1
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Dib-Hajj SD, Waxman SG. Disordered but effective: short linear motifs as gene therapy targets for hyperexcitability disorders. J Clin Invest 2024; 134:e182198. [PMID: 38949022 PMCID: PMC11213459 DOI: 10.1172/jci182198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Multiple approaches have targeted voltage-gated sodium (Nav) channels for analgesia. In this issue of the JCI, Shin et al. identified a peptide aptamer, NaViPA1, carrying a short polybasic motif flanked by serine residues in a structurally disordered region of loop 1 in tetrodotoxin-sensitive (TTX-S) but not tetrodotoxin-resistant (TTX-R) channels. NaViPA1h inhibited TTX-S NaV channels and attenuated excitability of sensory neurons. Delivery of NaViPA1 in vivo via adeno-associated virions restricted its expression to peripheral sensory neurons and induced analgesia in rats. Targeting of short linear motifs in this manner may provide a gene therapy modality, with minimal side effects due to its peripherally-restricted biodistribution, which opens up a therapeutic strategy for hyperexcitability disorders, including pain.
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Affiliation(s)
- Sulayman D. Dib-Hajj
- Department of Neurology and
- Center for Neuroscience & Regeneration Research, Yale University, New Haven, Connecticut, USA
- Center for Rehabilitation Research, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Stephen G. Waxman
- Department of Neurology and
- Center for Neuroscience & Regeneration Research, Yale University, New Haven, Connecticut, USA
- Center for Rehabilitation Research, VA Connecticut Healthcare System, West Haven, Connecticut, USA
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2
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Heinle JW, Dalessio S, Janicki P, Ouyang A, Vrana KE, Ruiz-Velasco V, Coates MD. Insights into the voltage-gated sodium channel, Na V1.8, and its role in visceral pain perception. Front Pharmacol 2024; 15:1398409. [PMID: 38855747 PMCID: PMC11158627 DOI: 10.3389/fphar.2024.1398409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/29/2024] [Indexed: 06/11/2024] Open
Abstract
Pain is a major issue in healthcare throughout the world. It remains one of the major clinical issues of our time because it is a common sequela of numerous conditions, has a tremendous impact on individual quality of life, and is one of the top drivers of cost in medicine, due to its influence on healthcare expenditures and lost productivity in those affected by it. Patients and healthcare providers remain desperate to find new, safer and more effective analgesics. Growing evidence indicates that the voltage-gated sodium channel Nav1.8 plays a critical role in transmission of pain-related signals throughout the body. For that reason, this channel appears to have strong potential to help develop novel, more selective, safer, and efficacious analgesics. However, many questions related to the physiology, function, and clinical utility of Nav1.8 remain to be answered. In this article, we discuss the latest studies evaluating the role of Nav1.8 in pain, with a particular focus on visceral pain, as well as the steps taken thus far to evaluate its potential as an analgesic target. We also review the limitations of currently available studies related to this topic, and describe the next scientific steps that have already been undertaken, or that will need to be pursued, to fully unlock the capabilities of this potential therapeutic target.
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Affiliation(s)
- J. Westley Heinle
- Division of Gastroenterology and Hepatology, Penn State College of Medicine, Hershey, PA, United States
| | - Shannon Dalessio
- Division of Gastroenterology and Hepatology, Penn State College of Medicine, Hershey, PA, United States
| | - Piotr Janicki
- Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Ann Ouyang
- Division of Gastroenterology and Hepatology, Penn State College of Medicine, Hershey, PA, United States
| | - Kent E. Vrana
- Department of Pharmacology, Penn State College of Medicine, Hershey, PA, United States
| | - Victor Ruiz-Velasco
- Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Matthew D. Coates
- Division of Gastroenterology and Hepatology, Penn State College of Medicine, Hershey, PA, United States
- Department of Pharmacology, Penn State College of Medicine, Hershey, PA, United States
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3
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Kaye AD, Greene DR, Nguyen C, Ragland A, Granger MP, Wilhite WP, Dufrene K, Shekoohi S, Robinson CL. Emerging Medications and Strategies in Acute Pain Management: Evolving Role of Novel Sodium and Calcium Channel Blockers, Peptide-Based Pharmacologic Drugs, and Non-Medicinal Methods. Curr Pain Headache Rep 2024:10.1007/s11916-024-01265-z. [PMID: 38761297 DOI: 10.1007/s11916-024-01265-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE OF REVIEW The present investigation evaluated integration of novel medication technology to enhance treatment options, while improving patient outcomes in acute pain management. In this regard, we focused on determining the role of development and utilization of cutting-edge pharmaceutical advancements, such as targeted drug delivery systems, as well as non-pharmacologic interventions in addressing acute pain states. Further research in this area is warranted related to the need for increased patient comfort and reduced adverse effects. RECENT FINDINGS Recent innovations and techniques are discussed including pharmacologic drugs targeting sodium and calcium channels, peptide-based pharmacologic drugs, and non-medicinal methods of alleviating pain such as soothing music or virtual reality. The present investigation included review of current literature on the application of these innovative technologies, analyzing mechanisms of action, pharmacokinetics, and clinical effectiveness. Our study also investigated the potential benefits in terms of pain relief, reduced side effects, and improved patient adherence. The research critically examines the challenges and considerations associated with implementing these technologies in acute pain management, considering factors like cost, accessibility, and regulatory aspects. Additionally, case studies and clinical trials are highlighted which demonstrate practical implications of these novel medication technologies in real-world scenarios. The findings aim to provide healthcare professionals with a comprehensive understanding of the evolving landscape in acute pain management while guiding future research and clinical practices toward optimizing their use in enhancing patient care.
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Affiliation(s)
- Alan D Kaye
- Department of Anesthesiology, Department of Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA
| | - Driskell R Greene
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA
| | - Catherine Nguyen
- School of Medicine, Louisiana State University Health Sciences Center, 2020 Gravier Street, New Orleans, 70112, LA, USA
| | - Amanda Ragland
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA
| | - Mason P Granger
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA
| | - William Peyton Wilhite
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA
| | - Kylie Dufrene
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| | - Christopher L Robinson
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, 02215, USA
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4
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Weng HR. Emerging Molecular and Synaptic Targets for the Management of Chronic Pain Caused by Systemic Lupus Erythematosus. Int J Mol Sci 2024; 25:3602. [PMID: 38612414 PMCID: PMC11011483 DOI: 10.3390/ijms25073602] [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: 02/23/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Patients with systemic lupus erythematosus (SLE) frequently experience chronic pain due to the limited effectiveness and safety profiles of current analgesics. Understanding the molecular and synaptic mechanisms underlying abnormal neuronal activation along the pain signaling pathway is essential for developing new analgesics to address SLE-induced chronic pain. Recent studies, including those conducted by our team and others using the SLE animal model (MRL/lpr lupus-prone mice), have unveiled heightened excitability in nociceptive primary sensory neurons within the dorsal root ganglia and increased glutamatergic synaptic activity in spinal dorsal horn neurons, contributing to the development of chronic pain in mice with SLE. Nociceptive primary sensory neurons in lupus animals exhibit elevated resting membrane potentials, and reduced thresholds and rheobases of action potentials. These changes coincide with the elevated production of TNFα and IL-1β, as well as increased ERK activity in the dorsal root ganglion, coupled with decreased AMPK activity in the same region. Dysregulated AMPK activity is linked to heightened excitability in nociceptive sensory neurons in lupus animals. Additionally, the increased glutamatergic synaptic activity in the spinal dorsal horn in lupus mice with chronic pain is characterized by enhanced presynaptic glutamate release and postsynaptic AMPA receptor activation, alongside the reduced activity of glial glutamate transporters. These alterations are caused by the elevated activities of IL-1β, IL-18, CSF-1, and thrombin, and reduced AMPK activities in the dorsal horn. Furthermore, the pharmacological activation of spinal GPR109A receptors in microglia in lupus mice suppresses chronic pain by inhibiting p38 MAPK activity and the production of both IL-1β and IL-18, as well as reducing glutamatergic synaptic activity in the spinal dorsal horn. These findings collectively unveil crucial signaling molecular and synaptic targets for modulating abnormal neuronal activation in both the periphery and spinal dorsal horn, offering insights into the development of analgesics for managing SLE-induced chronic pain.
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Affiliation(s)
- Han-Rong Weng
- Department of Basic Sciences, California Northstate University College of Medicine, Elk Grove, CA 95757, USA
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5
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Xu YM, Wijeratne EMK, Calderon-Rivera A, Loya-López S, Perez-Miller S, Khanna R, Gunatilaka AAL. Argentatin C Analogues with Potential Antinociceptive Activity and Other Triterpenoid Constituents from the Aerial Parts of Parthenium incanum. ACS OMEGA 2023; 8:20085-20095. [PMID: 37305315 PMCID: PMC10249386 DOI: 10.1021/acsomega.3c02302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023]
Abstract
Four new triterpenes, 25-dehydroxy-25-methoxyargentatin C (1), 20S-hydroxyargentatin C (2), 20S-hydroxyisoargentatin C (3), and 24-epi-argentatin C (4), together with 10 known triterpenes (5-14) were isolated from the aerial parts of Parthenium incanum. The structures of 1-4 were elucidated by detailed analysis of their spectroscopic data, and the known compounds 5-14 were identified by comparison of their spectroscopic data with those reported. Since argentatin C (11) was found to exhibit antinociceptive activity by decreasing the excitability of rat and macaque dorsal root ganglia (DRG) neurons, 11 and its new analogues 1-4 were evaluated for their ability to decrease the excitability of rat DRG neurons. Of the argentatin C analogues tested, 25-dehydroxy-25-methoxyargentatin C (1) and 24-epi-argentatin C (4) decreased neuronal excitability in a manner comparable to 11. Preliminary structure-activity relationships for the action potential-reducing effects of argentatin C (11) and its analogues 1-4, and their predicted binding sites in pain-relevant voltage-gated sodium and calcium channels (VGSCs and VGCCs) in DRG neurons are presented.
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Affiliation(s)
- Ya-ming Xu
- Southwest
Center for Natural Products Research, School of Natural Resources
and the Environment, College of Agriculture and Life Sciences, University of Arizona, 1064 E. Lowell St., Tucson, Arizona 85719, United States
| | - E. M. Kithsiri Wijeratne
- Southwest
Center for Natural Products Research, School of Natural Resources
and the Environment, College of Agriculture and Life Sciences, University of Arizona, 1064 E. Lowell St., Tucson, Arizona 85719, United States
| | - Aida Calderon-Rivera
- NYU
Pain Research Center and Department of Molecular Pathobiology, College
of Dentistry, New York University, 433 First Avenue, New York, New York 10010, United States
| | - Santiago Loya-López
- NYU
Pain Research Center and Department of Molecular Pathobiology, College
of Dentistry, New York University, 433 First Avenue, New York, New York 10010, United States
| | - Samantha Perez-Miller
- NYU
Pain Research Center and Department of Molecular Pathobiology, College
of Dentistry, New York University, 433 First Avenue, New York, New York 10010, United States
| | - Rajesh Khanna
- NYU
Pain Research Center and Department of Molecular Pathobiology, College
of Dentistry, New York University, 433 First Avenue, New York, New York 10010, United States
- Department
of Neuroscience and Physiology and Neuroscience Institute, School
of Medicine, New York University, New York, New York 10010, United States
| | - A. A. Leslie Gunatilaka
- Southwest
Center for Natural Products Research, School of Natural Resources
and the Environment, College of Agriculture and Life Sciences, University of Arizona, 1064 E. Lowell St., Tucson, Arizona 85719, United States
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Di Maio G, Villano I, Ilardi CR, Messina A, Monda V, Iodice AC, Porro C, Panaro MA, Chieffi S, Messina G, Monda M, La Marra M. Mechanisms of Transmission and Processing of Pain: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3064. [PMID: 36833753 PMCID: PMC9964506 DOI: 10.3390/ijerph20043064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/27/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Knowledge about the mechanisms of transmission and the processing of nociceptive information, both in healthy and pathological states, has greatly expanded in recent years. This rapid progress is due to a multidisciplinary approach involving the simultaneous use of different branches of study, such as systems neurobiology, behavioral analysis, genetics, and cell and molecular techniques. This narrative review aims to clarify the mechanisms of transmission and the processing of pain while also taking into account the characteristics and properties of nociceptors and how the immune system influences pain perception. Moreover, several important aspects of this crucial theme of human life will be discussed. Nociceptor neurons and the immune system play a key role in pain and inflammation. The interactions between the immune system and nociceptors occur within peripheral sites of injury and the central nervous system. The modulation of nociceptor activity or chemical mediators may provide promising novel approaches to the treatment of pain and chronic inflammatory disease. The sensory nervous system is fundamental in the modulation of the host's protective response, and understanding its interactions is pivotal in the process of revealing new strategies for the treatment of pain.
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Affiliation(s)
- Girolamo Di Maio
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Ines Villano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Ciro Rosario Ilardi
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Vincenzo Monda
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Ashlei Clara Iodice
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Chiara Porro
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto, 71100 Foggia, Italy
| | - Maria Antonietta Panaro
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, 70125 Bari, Italy
| | - Sergio Chieffi
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto, 71100 Foggia, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Marco La Marra
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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7
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Tufvesson H, Hamrefors V, Ohlsson B. Mechanisms behind diffuse idiopathic peripheral neuropathy in humans - a systematic review. Scand J Gastroenterol 2022; 58:572-582. [PMID: 36546668 DOI: 10.1080/00365521.2022.2160272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Introduction: Diffuse peripheral neuropathy is a well-known complication of several conditions, whereas many patients have peripheral neuropathy of unknown etiology and pathophyisology. Increased knowledge of mechanisms may provide insight into enteric neuropathy with gastrointestinal dysmotility. The aim of the present systematic review was to identify mechanisms behind diffuse idiopathic peripheral neuropathies in humans.Methods: Searches were performed in PubMed, Embase, and Web of Science. Human original and review articles, written in English, describing mechanisms behind diffuse peripheral neuropathy verified by objective examinations were intended to be studied. Articles that described animal models, well-described hereditary diseases, drug-induced neuropathy, pain syndromes, malnutrition, and local neuropathy were excluded.Results: In total, 4712 articles were identified. After scrutinizing titles and abstracts, 633 remained and were studied in full text. After the removal of articles not fulfilling inclusion or exclusion criteria, 52 were finally included in this review. The most frequently described neuropathy was diabetic neuropathy, with a wide range of mechanisms involving mitochondrial dysfunction such as oxidative stress and inflammation. Microvascular changes in diabetes and vasculitis lead to ischemia and secondary oxidative stress with inflammation. Structural changes in neurons and glial cells are observed, with abnormalities in different neurotrophic factors. Neuropathy induced by autoantibodies or immunological mechanisms is described in infectious and systemic inflammatory diseases. Several ion channels may be involved in painful neuropathy. No study identified why some patients mainly develop large fiber neuropathy and others small fiber neuropathy.Conclusion: Metabolic and immunological factors and channelopathy may be considered in diffuse idiopathic peripheral neuropathy.
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Affiliation(s)
- Hanna Tufvesson
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Gastroenterology and Hepatology, Skåne University Hopsital, Malmö, Sweden
| | - Viktor Hamrefors
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Bodil Ohlsson
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Internal Medicine, Skåne University Hopsital, Malmö, Sweden
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8
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Benarroch E. What Is the Role of 2-Pore Domain Potassium Channels (K2P) in Pain? Neurology 2022; 99:516-521. [PMID: 36123135 DOI: 10.1212/wnl.0000000000201197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/15/2022] Open
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9
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Sabnis RW. 5-Oxopyrrolidine-3-carboxamides as Na v1.8 Inhibitors for Treating Pain Disorders, Cough Disorders, and Acute and Chronic Itch Disorders. ACS Med Chem Lett 2022; 13:761-762. [PMID: 35586433 PMCID: PMC9109472 DOI: 10.1021/acsmedchemlett.2c00144] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ram W. Sabnis
- Smith, Gambrell & Russell LLP, 1105 West Peachtree Street NE, Suite 1000, Atlanta, Georgia 30309, United States
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10
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Nikolenko VN, Shelomentseva EM, Tsvetkova MM, Abdeeva EI, Giller DB, Babayeva JV, Achkasov EE, Gavryushova LV, Sinelnikov MY. Nociceptors: Their Role in Body’s Defenses, Tissue Specific Variations and Anatomical Update. J Pain Res 2022; 15:867-877. [PMID: 35392632 PMCID: PMC8982820 DOI: 10.2147/jpr.s348324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/12/2022] [Indexed: 01/13/2023] Open
Abstract
The human body is constantly under the influence of numerous pathological factors: both external and internal. These factors can be potentially harmful and are perceived as such with a specialized nervous system subunit: the nociceptive system. The functional unit of the nociceptive system is the nociceptor. Recent studies have shown that nociceptors play a crucial role in maintaining of defensive homeostasis (responsive, immune, behavioral). Nociceptors respond to potentially harmful stimuli within viscera, bones, muscles, skin and specialized sensory organs. They function as complex predictors of harm through formation of pain stimulus. Their function and structures vary within different tissues. This variability reflects the anatomical and pathological peculiarities of varying tissues. Nociceptors play a significant role in adaptive, protective and behavioral reactions. Their functional capabilities and vast spread throughout the body make them the main units of the body’s defense system, allowing us to interact with the inner and outer environments.
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Affiliation(s)
- Vladimir N Nikolenko
- First Moscow State Medical University Named After I.M. Sechenov (Sechenov University), Moscow, 119991, Russia
- Lomonosov Moscow State University, Moscow, 119991, Russia
| | | | | | - Elina I Abdeeva
- First Moscow State Medical University Named After I.M. Sechenov (Sechenov University), Moscow, 119991, Russia
| | - Dmitriy B Giller
- First Moscow State Medical University Named After I.M. Sechenov (Sechenov University), Moscow, 119991, Russia
| | - Juliya V Babayeva
- First Moscow State Medical University Named After I.M. Sechenov (Sechenov University), Moscow, 119991, Russia
| | - Evgeny E Achkasov
- First Moscow State Medical University Named After I.M. Sechenov (Sechenov University), Moscow, 119991, Russia
| | | | - Mikhail Y Sinelnikov
- First Moscow State Medical University Named After I.M. Sechenov (Sechenov University), Moscow, 119991, Russia
- Research Institute of Human Morphology, Moscow, 119901, Russian Federation
- Correspondence: Mikhail Y Sinelnikov, Sechenov University, Trubetskaya 8, Moscow, 119991, Russian Federation, Tel/Fax +7 89199688587, Email
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11
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Nguyen PT, Yarov-Yarovoy V. Towards Structure-Guided Development of Pain Therapeutics Targeting Voltage-Gated Sodium Channels. Front Pharmacol 2022; 13:842032. [PMID: 35153801 PMCID: PMC8830516 DOI: 10.3389/fphar.2022.842032] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/12/2022] [Indexed: 12/19/2022] Open
Abstract
Voltage-gated sodium (NaV) channels are critical molecular determinants of action potential generation and propagation in excitable cells. Normal NaV channel function disruption can affect physiological neuronal signaling and lead to increased sensitivity to pain, congenital indifference to pain, uncoordinated movement, seizures, or paralysis. Human genetic studies have identified human NaV1.7 (hNaV1.7), hNaV1.8, and hNaV1.9 channel subtypes as crucial players in pain signaling. The premise that subtype selective NaV inhibitors can reduce pain has been reinforced through intensive target validation and therapeutic development efforts. However, an ideal therapeutic has yet to emerge. This review is focused on recent progress, current challenges, and future opportunities to develop NaV channel targeting small molecules and peptides as non-addictive therapeutics to treat pain.
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Affiliation(s)
- Phuong T Nguyen
- Department of Physiology and Membrane Biology, University of California, Davis, Davis, CA, United States
| | - Vladimir Yarov-Yarovoy
- Department of Physiology and Membrane Biology, University of California, Davis, Davis, CA, United States.,Department of Anesthesiology and Pain Medicine, University of California, Davis, Davis, CA, United States
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12
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Kollarik M, Ru F, Pavelkova N, Mulcahy J, Hunter J, Undem BJ. Role of Na V 1.7 in action potential conduction along human bronchial vagal afferent C-fibres. Br J Pharmacol 2022; 179:242-251. [PMID: 34634134 DOI: 10.1111/bph.15686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/20/2021] [Accepted: 09/17/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to determine the role of NaV 1.7 in action potential conduction in C-fibres in the bronchial branches of the human vagus nerve. EXPERIMENTAL APPROACH Bronchial branches of the vagus nerve were dissected from human donor tissue. The C-wave of the electrically evoked compound action potential was quantified in the absence and presence of increasing concentrations of the selective NaV 1.7 blocking drugs, PF-05089771 and ST-2262, as well as the NaV 1.1, 1.2, and 1.3 blocking drug ICA121-431. The efficacy and potency of these inhibitors were compared to the standard NaV 1 blocker, tetrodotoxin. We then compared the relative potencies of the NaV 1 blockers in inhibiting the C-wave of the compound action potential, with their ability to inhibit parasympathetic cholinergic contraction of human isolated bronchi, a response previously shown to be strictly dependent on NaV 1.7 channels. KEY RESULTS The selective NaV 1.7 blockers inhibited the C-wave of the compound action potential with potencies similar to that observed in the NaV 1.7 bronchial contractions assay. Using rt-PCR, we noted that NaV 1.7 mRNA was strongly expressed and transported down the vagus nerve bundles. CONCLUSIONS AND IMPLICATIONS NaV 1.7 blockers can prevent action potential conduction in the majority of vagal C-fibres arising from human bronchi. Blockers of NaV 1.7 channels may therefore have value in inhibiting the responses to excessive airway C-fibre activation in inflammatory airway disease, responses that include coughing as well as reflex bronchoconstriction and secretions.
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Affiliation(s)
- Marian Kollarik
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Fei Ru
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Nikoleta Pavelkova
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - John Mulcahy
- SiteOne Therapeutics, South San Francisco, CA, USA
| | - John Hunter
- SiteOne Therapeutics, South San Francisco, CA, USA
| | - Bradley J Undem
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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13
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Jayakar S, Shim J, Jo S, Bean BP, Singeç I, Woolf CJ. Developing nociceptor-selective treatments for acute and chronic pain. Sci Transl Med 2021; 13:eabj9837. [PMID: 34757806 PMCID: PMC9964063 DOI: 10.1126/scitranslmed.abj9837] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Despite substantial efforts dedicated to the development of new, nonaddictive analgesics, success in treating pain has been limited. Clinically available analgesic agents generally lack efficacy and may have undesirable side effects. Traditional target-based drug discovery efforts that generate compounds with selectivity for single targets have a high rate of attrition because of their poor clinical efficacy. Here, we examine the challenges associated with the current analgesic drug discovery model and review evidence in favor of stem cell–derived neuronal-based screening approaches for the identification of analgesic targets and compounds for treating diverse forms of acute and chronic pain.
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Affiliation(s)
- Selwyn Jayakar
- F.M. Kirby Neurobiology, Boston Children's Hospital, and Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Jaehoon Shim
- F.M. Kirby Neurobiology, Boston Children's Hospital, and Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Sooyeon Jo
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Bruce P Bean
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Ilyas Singeç
- National Center for Advancing Translational Sciences (NCATS), Stem Cell Translation Laboratory (SCTL), National Institutes of Health (NIH), Rockville, MD 20850, USA
| | - Clifford J Woolf
- F.M. Kirby Neurobiology, Boston Children's Hospital, and Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
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Üçeyler N. The pathobiology of peripheral nerve disease: New clues from cell and molecular biology. Neurosci Lett 2021; 746:135673. [PMID: 33493645 DOI: 10.1016/j.neulet.2021.135673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Nurcan Üçeyler
- Department of Neurology, University of Würzburg, Germany.
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