Susan Dorsey

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Researcher:

Susan Dorsey, PhD, RN, FAAN, professor

Areas of Expertise:

Dorsey’s neuroscience research specializes in the molecular, cellular, and genetic mechanisms that influence the symptoms and self-management of chronic pain, a condition that impairs more people than cancer, heart disease, and diabetes combined. Relieving chronic pain costs the U.S. more than $600 billion annually, though few effective treatments exist that do not significantly disrupt quality of life. Dorsey is one of the earliest scientists to incorporate transcriptomics — the study of the full set of RNA instructions within a cell — to understand their role in cellular processes and the development of disease. Her research seeks to identify new therapeutic targets and biomarkers to better predict a patient’s risk for chronic pain and other health disorders.

Dorsey’s translational research lies at the intersection of bench science and clinical care and has led to nearly $30 million in National Institutes of Health (NIH) funding as principal investigator or co-investigator, as well as numerous publications, honors, and awards.

Dorsey joined UMSON in 2004 and served as founding chair of the Department of Pain and Translational Symptom Science from 2014 - 22. She was also the founding co-director of the UMB Center to Advance Chronic Pain Research and assisted in securing funding from the National Institute of Nursing Research to create it.

The Big Idea:

In April 2003, publication of the first comprehensive map of the human genome — the complete sequence of DNA codes in a human cell — revolutionized scientific discovery and fundamental understanding of human biology. With this singular breakthrough, scientists unlocked the molecular template that controls how humans develop and perform, enabling regimented studies of gene function.

While genomics studies an organism’s entire set of DNA, its allied science — transcriptomics — probes the RNA instructions that have been “transcribed” from a cell’s DNA codes and that regulate the body’s biological processes. By exploring how and when genes are turned on or off or altered in cells, researchers are learning the mechanics of how genes express themselves in the form of cancer, diabetes, heart disease, and other diseases. What’s more, that knowledge is a promising tool for developing vital targeted therapies

Why does the research matter?

Autism is a neurodevelopmental disorder that produces a spectrum of deficits in social interactions, including impaired language, intellectual disability, loss of interest, anxiety, and seizures. Recent studies have revealed that autism, typically diagnosed around age 2, can arise before birth during the early growth of a fetus. Though scientists don’t yet understand the underlying neurological mechanisms of autism, nor whether it is a single disorder or multiple disorders with common features, “it is generally assumed that dysregulation of one or more genes, due to either genetic variants or exposure to environmental stressors, underlies the development of the autistic brain,” says Dorsey along with University of Maryland School of Medicine colleagues in a recent study published in the journal Translational Psychiatry.

While most autism cases are inherited, the authors explain, “many cases have been linked to in-utero exposure to environmental factors such as pharmaceuticals, air pollution, insecticides, and maternal infection.”

For example, autism increasingly has appeared in children of women who take the anti-epileptic, mood-stabilizing drug valproic acid (VPA), more commonly known by its trade names Stavzor or Depakote, during pregnancy. In their August 2024 study, funded by a $424,000 grant from the National Institute of Environmental Health Sciences, Dorsey and her team gave pregnant mice a single injection of VPA at a crucial time for fetal brain development to explore how VPA might alter gene functioning. After their analysis identified more than 7,000 genes whose regulation was significantly affected by VPA, the researchers narrowed those to nine genes also known to influence neurodevelopment in humans. That “short list,” the authors propose, is a “potential starting point” for future studies to determine whether VPA’s disturbances to gene functioning contribute to autistic-like behavior in animals.

Who does the research matter to?

The research is important to anyone experiencing a health condition, their affected families or caregivers, and researchers seeking crucial therapies. With the advance of transcriptomics, scientists once limited to the time-consuming task of investigating cell functioning gene by gene now can investigate an entire set of a cell’s RNA instructions.

What are the clinical applications of the research?

Dorsey is analyzing transcriptomics data to generate new hypotheses about how disturbances in gene expression can lead to disease. Specifically, she is exploring how genes influence the molecular signals that trigger chronic pain across three populations: sufferers of low-back pain, those with trauma from lower-extremity fractures, and those who have facial and neck pain from temporomandibular disorder. Funded by $6 million in multiple NIH grants, the work aims to identify early biomarkers of patients who are likely to transition from acute to chronic pain, such as following surgery. Testing blood, urine, or saliva to uncover signs of one’s susceptibility to chronic pain and other health disorders is “an evolving science,” Dorsey explains, expanding the potential to intervene with new preventive therapies.

More Highlighted Research

Getting Big Data to Get Along

‌By Dan Mezibov

(from the fall 2018 issue of Nursing For/um magazine)

‌ conceptual illustration of figures working with data Do researchers all speak the same scientific language? Not necessarily, especially when they collect data differently.

The various ways researchers define demographic data (such as age, ethnicity, and marital status), symptom and self-management data (such as intensity of pain), and other patient characteristics can hinder investigators’ ability to test hypotheses across studies conducted at different sites. Too often, small sample sizes from single sites and other limitations make it difficult to draw meaningful conclusions.

"You’re not comparing equal measures," says Susan Dorsey, PhD ’01, MS ’98, RN, FAAN, professor and chair of UMSON’s Department of Pain and Translational Symptom Science. What’s more, the average large study requires 12-18 months to secure funding and another five years to complete, Dorsey explains. With the use of a common set of measures that have been identified up front combined with biospecimens banked across many studies, "it is possible to get an answer to my question in one year instead of eight, at much less expense," she says.

To help develop such leverage, Dorsey and 13 co-authors published a landmark study in the Journal of Nursing Scholarship in 2017 describing a collaboration of five schools of nursing – Case Western Reserve University, Duke University, Emory University, the University of Maryland, and the University of Washington – aimed at examining whether data collected at different sites without the use of common data elements (CDEs) could be combined. This study provided further support for the idea that CDEs need to be identified up front and that trying to combine results across studies upon their completion does not work. The study was one of three important articles by Dorsey and colleagues that began a national conversation about the need to collect CDEs.

That discussion was initiated, in part, in 2014 when Patricia A. Grady, PhD, MS ’68, RN, FAAN, one of Dorsey’s co-authors and director of the National Institute for Nursing Research (NINR) from 1995 until her retirement this summer, convened a meeting of the NINR Center directors to identify CDEs to be collected in studies of behavioral symptoms related to sleep disturbance, fatigue, pain, cognition, and depression and for evaluating patients’ self-management of their symptoms. NINR has expanded the effort by establishing its own CDE repository.

Nursing didn’t invent CDEs, Dorsey says, but was "very early to adopt CDEs associated with symptom and self-management science. We’re leading in that effort."

To move the science further, Dorsey, Grady, and their co-authors also have published a "minimum set" of biomarkers to use as CDEs when studying the underlying biological basis for pain and other symptoms. Moreover, in a separate commentary, Dorsey and colleagues outlined how health methodologies such as genomics and other omics disciplines can be targeted to manage chronic pain more effectively, especially in older adults.

In 2009, a $2.4 million NINR Center grant helped establish the interdisciplinary University of Maryland, Baltimore (UMB) Center to Advance Chronic Pain Research, which aims to conduct translational research on a variety of chronic pain conditions using molecular, cellular, physiological, imaging, and omics methods. Dorsey and Joel D. Greenspan, PhD, professor in the University of Maryland School of Dentistry, co-direct the interdisciplinary effort, which joins researchers from the University of Maryland schools of Nursing, Medicine, and Dentistry and the University of Maryland’s Marlene and Stewart Greenebaum Cancer Center. Dorsey is also a multiple principal investigator for the Omics Associated with Self-Management Intervention for Symptoms Center at UMSON, which is using CDEs to determine how individual differences influence the effectiveness of exercise on managing chronic pain.

"We know that exercise can reduce or even ameliorate pain, but we also know it doesn’t work for everybody. And we don’t know the dose, intensity, or timing of what would work for some," Dorsey explains.

Her goal, she says, is to tailor precise interventions to individual patients by developing a "biosignature" that identifies which self-management strategies eliminate or reduce burdensome symptoms from disease or treatment. "Right now," Dorsey points out, "it’s pretty much one size fits most."