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Kogan F, Yoon D, Teeter MG, Chaudhari AJ, Hales L, Barbieri M, Gold GE, Vainberg Y, Goyal A, Watkins L. Multimodal positron emission tomography (PET) imaging in non-oncologic musculoskeletal radiology. Skeletal Radiol 2024; 53:1833-1846. [PMID: 38492029 DOI: 10.1007/s00256-024-04640-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/18/2024]
Abstract
Musculoskeletal (MSK) disorders are associated with large impacts on patient's pain and quality of life. Conventional morphological imaging of tissue structure is limited in its ability to detect pain generators, early MSK disease, and rapidly assess treatment efficacy. Positron emission tomography (PET), which offers unique capabilities to evaluate molecular and metabolic processes, can provide novel information about early pathophysiologic changes that occur before structural or even microstructural changes can be detected. This sensitivity not only makes it a powerful tool for detection and characterization of disease, but also a tool able to rapidly assess the efficacy of therapies. These benefits have garnered more attention to PET imaging of MSK disorders in recent years. In this narrative review, we discuss several applications of multimodal PET imaging in non-oncologic MSK diseases including arthritis, osteoporosis, and sources of pain and inflammation. We also describe technical considerations and recent advancements in technology and radiotracers as well as areas of emerging interest for future applications of multimodal PET imaging of MSK conditions. Overall, we present evidence that the incorporation of PET through multimodal imaging offers an exciting addition to the field of MSK radiology and will likely prove valuable in the transition to an era of precision medicine.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, CA, USA.
| | - Daehyun Yoon
- Department of Radiology, University of California-San Francisco, San Francisco, CA, USA
| | - Matthew G Teeter
- Department of Medical Biophysics, Western University, London, ON, Canada
| | | | - Laurel Hales
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Marco Barbieri
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Yael Vainberg
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Ananya Goyal
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Lauren Watkins
- Department of Radiology, Stanford University, Stanford, CA, USA
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Kwon SG, Choi HS, Yoon SY, Roh DH, Lee JH. Intraplantar aminoglutethimide, a P450scc inhibitor, reduced the induction of mechanical allodynia in a rat model of thrombus-induced ischemic pain. Mol Brain 2024; 17:50. [PMID: 39095918 PMCID: PMC11295590 DOI: 10.1186/s13041-024-01125-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 07/28/2024] [Indexed: 08/04/2024] Open
Abstract
Neuroactive steroids (NASs) directly affect neuronal excitability. Despite their role in the nervous system is intimately linked to pain control, knowledge is currently limited. This study investigates the peripheral involvement of NASs in chronic ischemic pain by targeting the cytochrome P450 side-chain cleavage enzyme (P450scc). Using a rat model of hind limb thrombus-induced ischemic pain (TIIP), we observed an increase in P450scc expression in the ischemic hind paw skin. Inhibiting P450scc with intraplantar aminoglutethimide (AMG) administration from post-operative day 0 to 3 significantly reduced the development of mechanical allodynia. However, AMG administration from post-operative day 3 to 6 did not affect established mechanical allodynia. In addition, we explored the role of the peripheral sigma-1 receptor (Sig-1R) by co-administering PRE-084 (PRE), a Sig-1R agonist, with AMG. PRE reversed the analgesic effects of AMG during the induction phase. These findings indicate that inhibiting steroidogenesis with AMG alleviates peripheral ischemic pain during the induction phase via Sig-1Rs.
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Affiliation(s)
| | - Hoon-Seong Choi
- Research Animal Resource Center, Korea Institute of Science and Technology, Seoul, 02792, Korea
| | - Seo-Yeon Yoon
- Department of Companion Animal Health, Yuhan University, Bucheon-si, 14780, Gyeonggi-do, Korea
| | - Dae-Hyun Roh
- Department of Oral Physiology, School of Dentistry, Kyung Hee University, Seoul, 02447, Korea.
| | - Jang-Hern Lee
- Department of Veterinary Physiology, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea.
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Shen B, Yoon D, Castillo J, Biswal S. A Practical Guide to Sigma-1 Receptor Positron Emission Tomography/Magnetic Resonance Imaging: A New Clinical Molecular Imaging Method to Identify Peripheral Pain Generators in Patients with Chronic Pain. Semin Musculoskelet Radiol 2023; 27:601-617. [PMID: 37935207 PMCID: PMC10629991 DOI: 10.1055/s-0043-1775744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Accurately identifying the peripheral pain generator in patients with chronic pain remains a major challenge for modern medicine. Millions of patients around the world suffer endlessly from difficult-to-manage debilitating pain because of very limited diagnostic tests and a paucity of pain therapies. To help these patients, we have developed a novel clinical molecular imaging approach, and, in its early stages, it has been shown to accurately identify the exact site of pain generation using an imaging biomarker for the sigma-1 receptor and positron emission tomography/magnetic resonance imaging. We hope the description of the work in this article can help others begin their own pain imaging programs at their respective institutions.
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Affiliation(s)
- Bin Shen
- Cyclotron Radiochemistry Facility, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, California
| | - Daehyun Yoon
- Department of Radiology, University of California San Francisco School of Medicine, San Francisco, California
| | - Jessa Castillo
- Radiochemistry Facility, University of California San Francisco School of Medicine, San Francisco, California
| | - Sandip Biswal
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Ruiz-Cantero MC, Huerta MÁ, Tejada MÁ, Santos-Caballero M, Fernández-Segura E, Cañizares FJ, Entrena JM, Baeyens JM, Cobos EJ. Sigma-1 receptor agonism exacerbates immune-driven nociception: Role of TRPV1 + nociceptors. Biomed Pharmacother 2023; 167:115534. [PMID: 37729726 DOI: 10.1016/j.biopha.2023.115534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/14/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023] Open
Abstract
The analgesic effects of sigma-1 antagonists are undisputed, but the effects of sigma-1 agonists on pain are not well studied. Here, we used a mouse model to show that the administration of the sigma-1 agonists dextromethorphan (a widely used antitussive drug), PRE-084 (a standard sigma-1 ligand), and pridopidine (a selective drug being investigated in clinical trials for the treatment of neurodegenerative diseases) enhances PGE2-induced mechanical hyperalgesia. Superficial plantar incision induced transient weight-bearing asymmetry at early time points, but the mice appeared to recover at 24 h, despite noticeable edema and infiltration of neutrophils (a well-known cellular source of PGE2) at the injured site. Sigma-1 agonists induced a relapse of weight bearing asymmetry in a manner dependent on the presence of neutrophils. The effects of sigma-1 agonists were all reversed by administration of the sigma-1 antagonist BD-1063 in wild-type mice, and were absent in sigma-1 knockout mice, supporting the selectivity of the effects observed. The proalgesic effects of sigma-1 agonism were also abolished by the TRP antagonist ruthenium red and by in vivo resiniferatoxin ablation of TRPV1 + peripheral sensory neurons. Therefore, sigma-1 agonism exacerbates pain-like responses in mice with a mild inflammatory state through the action of TRPV1 + nociceptors. We also show that sigma-1 receptors are present in most (if not all) mouse and human DRG neurons. If our findings translate to humans, further studies will be needed to investigate potential proalgesic effects induced by sigma-1 agonism in patients treated with sigma-1 agonists.
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Affiliation(s)
- M Carmen Ruiz-Cantero
- Department of Pharmacology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain
| | - Miguel Á Huerta
- Department of Pharmacology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain
| | - Miguel Á Tejada
- Department of Pharmacology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain
| | - Miriam Santos-Caballero
- Department of Pharmacology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain
| | - Eduardo Fernández-Segura
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain; Department of Histology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
| | - Francisco J Cañizares
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain; Department of Histology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
| | - José M Entrena
- Department of Pharmacology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain
| | - José M Baeyens
- Department of Pharmacology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain
| | - Enrique J Cobos
- Department of Pharmacology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla, 18100 Granada, Spain; Biosanitary Research Institute ibs.GRANADA, 18012 Granada, Spain; Teófilo Hernando Institute for Drug Discovery, 28029 Madrid, Spain.
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Munguia-Galaviz FJ, Miranda-Diaz AG, Cardenas-Sosa MA, Echavarria R. Sigma-1 Receptor Signaling: In Search of New Therapeutic Alternatives for Cardiovascular and Renal Diseases. Int J Mol Sci 2023; 24:ijms24031997. [PMID: 36768323 PMCID: PMC9916216 DOI: 10.3390/ijms24031997] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Cardiovascular and renal diseases are among the leading causes of death worldwide, and regardless of current efforts, there is a demanding need for therapeutic alternatives to reduce their progression to advanced stages. The stress caused by diseases leads to the activation of protective mechanisms in the cell, including chaperone proteins. The Sigma-1 receptor (Sig-1R) is a ligand-operated chaperone protein that modulates signal transduction during cellular stress processes. Sig-1R interacts with various ligands and proteins to elicit distinct cellular responses, thus, making it a potential target for pharmacological modulation. Furthermore, Sig-1R ligands activate signaling pathways that promote cardioprotection, ameliorate ischemic injury, and drive myofibroblast activation and fibrosis. The role of Sig-1R in diseases has also made it a point of interest in developing clinical trials for pain, neurodegeneration, ischemic stroke, depression in patients with heart failure, and COVID-19. Sig-1R ligands in preclinical models have significantly beneficial effects associated with improved cardiac function, ventricular remodeling, hypertrophy reduction, and, in the kidney, reduced ischemic damage. These basic discoveries could inform clinical trials for heart failure (HF), myocardial hypertrophy, acute kidney injury (AKI), and chronic kidney disease (CKD). Here, we review Sig-1R signaling pathways and the evidence of Sig-1R modulation in preclinical cardiac and renal injury models to support the potential therapeutic use of Sig-1R agonists and antagonists in these diseases.
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Affiliation(s)
- Francisco Javier Munguia-Galaviz
- Departamento de Fisiologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
- Division de Ciencias de la Salud, Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzman 49000, Jalisco, Mexico
| | - Alejandra Guillermina Miranda-Diaz
- Departamento de Fisiologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Miguel Alejandro Cardenas-Sosa
- Departamento de Fisiologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Raquel Echavarria
- CONACYT-Centro de Investigacion Biomedica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44340, Jalisco, Mexico
- Correspondence:
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Shin SM, Wang F, Qiu C, Itson-Zoske B, Hogan QH, Yu H. Sigma-1 receptor activity in primary sensory neurons is a critical driver of neuropathic pain. Gene Ther 2022; 29:1-15. [PMID: 32424233 PMCID: PMC7671947 DOI: 10.1038/s41434-020-0157-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/21/2020] [Accepted: 05/04/2020] [Indexed: 12/15/2022]
Abstract
The Sigma-1 receptor (σ1R) is highly expressed in the primary sensory neurons (PSNs) that are the critical site of initiation and maintenance of pain following peripheral nerve injury. By immunoblot and immunohistochemistry, we observed increased expression of both σ1R and σ1R-binding immunoglobulin protein (BiP) in the lumbar (L) dorsal root ganglia (DRG) ipsilateral to painful neuropathy induced by spared nerve injury (SNI). To evaluate the therapeutic potential of PSN-targeted σ1R inhibition at a selected segmental level, we designed a recombinant adeno-associated viral (AAV) vector expressing a small hairpin RNA (shRNA) against rat σ1R. Injection of this vector into the L4/L5 DRGs induced downregulation of σ1R in DRG neurons of all size groups, while expression of BiP was not affected. This was accompanied by attenuation of SNI-induced cutaneous mechanical and thermal hypersensitivity. Whole-cell current-clamp recordings of dissociated neurons showed that knockdown of σ1R suppressed neuronal excitability, suggesting that σ1R silencing attenuates pain by reversal of injury-induced neuronal hyperexcitability. These findings support a critical role of σ1R in modulating PSN nociceptive functions, and that the nerve injury-induced elevated σ1R activity in the PSNs can be a significant driver of neuropathic pain. Further understanding the role of PSN-σ1R in pain pathology may open routes to exploit this system for DRG-targeted pain therapy.
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Affiliation(s)
- Seung Min Shin
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
- Zablocki Veterans Affairs Medical Center, Milwaukee, WI, 53295, USA
| | - Fei Wang
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
- Medical Experiment Center, Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, PR China
| | - Chensheng Qiu
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
- Department of Orthopedic Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266000, PR China
| | - Brandon Itson-Zoske
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Quinn H Hogan
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
- Zablocki Veterans Affairs Medical Center, Milwaukee, WI, 53295, USA
| | - Hongwei Yu
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
- Zablocki Veterans Affairs Medical Center, Milwaukee, WI, 53295, USA.
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7
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Identifying Musculoskeletal Pain Generators Using Molecular Imaging. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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8
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Yoon D, Kogan F, Gold GE, Biswal S. Identifying Musculoskeletal Pain Generators Using Clinical PET. Semin Musculoskelet Radiol 2020; 24:441-450. [DOI: 10.1055/s-0040-1713607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractIdentifying the source of a person's pain is a significant clinical challenge because the physical sensation of pain is believed to be subjective and difficult to quantify. The experience of pain is not only modulated by the individual's threshold to painful stimuli but also a product of the person's affective contributions, such as fear, anxiety, and previous experiences. Perhaps then to quantify pain is to examine the degree of nociception and pro-nociceptive inflammation, that is, the extent of cellular, chemical, and molecular changes that occur in pain-generating processes. Measuring changes in the local density of receptors, ion channels, mediators, and inflammatory/immune cells that are involved in the painful phenotype using targeted, highly sensitive, and specific positron emission tomography (PET) radiotracers is therefore a promising approach toward objectively identifying peripheral pain generators. Although several preclinical radiotracer candidates are being developed, a growing number of ongoing clinical PET imaging approaches can measure the degree of target concentration and thus serve as a readout for sites of pain generation. Further, when PET is combined with the spatial and contrast resolution afforded by magnetic resonance imaging, nuclear medicine physicians and radiologists can potentially identify pain drivers with greater accuracy and confidence. Clinical PET imaging approaches with fluorine-18 fluorodeoxyglucose, fluorine-18 sodium fluoride, and sigma-1 receptor PET radioligand and translocator protein radioligands to isolate the source of pain are described here.
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Affiliation(s)
- Daehyun Yoon
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Feliks Kogan
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Garry E. Gold
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Sandip Biswal
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
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Arena E, Dichiara M, Floresta G, Parenti C, Marrazzo A, Pittalà V, Amata E, Prezzavento O. Novel Sigma-1 receptor antagonists: from opioids to small molecules: what is new? Future Med Chem 2018; 10:231-256. [PMID: 29185346 DOI: 10.4155/fmc-2017-0164] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Sigma-1 (σ1) receptor has been identified as a chaperone protein that interacts with other proteins, such as N-methyl-D-aspartate (NMDA) and opioid receptors, modulating their activity. σ1 receptor antagonists have been developed to obtain useful compounds for the treatment of psychoses, pain, drug abuse and cancer. Some interesting compounds such as E-5842 (5) and MS-377 (24), haloperidol and piperazine derivatives, respectively, were endowed with high affinity for σ1 receptors (Ki σ1 = 4 and 73 nM; Ki σ2 = 220 and 6900, respectively). They were developed for the treatment of psychotic disorders and 5 also underwent Phase II clinical trials suggesting interesting potential therapeutic applications. Here, σ1 receptor antagonists have been grouped based on chemical structure and reviewed according to structure-activity relationship and potential therapeutic role.
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Affiliation(s)
- Emanuela Arena
- Department of Drug Sciences, Medicinal Chemistry Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
| | - Maria Dichiara
- Department of Drug Sciences, Medicinal Chemistry Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
| | - Giuseppe Floresta
- Department of Drug Sciences, Medicinal Chemistry Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
- Department of Chemical Sciences, University of Catania, Viale A Doria 6, 95125 Catania, Italy
| | - Carmela Parenti
- Department of Drug Sciences, Pharmacology Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
| | - Agostino Marrazzo
- Department of Drug Sciences, Medicinal Chemistry Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
| | - Valeria Pittalà
- Department of Drug Sciences, Medicinal Chemistry Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
| | - Emanuele Amata
- Department of Drug Sciences, Medicinal Chemistry Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
| | - Orazio Prezzavento
- Department of Drug Sciences, Medicinal Chemistry Section, University of Catania, Viale A Doria 6, 95125 Catania, Italy
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Merlos M, Burgueño J, Portillo-Salido E, Plata-Salamán CR, Vela JM. Pharmacological Modulation of the Sigma 1 Receptor and the Treatment of Pain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 964:85-107. [PMID: 28315267 DOI: 10.1007/978-3-319-50174-1_8] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
There is a critical need for new analgesics acting through new mechanisms of action, which could increase the efficacy with respect to existing therapies and reduce their unwanted effects. Current preclinical evidence supports the modulatory role of sigma-1 receptors (σ1R) in nociception, mainly based on the pain-attenuated phenotype of σ1R knockout mice and on the antinociceptive effect exerted by σ1R antagonists on pains of different etiologies. σ1R is highly expressed in different pain areas of the CNS and the periphery (particularly dorsal root ganglia), and interacts and modulates the functionality of different receptors and ion channels . The antagonism of σ1R leads to decreased amplification of pain signaling within the spinal cord (central sensitization), but recent data also support a role at the periphery. σ1R antagonists have consistently demonstrated efficacy in neuropathic pain , but also in other types of pain including inflammatory, orofacial, visceral, and post-operative pain. Apart from acting alone, when combined with opioids, σ1R antagonists enhance opioid analgesia but not opioid-induced unwanted effects. Interestingly, unlike opioids, σ1R antagonists do not modify normal sensory mechanical and thermal sensitivity thresholds but they exert antihypersensitive effects in sensitizing conditions, enabling the reversal of nociceptive thresholds back to normal values. Accordingly, σ1R antagonists are not strictly analgesics; they are antiallodynic and antihyperalgesic drugs acting when the system is sensitized following prolonged noxious stimulation or persistent abnormal afferent input (e.g., secondary to nerve injury). These are distinctive features allowing σ1R antagonists to exert a modulatory effect specifically in pathophysiological conditions such as chronic pain .
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Affiliation(s)
- Manuel Merlos
- Drug Discovery and Preclinical Development, ESTEVE. Parc Científic de Barcelona, Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - Javier Burgueño
- Drug Discovery and Preclinical Development, ESTEVE. Parc Científic de Barcelona, Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - Enrique Portillo-Salido
- Drug Discovery and Preclinical Development, ESTEVE. Parc Científic de Barcelona, Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - Carlos Ramón Plata-Salamán
- Drug Discovery and Preclinical Development, ESTEVE. Parc Científic de Barcelona, Baldiri Reixac 4-8, 08028, Barcelona, Spain
| | - José Miguel Vela
- Drug Discovery and Preclinical Development, ESTEVE. Parc Científic de Barcelona, Baldiri Reixac 4-8, 08028, Barcelona, Spain.
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Paniagua N, Girón R, Goicoechea C, López‐Miranda V, Vela J, Merlos M, Martín Fontelles M. Blockade of sigma 1 receptors alleviates sensory signs of diabetic neuropathy in rats. Eur J Pain 2017; 21:61-72. [PMID: 27341510 PMCID: PMC5215451 DOI: 10.1002/ejp.897] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND E-52862 (S1RA, 4-[2-[[5-methyl-1-(2-naphthalenyl)-1H-pyrazol-3-yl]oxy]ethyl]-morpholine), a novel selective sigma 1 receptor (σ1R) antagonist, has demonstrated efficacy in nociceptive and neuropathic pain models. Our aim was to test if σ1R blockade with E-52862 may modify the signs of neuropathy in Zucker diabetic fatty (ZDF) rats, a type 2 diabetes model. METHODS Mechanical and thermal response thresholds were tested on 7-, 13-, 14- and 15-week-old ZDF rats treated with saline or with E-52862 acutely administered on week 13, followed by sub-chronic administration (14 days). Axonal peripheral activity (skin-saphenous nerve preparation) and isolated aorta or mesenteric bed reactivity were analysed in 15-week-old ZDF rats treated with saline or E-52862 and in LEAN rats. RESULTS Zucker diabetic fatty rats showed significantly decreased thermal withdrawal latency and threshold to mechanical stimulation on week 13 compared to week 7 (prediabetes) and with LEAN animals; single-dose and sub-chronic E-52862 administration restored both parameters to those recorded on week 7. Regarding axonal peripheral activity, E-52862 treatment increased the mean mechanical threshold (77.3 ± 21 mN vs. 19.6 ± 1.5 mN, saline group) and reduced the response evoked by mechanical increasing stimulation (86.4 ± 36.5 vs. 352.8 ± 41.4 spikes) or by repeated mechanical supra-threshold steps (39.4 ± 1.4 vs. 83.5 ± 0.9). E-52862 treatment also restored contractile response to phenylephrine in aorta and mesenteric bed. CONCLUSIONS E-52862 administration reverses neuropathic (behavioural and electrophysiological) and vascular signs in the ZDF rat. SIGNIFICANCE Blockade of σ1R avoids the development of diabetic neuropathy in rats, and may represent a potentially useful therapeutic approach to peripheral neuropathies in diabetic patients. WHAT DOES THIS STUDY ADD?: This study presents evidences for the potential usefulness of sigma receptor blockade on diabetic neuropathy in rats. The methodology includes behavioural evidences, electrophysiological data and vascular-isolated models.
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Affiliation(s)
- N. Paniagua
- Farmacología y NutriciónFacultad de Ciencias de la SaludUniversidad Rey Juan CarlosUnidad Asociada CSIC‐IQMAlcorcónSpain
| | - R. Girón
- Farmacología y NutriciónFacultad de Ciencias de la SaludUniversidad Rey Juan CarlosUnidad Asociada CSIC‐IQMAlcorcónSpain
| | - C. Goicoechea
- Farmacología y NutriciónFacultad de Ciencias de la SaludUniversidad Rey Juan CarlosUnidad Asociada CSIC‐IQMAlcorcónSpain
| | - V. López‐Miranda
- Farmacología y NutriciónFacultad de Ciencias de la SaludUniversidad Rey Juan CarlosUnidad Asociada CSIC‐IQMAlcorcónSpain
| | - J.M. Vela
- Drug Discovery & Preclinical ResearchEsteveBarcelonaSpain
| | - M. Merlos
- Drug Discovery & Preclinical ResearchEsteveBarcelonaSpain
| | - M.I. Martín Fontelles
- Farmacología y NutriciónFacultad de Ciencias de la SaludUniversidad Rey Juan CarlosUnidad Asociada CSIC‐IQMAlcorcónSpain
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Abstract
There is a critical need for new analgesics acting through new mechanisms of action, which could increase the efficacy respect to existing therapies and/or reduce their unwanted effects. Current preclinical evidence supports the modulatory role of the sigma-1 receptor (σ1R) in nociception, mainly based on the pain-attenuated phenotype of σ1R knockout mice and on the antinociceptive effect exerted by σ1R antagonists on pain of different etiology, very consistently in neuropathic pain, but also in nociceptive, inflammatory, and visceral pain. σ1R is highly expressed in different pain areas of the CNS and the periphery, particularly dorsal root ganglia (DRG), and interacts and modulates the functionality of different receptors and ion channels. Accordingly, antinociceptive effects of σ1R antagonists both acting alone and in combination with other analgesics have been reported at both central and peripheral sites. At the central level, behavioral, electrophysiological, neurochemical, and molecular findings support a role for σ1R antagonists in inhibiting augmented excitability secondary to sustained afferent input. Moreover, the involvement of σ1R in mechanisms regulating pain at the periphery has been recently confirmed. Unlike opioids, σ1R antagonists do not modify normal sensory mechanical and thermal sensitivity thresholds but they exert antihypersensitivity effects (antihyperalgesic and antiallodynic) in sensitizing conditions, enabling the reversal of nociceptive thresholds back to normal values. These are distinctive features allowing σ1R antagonists to exert a modulatory effect specifically in pathophysiological conditions such as chronic pain.
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Affiliation(s)
- Manuel Merlos
- Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain
| | - Luz Romero
- Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain
| | - Daniel Zamanillo
- Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain
| | | | - José Miguel Vela
- Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain.
- Parc Científic de Barcelona, Baldiri Reixac 4-8, 08028, Barcelona, Spain.
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13
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Sánchez-Fernández C, Entrena JM, Baeyens JM, Cobos EJ. Sigma-1 Receptor Antagonists: A New Class of Neuromodulatory Analgesics. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 964:109-132. [PMID: 28315268 DOI: 10.1007/978-3-319-50174-1_9] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The sigma-1 receptor is a unique ligand-operated chaperone present in key areas for pain control, in both the peripheral and central nervous system. Sigma-1 receptors interact with a variety of protein targets to modify their function. These targets include several G-protein-coupled receptors such as the μ-opioid receptor, and ion channels such as the N-methyl-D-aspartate receptor (NMDAR). Sigma-1 antagonists modify the chaperoning activity of sigma-1 receptor by increasing opioid signaling and decreasing NMDAR responses, consequently enhancing opioid antinociception and decreasing the sensory hypersensitivity that characterizes pathological pain conditions. However, the participation in pain relief of other protein partners of sigma-1 receptors in addition to opioid receptors and NMDARs cannot be ruled out. The enhanced opioid antinociception by sigma-1 antagonism is not accompanied by an increase in opioid side effects , including tolerance, dependence or constipation, so the use of sigma-1 antagonists may increase the therapeutic index of opioids. Furthermore, sigma-1 antagonists (in the absence of opioids) have been shown to exert antinociceptive effects in preclinical models of neuropathic pain induced by nerve trauma or chemical injury (the antineoplastic paclitaxel), and more recently in inflammatory and ischemic pain. Although most studies attributed the analgesic properties of sigma-1 antagonists to their central actions, it is now known that peripheral sigma-1 receptors also participate in their effects. Overwhelming preclinical evidence of the role of sigma-1 receptors in pain has led to the development of the first selective sigma-1 antagonist with an intended indication for pain treatment, which is currently in Phase II clinical trials.
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Affiliation(s)
- Cristina Sánchez-Fernández
- Department of Pharmacology, School of Medicine, University of Granada, Avenida de la Investigación 11, 18016, Granada, Spain
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Parque Tecnológico de Ciencias de la Salud, 18100, Armilla, Granada, Spain
| | - José Manuel Entrena
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Parque Tecnológico de Ciencias de la Salud, 18100, Armilla, Granada, Spain
- Animal Behavior Research Unit, Scientific Instrumentation Center, University of Granada, Parque Tecnológico de Ciencias de la Salud, 18100, Armilla, Granada, Spain
| | - José Manuel Baeyens
- Department of Pharmacology, School of Medicine, University of Granada, Avenida de la Investigación 11, 18016, Granada, Spain
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Parque Tecnológico de Ciencias de la Salud, 18100, Armilla, Granada, Spain
| | - Enrique José Cobos
- Department of Pharmacology, School of Medicine, University of Granada, Avenida de la Investigación 11, 18016, Granada, Spain.
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Parque Tecnológico de Ciencias de la Salud, 18100, Armilla, Granada, Spain.
- Teófilo Hernando Institute for Drug Discovery, 28029, Madrid, Spain.
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14
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Entrena JM, Sánchez-Fernández C, Nieto FR, González-Cano R, Yeste S, Cobos EJ, Baeyens JM. Sigma-1 Receptor Agonism Promotes Mechanical Allodynia After Priming the Nociceptive System with Capsaicin. Sci Rep 2016; 6:37835. [PMID: 27886264 PMCID: PMC5122889 DOI: 10.1038/srep37835] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/02/2016] [Indexed: 01/23/2023] Open
Abstract
Sigma-1 receptor antagonists promote antinociception in several models of pain, but the effects of sigma-1 agonists on nociception (particularly when the nociceptive system is primed) are not so well characterized; therefore we evaluated the effects of sigma-1 agonists on pain under different experimental conditions. The systemic administration of the selective sigma-1 agonists (+)-pentazocine and PRE-084, as well as the nonselective sigma-1 agonist carbetapentane (used clinically as an antitussive drug), did not alter sensitivity to mechanical stimulation under baseline conditions. However, they greatly promoted secondary mechanical allodynia after priming the nociceptive system with capsaicin. These effects of sigma-1 agonists were consistent in terms potency with the affinities of these drugs for sigma-1 receptors, were reversed by sigma-1 antagonists, and were not observed in sigma-1 knockout mice, indicating that they are sigma-1-mediated. Repeated systemic treatment with PRE-084 induced proallodynic effects even 24 h after treatment completion, but only after the nociceptive system was primed. However, neither the presence of this drug in the organism nor changes in sigma-1 receptor expression in areas involved in pain processing explains its long-term effects, suggesting that sustained sigma-1 agonism induces plastic changes in the nociceptive system that promote nociception.
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Affiliation(s)
- J. M. Entrena
- Institute of Neuroscience, Biomedical Research Center, University of Granada, 18100 Armilla, Granada, Spain
- Animal Behavior Research Unit, Scientific Instrumentation Center, University of Granada, 18100 Armilla, Granada, Spain
- Biosanitary Research Institute, University Hospital Complex of Granada, 18012 Granada, Spain
| | - C. Sánchez-Fernández
- Institute of Neuroscience, Biomedical Research Center, University of Granada, 18100 Armilla, Granada, Spain
- Biosanitary Research Institute, University Hospital Complex of Granada, 18012 Granada, Spain
- Department of Pharmacology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - F. R. Nieto
- Institute of Neuroscience, Biomedical Research Center, University of Granada, 18100 Armilla, Granada, Spain
- Biosanitary Research Institute, University Hospital Complex of Granada, 18012 Granada, Spain
- Department of Pharmacology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - R. González-Cano
- Institute of Neuroscience, Biomedical Research Center, University of Granada, 18100 Armilla, Granada, Spain
- Biosanitary Research Institute, University Hospital Complex of Granada, 18012 Granada, Spain
- Department of Pharmacology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - S. Yeste
- Drug Discovery and Preclinical Development, Esteve, 08041, Barcelona, Spain
| | - E. J. Cobos
- Institute of Neuroscience, Biomedical Research Center, University of Granada, 18100 Armilla, Granada, Spain
- Biosanitary Research Institute, University Hospital Complex of Granada, 18012 Granada, Spain
- Department of Pharmacology, School of Medicine, University of Granada, 18016 Granada, Spain
- Teófilo Hernando Institute for Drug Discovery, 28029 Madrid, Spain
| | - J. M. Baeyens
- Institute of Neuroscience, Biomedical Research Center, University of Granada, 18100 Armilla, Granada, Spain
- Biosanitary Research Institute, University Hospital Complex of Granada, 18012 Granada, Spain
- Department of Pharmacology, School of Medicine, University of Granada, 18016 Granada, Spain
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15
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Romero L, Merlos M, Vela JM. Antinociception by Sigma-1 Receptor Antagonists: Central and Peripheral Effects. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2016; 75:179-215. [PMID: 26920013 DOI: 10.1016/bs.apha.2015.11.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is plenty of evidence supporting the modulatory role of sigma-1 receptors (σ1Rs) in nociception, mainly based on the pain-attenuated phenotype of σ1R knockout mice and on the antinociceptive effect exerted by σ1R antagonists, particularly in nonacute sensitizing conditions involving sustained afferent drive, activity-dependent plasticity/sensitization, and ultimately pain hypersensitivity, as it is the case in chronic pains of different etiology. Antinociceptive effects of σ1R antagonists both when acting alone and in combination with opioids (to enhance opioid analgesia) have been reported at both central and peripheral sites. At the central level, findings at the behavioral (animal pain models), electrophysiological (spinal wind-up recordings), neurochemical (spinal release of neurotransmitters) and molecular (NMDAR function) level supports a role for σ1R antagonists in inhibiting augmented excitability secondary to sustained afferent input. Attenuation of activity-induced plastic changes (central sensitization) following tissue injury/inflammation or nerve damage could thus underlie the central inhibitory effect of σ1R antagonists. Moreover, recent pieces of information confirm the involvement of σ1R in mechanisms regulating pain at the periphery, where σ1Rs are highly expressed, particularly in dorsal root ganglia. Indeed, local peripheral administration of σ1R antagonists reduces inflammatory hyperalgesia. Potentiation of opioid analgesia is also supported, particularly at supraspinal sites and at the periphery, where locally administered σ1R antagonists unmask opioid analgesia. Altogether, whereas σ1R activation is coupled to pain facilitation and inhibition of opioid antinociception, σ1R antagonism inhibits pain hypersensitivity and "releases the brake" enabling opioids to exert enhanced antinociceptive effects, both at the central nervous system and at the periphery.
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Affiliation(s)
- Luz Romero
- Drug Discovery and Preclinical Development, ESTEVE, Parc Científic de Barcelona, Baldiri Reixac 4-8, Barcelona, Spain
| | - Manuel Merlos
- Drug Discovery and Preclinical Development, ESTEVE, Parc Científic de Barcelona, Baldiri Reixac 4-8, Barcelona, Spain
| | - José Miguel Vela
- Drug Discovery and Preclinical Development, ESTEVE, Parc Científic de Barcelona, Baldiri Reixac 4-8, Barcelona, Spain.
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