Páll Karlsson has brought about a paradigm shift with his method of analysing skin biopsies. His expertise puts him right up there among the international élite of researchers in his field. He himself says he has only made a small contribution.

It’s just seven years since Iceland-born Páll Karlsson defended his PhD, and that means he’s just now marking his first decade as a researcher. He started out by implementing, for the first time in Denmark, a new technique for taking and analysing biopsies that can provide information about the condition of the skin’s nerve fibres. He has since developed and optimized this method so that the little pinprick in the skin can tell us even more about what is hidden beneath the skin. The method is being called a paradigm shift, and it plays a big part in the work of the Danish Pain Research Center in Aarhus, where Páll has worked since 2010.

‘A biopsy is an asset in a field as subjective as pain. That makes it a tool of both diagnosis and research. It’s my small contribution to the high-quality research going on at the Pain Center and the Steno Diabetes Centers’, modestly explains Páll Karlsson, who has just been honoured with the DDA-Funded Scientist Award 2020, which comes with a cheque for DKK 25,000.

‘After all, I haven’t been around very long. A lot of the people around me have been doing this for several decades. I hope the same will happen to me. I am profoundly grateful for the support and training I’ve received from my mentors, Professor Troels Staehelin Jensen, Professor Jens Randel Nyengaard and Professor Nanna Brix Finnerup. Around 30% of people with diabetic neuritis experience chronic pain, so it’s an area where a lot of research is needed. I myself hope that I can manage to expand my research group. It happens to be an area that has attracted increased attention, and I think that’s really good’, says Páll Karlsson.

Confronted with a paradox

About half of all people with diabetes develop diabetic neuritis, in which many nerves become damaged. Nevertheless, they feel pain. This is the paradox confronting Páll Karlsson and his colleagues.

‘How can you have the same, or greater, sense of pain when you have fewer pain nerves? That’s the paradox confronting us, and it makes research difficult. The biopsy can tell us something concrete about the condition of the nerve molecules, but the patient’s experience of pain may be completely different, and that makes the work interesting’, explains Páll Karlsson.

Motivated by meeting patients

Contact with patients is particularly important to the Icelander, who has lived in Denmark since 2007. He has the opportunity to follow patients over an extended period, and this provides him with knowledge and experience that he can use in his research.

‘I’m motivated by the meeting with patients, where I make a point of giving them a thorough briefing on what is going to happen. I take my time, because it’s necessary. Some patients come on really intensive courses of treatment. Nobody can say why they experience pain or symptoms, and it’s a challenge for everyone – both the patient and the team around them. It is a team effort, and there’s a need for a variety of angles on a patient’s experience of pain’, explains Páll, referring to the Pain Research Center and Pain Clinic in Aarhus, consisting of researchers, clinicians, nurses, psychologists and an anthropologist, among others.

Research career began elsewhere

That diabetes research became Páll Karlsson’s lot in life is something of an accident. When a close family member was diagnosed with motor neurone disease, he decided to become a doctor or an MND researcher. He gained his bachelor’s degree in molecular biology in 2007, and he and his family then moved to Denmark, where he found a research group. In 2009, he wrote his thesis on MND. Professor Troels Staehelin Jensen had by then got his eye on the talented researcher, and Karlsson joined the Danish Pain Research Center in Aarhus the following year.

His colleagues at the Center will notice that they are now working with the winner of the DDA-Funded Scientist Award 2020.

‘At weekends, I enjoy being in the kitchen with my family. We make food, bake cakes or make sweets. I think that’ll work out nicely for my fantastic colleagues when we celebrate it’, says Páll Karlsson.

Watch the video of when Páll Karlsson got a surprise visit, flowers and the award.

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Associate Professor Páll Karlsson, Department of Clinical Medicine - Danish Pain Research Center, Aarhus University, b. 1981

Páll Karlsson completed his postdoc in 2014 with financial support from the DDA.

He was nominated by Professor Troels Staehelin Jensen and Professor Jens Randal Nyengaard of the Danish Pain Research Center.

By Pernille Fløjstrup Andersen, Communications Officer