

    The Orofacial Pain Research Group is part of the larger Orofacial Neuroscience Group at the Division of Oral Rehabilitation, and collaborates with several other research groups within KI and other Swedish and International universities. The group also has a close collaboration with the Specialist Clinic for Orofacial Pain at the Eastman Institute in Stockholm.

    For information about specific research projects, please visit the Department's Research pages.

Teaching

  • During my academic career I have always shown a great interest in teaching and throughout the years been a member of various educational committees. As Professor I have initiated radical changes of the teaching in my subject (Orofacial Pain and Jaw Function) for dental students, which was further developed and implemented by colleagues. This meant a change from having a more traditional teaching with lectures to Team-based learning. I was also responsible for the implementation of Observed Structural Clinical Examination (OSCE) within the undergraduate dental curriculum in 2009 and was in lead for the exam for several years.

    I have further supervised more than 12 PhD students, 9 MSci theses, and 39 student theses and have given several presentations and lectures at National and International conferences as invited speaker.

Articles

All other publications

Grants

  • Canadian Institutes of Health Research
    1 April 2023 - 31 March 2028
    Jaw pain is one of the most common facial pain. Among individuals affected, approximately half to two-thirds will seek professional care. Nevertheless, a large proportion of these individuals still report persistent pain 5 years later, and some are even left with long-term disabilities. Unfortunately, there is no clear evidence on how to predict or prevent the persistence of PTMD. Thus, we will conduct this longitudinal study to investigate the factors associated with the persistence of jaw pain and to identify the biomarkers. Participants will be enrolled from dental clinics in Montreal, Ottawa, Toronto, and Edmonton. They will fill out questionnaires and provide saliva during the study to measure jaw pain, and the potential factors and biomarkers associated with the persistence of jaw pain. This study will cast new light on PTMD factors that could prevent the persistence of this pain.
  • Is the kynurenine pathway upregulated in chronic muscle pain?
    Region Stockholm, SOF
    1 January 2023 - 31 December 2025
    Aim: Chronic musculoskeletal pain is the most frequent cause of reduced work capacity and long-term sick leave. The underlying pathogenesis is not known, but a shift in the tryptophan metabolism towards kynurenine can be an important piece of puzzle that can explain both that the pain is maintained as well as the comorbidity with IBS, insomnia, depression, and headache. Therefore, this project aims to explore if a shift in the tryptophan metabolism along the kynurenine pathway participates in the pathogenesis of chronic myalgia Patients and Methods: Patients with local (MYA), regional (myofascial pain, MFP), and widespread myalgia (fibromyalgia, FMS) as well as sex- and age matched healthy controls will be included. The participants complete a questionnaire including demographic and validated instruments to assess pain variables, physical function, and presence of comorbidities, such as headache, irritable bowel syndrome (IBS), and mental health. After a clinical examination saliva and blood are sampled. In case-control studies we will investigate 1) the presence of comorbidities (n=80 per group), 2) the relation between different tryptophan metabolites in plasma and their relation to comorbidities (n=80 per group), 3) the intramuscular concentration of tryptophan metabolites in the masseter muscle before and after isometric muscle contractions (n=15-20 per group), and 4) if the salivary microflora differ between groups (n=80 per group). Plasma and muscle dialysate are analysed for tryptophan, serotonin (5-HT), kynurenine and its metabolites (LC/MS) as well as pro-inflammatory cytokines (Multiplex assay). The saliva microbiome of selected bacterial species is analysed with qPCR, amplified with 16S rRNA gene sequencing and compared to a database. Significance: If our hypotheses can be confirmed the effects for health care can be considerable, since it generates new knowledge about the relation between chronic pain and its comorbidities, about the tryptophan metabolism as well as the salivary microflora. As to the best of our knowledge, no previous study has used such a holistic approach to study chronic pain and comorbidities, but only studied each condition separately. The project can therefore be of great value for the individual patient, for work life as well as for the society.
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases
    23 September 2022 - 31 August 2027
    The knowledge of the function, types, distributions, and plasticity of afferent neurites innervating temporomandibular joint (TMJ) tissues is needed to understand the underlying mechanisms controlling the development of temporomandibular joint disorder (TMJD) pain. The objective of this proposal is to address this critical gap in knowledge by comprehensively elucidating the functions, types, neuroanatomical distributions, and plasticity of trigeminal (TG) neurons innervating the muscles, tendons, and fascia of the masseter (MM) and lateral pterygoid (LPM) muscles, as well as the cartilage, joint capsule, and ligament around TMJ condyle in male, female and aged mice, primates, and humans with and without TMJD pain conditions. In support of this proposal, we have demonstrated that TMJ tissues are innervated by trigeminal (TG) neurons with unique and distinct properties, distributions and molecular signatures compared to previously described TG and dorsal root ganglia (DRG) neurons. Based on supporting data and the expertise of our multi-disciplinary team, we anticipate that this project will map the location and elucidate the phenotype and plasticity for TG neurons innervating TMJ tissues in male, female, and aged mice, primates and humans with and without TMJD pain conditions. We also expect candidate therapeutic target identification in TMJD patients’ TMJ tissues, which could ultimately lead to possible new treatments for TMJD. This study will be conducted in four interconnected yet independent aims. Aim 1 identifies the molecular signature, function and plasticity of TG neurons innervating TMJ tissues in male, female and aged mice with and without TMJD. Aim 2 maps afferent neurites innervating TMJ tissues in mice with and without TMJD. Aim 3 maps the location of neurites and define the phenotype and plasticity of TG neurons innervating TMJ tissues in non-human primates (NHP) with and without TMJD. Aim 4 examines TMJ tissue nerves and cell plasticity in TMJD patients. Substantial amount of data generated by this work will have a substantial positive impact by achieving most objectives of the RE-JOIN program, including (1) mapping the location of the afferent neurites in TMJ tissues
    (2) phenotyping and functionally characterizing TG neurons innervating a variety of TMJ tissues
    (3) identifying TMJD-induced plasticity of these TG neurons in male, female and aged mice, primates and humans
    (4) identifying novel candidate therapeutic targets in biopsies from TMJD patients
    and (5) increasing study translatability by validating data from TMJD mouse models in primate and human tissues. The proposed experiments will create large, integrated, annotated datasets and metadata and develop advanced approaches, which will be shared with the research community conducting similar studies.
  • Diagnostic and prognostic salivary biomarkers in chronic muscle pain
    Region Stockholm, ALF
    1 January 2022 - 31 December 2024
  • The role of the kynurenine pathway and microbiota in chronic muscle pain
    Swedish Rheumatism Association
    8 March 2021 - 31 December 2024
  • The role of the kynurenine pathway and microbiota in chronic muscle pain
    Region Stockholm, SOF
    1 January 2020 - 31 December 2022
  • The role of the kynurenine pathway and microbiota in chronic muscle pain
    Region Stockholm, ALF
    1 January 2019 - 31 December 2019
  • Significance of molecular biomarkers for the pathogenesis of temporomandibular disorders myalgia.
    Region Stockholm, SOF
    1 January 2018 - 31 December 2020
  • Significance of peripheral biomarkers and polymorphisms in the serotonergic system for the pathogenesis of chronic muscle pain
    Region Stockholm, SOF
    1 January 2016 - 31 December 2018
  • Significance of biomarkers for the pathogenesis, treatment and outcome in myofascial temporomandibular disorders
    Region Stockholm, SOF
    1 June 2012 - 31 December 2012
  • Myofascial TMD- peripheral mechanisms, influence of pain genes and treatment outcome
    Region Stockholm, ALF
    1 January 2012 - 31 December 2014

Employments

  • Professor/Senior Dentist, Department of Dental Medicine, Karolinska Institutet, 2012-2026

Degrees and Education

  • Docent, Karolinska Institutet, 2004
  • Doctor Of Philosophy, Department of Dental Medicine, Karolinska Institutet, 1999
  • DDS, Karolinska Institutet, 1979

Distinction and awards

  • The Henry Beyron award for scientific achievments in Prosthetic dentistry and Orofacial pain in Sweden or abroad, 2012
  • The Swedish Dental Society award for the best doctoral thesis in odontology, 2001

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