1
|
Du Z, Zhang J, Han X, Yu W, Gu X. Potential novel therapeutic strategies for neuropathic pain. Front Mol Neurosci 2023; 16:1138798. [PMID: 37152429 PMCID: PMC10160452 DOI: 10.3389/fnmol.2023.1138798] [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: 01/06/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Purpose To explore the potential therapeutic strategies of different types of neuropathic pain (NP) and to summarize the cutting-edge novel approaches for NP treatment based on the clinical trials registered on ClinicalTrials.gov. Methods The relevant clinical trials were searched using ClinicalTrials.gov Dec 08, 2022. NP is defined as a painful condition caused by neurological lesions or diseases. All data were obtained and reviewed by the investigators to confirm whether they were related to the current topic. Results A total of 914 trials were included in this study. They were divided into painful diabetic neuropathy (PDN), postherpetic neuralgia (PHN), sciatica (SC), peripheral nerve injury-related NP (PNI), trigeminal neuralgia (TN), chemotherapy-induced NP (CINP), general peripheral NP (GPNP) and spinal cord injury NP (SCI-NP). Potential novel therapeutic strategies, such as novel drug targets and physical means, were discussed for each type of NP. Conclusion NP treatment is mainly dominated by drug therapy, and physical means have become increasingly popular. It is worth noting that novel drug targets, new implications of conventional medicine, and novel physical means can serve as promising strategies for the treatment of NP. However, more attention needs to be paid to the challenges of translating research findings into clinical practice.
Collapse
|
2
|
Subunit-dependent interaction of propoxazepam and its metabolite with the -aminobuturic acid type A receptor. EUREKA: HEALTH SCIENCES 2022. [DOI: 10.21303/2504-5679.2022.002649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Benzodiazepines (BDZ) are widely used in clinics in the treatment of psychiatric disorders, and their main action is considered to be determined by more selective binding with α1, α2, α3 or α5 subunits of GABA receptor.
The aim of this work was studying of the molecular mechanism of action of new analgesic – propoxazepam and its metabolite (3-hydroxypropoxazepam) on α1, α2, α3, α4 or α5 subunits containing GABAA channels.
Materials and methods GABA ha1b3g2, ha2b3g2, ha3b3g2, ha4b3g2 and ha5b3g2 ionotropic GABAARs expressed in HEK293 were used on the automated SP384PE Patch Clamp system. In addition, Propoxazepam, 3-hydroxypropoxazepam, diazepam (positive allosteric modulator) and GABA (positive control) were administered at concentrations 0.001–300 nM to determine the EC50 and Emax for corresponding substances.
Results The α subunit plays a significantl role in determining the receptor’s affinity for propoxazepam and 3-hydroxypropoxazepam. The rank order of decreasing EC50 are α1 = α5> α2 > α3 > α4 (propoxazepam) and α1> α2> α5 > α3 > α4 (3-hydroxypropoxazepam), and for Emax α3 > α2 >α5 > α1 > α4 (propoxazepam), α3 > α1 > α2> α5 > α4 (3-hydroxypropoxazepam).
The data, transformed to Emax/EC50, show that propoxazepam exhibits tenfold (compared to diazepam) activity (taking into account the magnitude of the maximum effect) to the α3 subunit, which distinguishes it from 3-hydroxypropoxazepam.
Conclusion Due to the determined selectivity of propoxazepam for binding with different α subunit-containing GABAA-receptors (mostly α3 and α2 types), it has the potential to provide analgesia with less sedation than non-selective BDZ.
Collapse
|
3
|
Cerne R, Lippa A, Poe MM, Smith JL, Jin X, Ping X, Golani LK, Cook JM, Witkin JM. GABAkines - Advances in the discovery, development, and commercialization of positive allosteric modulators of GABA A receptors. Pharmacol Ther 2022; 234:108035. [PMID: 34793859 PMCID: PMC9787737 DOI: 10.1016/j.pharmthera.2021.108035] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022]
Abstract
Positive allosteric modulators of γ-aminobutyric acid-A (GABAA) receptors or GABAkines have been widely used medicines for over 70 years for anxiety, epilepsy, sleep, and other disorders. Traditional GABAkines like diazepam have safety and tolerability concerns that include sedation, motor-impairment, respiratory depression, tolerance and dependence. Multiple GABAkines have entered clinical development but the issue of side-effects has not been fully solved. The compounds that are presently being developed and commercialized include several neuroactive steroids (an allopregnanolone formulation (brexanolone), an allopregnanolone prodrug (LYT-300), Sage-324, zuranolone, and ganaxolone), the α2/3-preferring GABAkine, KRM-II-81, and the α2/3/5-preferring GABAkine PF-06372865 (darigabat). The neuroactive steroids are in clinical development for post-partum depression, intractable epilepsy, tremor, status epilepticus, and genetic epilepsy disorders. Darigabat is in development for epilepsy and anxiety. The imidazodiazepine, KRM-II-81 is efficacious in animal models for the treatment of epilepsy and post-traumatic epilepsy, acute and chronic pain, as well as anxiety and depression. The efficacy of KRM-II-81 in models of pharmacoresistant epilepsy, preventing the development of seizure sensitization, and in brain tissue of intractable epileptic patients bodes well for improved therapeutics. Medicinal chemistry efforts are also ongoing to identify novel and improved GABAkines. The data document gaps in our understanding of the molecular pharmacology of GABAkines that drive differential pharmacological profiles, but emphasize advancements in the ability to successfully utilize GABAA receptor potentiation for therapeutic gain in neurology and psychiatry.
Collapse
Affiliation(s)
- Rok Cerne
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN USA,Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, Ljubljana, Slovenia.,RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA,Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Arnold Lippa
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA
| | | | - Jodi L. Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN USA
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University/Purdue University, Indianapolis, IN, USA
| | - Lalit K. Golani
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - James M. Cook
- RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA,Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jeffrey M. Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent, Indianapolis, IN USA,RespireRx Pharmaceuticals Inc, Glen Rock, NJ, USA,Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| |
Collapse
|
4
|
Opretzka LCF, de Freitas HF, Espírito-Santo RF, Abreu LS, Alves IM, Tavares JF, Velozo EDS, Castilho MS, Villarreal CF. 5- O-methylcneorumchromone K Exerts Antinociceptive Effects in Mice via Interaction with GABAA Receptors. Int J Mol Sci 2021; 22:ijms22073413. [PMID: 33810317 PMCID: PMC8037321 DOI: 10.3390/ijms22073413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022] Open
Abstract
The proper pharmacological control of pain is a continuous challenge for patients and health care providers. Even the most widely used medications for pain treatment are still ineffective or unsafe for some patients, especially for those who suffer from chronic pain. Substances containing the chromone scaffold have shown a variety of biological activities, including analgesic effects. This work presents for the first time the centrally mediated antinociceptive activity of 5-O-methylcneorumchromone K (5-CK). Cold plate and tail flick tests in mice showed that the 5-CK-induced antinociception was dose-dependent, longer-lasting, and more efficacious than that induced by morphine. The 5-CK-induced antinociception was not reversed by the opioid antagonist naloxone. Topological descriptors (fingerprints) were employed to narrow the antagonist selection to further investigate 5-CK's mechanism of action. Next, based on the results of fingerprints analysis, functional antagonist assays were conducted on nociceptive tests. The effect of 5-CK was completely reversed in both cold plate and tail-flick tests by GABAA receptor antagonist bicuculline, but not by atropine or glibenclamide. Molecular docking studies suggest that 5-CK binds to the orthosteric binding site, with a similar binding profile to that observed for bicuculline and GABA. These results evidence that 5-CK has a centrally mediated antinociceptive effect, probably involving the activation of GABAergic pathways.
Collapse
Affiliation(s)
- Luiza Carolina França Opretzka
- Laboratório de Farmacologia e Terapêutica Experimental, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador CEP 40 170-115, Brazil; (L.C.F.O.); (H.F.d.F.); (R.F.E.-S.); (I.M.A.); (E.d.S.V.); (M.S.C.)
| | - Humberto Fonseca de Freitas
- Laboratório de Farmacologia e Terapêutica Experimental, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador CEP 40 170-115, Brazil; (L.C.F.O.); (H.F.d.F.); (R.F.E.-S.); (I.M.A.); (E.d.S.V.); (M.S.C.)
| | - Renan Fernandes Espírito-Santo
- Laboratório de Farmacologia e Terapêutica Experimental, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador CEP 40 170-115, Brazil; (L.C.F.O.); (H.F.d.F.); (R.F.E.-S.); (I.M.A.); (E.d.S.V.); (M.S.C.)
- Laboratório de Engenharia Tecidual e Imunofarmacologia, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador CEP 40 296-710, Brazil
| | - Lucas Silva Abreu
- Instituto de Pesquisa em Fármacos e Medicamentos, Universidade Federal da Paraíba, João Pessoa CEP 58 050-585, Brazil; (L.S.A.); (J.F.T.)
| | - Iura Muniz Alves
- Laboratório de Farmacologia e Terapêutica Experimental, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador CEP 40 170-115, Brazil; (L.C.F.O.); (H.F.d.F.); (R.F.E.-S.); (I.M.A.); (E.d.S.V.); (M.S.C.)
| | - Josean Fechine Tavares
- Instituto de Pesquisa em Fármacos e Medicamentos, Universidade Federal da Paraíba, João Pessoa CEP 58 050-585, Brazil; (L.S.A.); (J.F.T.)
| | - Eudes da Silva Velozo
- Laboratório de Farmacologia e Terapêutica Experimental, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador CEP 40 170-115, Brazil; (L.C.F.O.); (H.F.d.F.); (R.F.E.-S.); (I.M.A.); (E.d.S.V.); (M.S.C.)
| | - Marcelo Santos Castilho
- Laboratório de Farmacologia e Terapêutica Experimental, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador CEP 40 170-115, Brazil; (L.C.F.O.); (H.F.d.F.); (R.F.E.-S.); (I.M.A.); (E.d.S.V.); (M.S.C.)
| | - Cristiane Flora Villarreal
- Laboratório de Farmacologia e Terapêutica Experimental, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador CEP 40 170-115, Brazil; (L.C.F.O.); (H.F.d.F.); (R.F.E.-S.); (I.M.A.); (E.d.S.V.); (M.S.C.)
- Laboratório de Engenharia Tecidual e Imunofarmacologia, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador CEP 40 296-710, Brazil
- Correspondence: ; Tel.: +55-71-3283-6933
| |
Collapse
|
5
|
Matthey A, Daali Y, Curtin F, Poncet A, Desmeules J, Besson M. GABAergic modulation of secondary hyperalgesia: A randomized controlled 4-way crossover trial with the α2-subunit preferring GABA positive allosteric modulator, N-desmethyl-clobazam in healthy volunteers. Eur J Pain 2020; 24:1094-1106. [PMID: 32171038 DOI: 10.1002/ejp.1554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 11/10/2022]
Abstract
The antihyperalgesic and sedative effects of the α2-subunit preferring GABAA positive allosteric modulator (GAM), N-desmethyl-clobazam (NDMC), 20 and 60 mg, were assessed in a randomized, placebo and active-controlled (clonazepam 1,5 mg), 4-way crossover study, in healthy volunteers, using the ultraviolet B-induced experimental pain model. Single (20, 40, 60 mg) and repeated doses (20 mg over 15 days) of NDMC pharmacokinetics were evaluated. Thirty-two subjects participated in the study. Primary outcome parameter was maximal change in the area of cutaneous UVB irradiation-induced secondary hyperalgesia (ASH). ASH decreased under all treatments. Mean (SD) relative change was 79 (22)%, 83 (24)%, 77 (30)% and 92 (16)% for placebo, NDMC20, NDMC60 and clonazepam, respectively. Neither absolute change nor relative change in ASH was significantly different between NDMC60 and placebo (mean difference = 2.3 cm2 [95% CI 4.0-8.5], p = .462 and 0.4% [-11.9 to 12.6], p = .952, respectively). An overall treatment effect was found on level of sedation. Compared to placebo, sedation was higher under clonazepam (mean difference = 39 mm [30-49] on a visual analogue scale, p < .001) while NDMC was free of sedative effect. NDMC pharmacokinetics after single doses showed poor absorption, but was linear. Steady-state plasma concentrations of NDMC20 were attained within 14 days, with low between-subjects variability. Mean steady-state concentration (CS-S , SD) reached 209 (22) ng/ml. NDMC absence of sedative effect and its overall well-characterized safety coming from years of utilization as a metabolite from clobazam, raise the prospect of dose escalating trials in patients to quantify its clinical utility. SIGNIFICANCE: This article, presenting the Phase I data of the new antihyperalgesic compound, α2-subunit GABAA positive allosteric modulator, N-desmethyl-clobazam (NDMC) is exploring the modulation of a new target in the treatment of neuropathic pain. Based on these results and on its preclinical properties NDMC would qualify as a good tool compound to seek confirmation of the clinical utility of selective GABA allosteric modulators in neuropathic pain patients.
Collapse
Affiliation(s)
- Alain Matthey
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| | - Youssef Daali
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - François Curtin
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Antoine Poncet
- Division of Clinical Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - Jules Desmeules
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Marie Besson
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| |
Collapse
|
6
|
Lara CO, Burgos CF, Moraga-Cid G, Carrasco MA, Yévenes GE. Pentameric Ligand-Gated Ion Channels as Pharmacological Targets Against Chronic Pain. Front Pharmacol 2020; 11:167. [PMID: 32218730 PMCID: PMC7079299 DOI: 10.3389/fphar.2020.00167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/07/2020] [Indexed: 12/31/2022] Open
Abstract
Chronic pain is a common detrimental condition that affects around 20% of the world population. The current drugs to treat chronic pain states, especially neuropathic pain, have a limited clinical efficiency and present significant adverse effects that complicates their regular use. Recent studies have proposed new therapeutic strategies focused on the pharmacological modulation of G-protein-coupled receptors, transporters, enzymes, and ion channels expressed on the nociceptive pathways. The present work intends to summarize recent advances on the pharmacological modulation of pentameric ligand-gated ion channels, which plays a key role in pain processing. Experimental data have shown that novel allosteric modulators targeting the excitatory nicotinic acetylcholine receptor, as well as the inhibitory GABAA and glycine receptors, reverse chronic pain-related behaviors in preclinical assays. Collectively, these evidences strongly suggest the pharmacological modulation of pentameric ligand-gated ion channels is a promising strategy towards the development of novel therapeutics to treat chronic pain states in humans.
Collapse
Affiliation(s)
- César O Lara
- Department of Physiology, Faculty of Biological Sciences, University of Concepcion, Concepcion, Chile
| | - Carlos F Burgos
- Department of Physiology, Faculty of Biological Sciences, University of Concepcion, Concepcion, Chile
| | - Gustavo Moraga-Cid
- Department of Physiology, Faculty of Biological Sciences, University of Concepcion, Concepcion, Chile
| | - Mónica A Carrasco
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Gonzalo E Yévenes
- Department of Physiology, Faculty of Biological Sciences, University of Concepcion, Concepcion, Chile
| |
Collapse
|
7
|
Effects of the α2/α3-subtype-selective GABAA receptor positive allosteric modulator KRM-II-81 on pain-depressed behavior in rats: comparison with ketorolac and diazepam. Behav Pharmacol 2020; 30:452-461. [PMID: 30640180 DOI: 10.1097/fbp.0000000000000464] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study examined effects of the α2/α3-subtype-selective GABAA receptor positive allosteric modulator KRM-II-81 in an assay of pain-related behavioral depression. Adult, male Sprague-Dawley rats responded for electrical brain stimulation in a frequency-rate intracranial self-stimulation (ICSS) procedure. Intraperitoneal injection of 1.8% lactic acid served as an acute noxious stimulus to depress ICSS. Effects of KRM-II-81 were evaluated in the absence and presence of the acid noxious stimulus. The NSAID ketorolac and the benzodiazepine diazepam were tested as comparators. Neither ketorolac nor KRM-II-81 altered ICSS in the absence of the acid noxious stimulus; however, diazepam produced facilitation consistent with its abuse liability. Ketorolac blocked acid-induced depression of ICSS, and effects of 1.0 mg/kg ketorolac lasted for at least 5 h. KRM-II-81 (1.0 mg/kg) produced significant antinociception after 30 min that dissipated by 60 min. Diazepam also attenuated acid-depressed ICSS, but only at doses that facilitated ICSS when administered alone. The lack of ketorolac or KRM-II-81 effects on ICSS in the absence of the acid noxious stimulus suggests low abuse liability for both compounds. The effectiveness of ketorolac to block acid-induced ICSS depression agrees with clinical analgesic efficacy of ketorolac. KRM-II-81 produced significant but less consistent and shorter-acting antinociception than ketorolac.
Collapse
|
8
|
Reduced efficacy and risk of seizure aggravation when cannabidiol is used without clobazam. Epilepsy Behav 2020; 103:106506. [PMID: 31526646 DOI: 10.1016/j.yebeh.2019.106506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 08/16/2019] [Accepted: 08/16/2019] [Indexed: 01/25/2023]
|
9
|
Nomura T, Hawkins NA, Kearney JA, George AL, Contractor A. Potentiating α 2 subunit containing perisomatic GABA A receptors protects against seizures in a mouse model of Dravet syndrome. J Physiol 2019; 597:4293-4307. [PMID: 31045243 DOI: 10.1113/jp277651] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/15/2019] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Dravet syndrome mice (Scn1a+/- ) demonstrate a marked strain dependence for the severity of seizures which is correlated with GABAA receptor α2 subunit expression. The α2 /α3 subunit selective positive allosteric modulator (PAM) AZD7325 potentiates inhibitory postsynaptic currents (IPSCs) specifically in perisomatic synapses. AZD7325 demonstrates stronger effects on IPSCs in the seizure resistant mouse strain, consistent with higher α2 subunit expression. AZD7325 demonstrates seizure protective effects in Scn1a+/- mice without apparent sedative effects in vivo. ABSTRACT GABAA receptor potentiators are commonly used for the treatment of epilepsy, but it is not clear whether targeting distinct GABAA receptor subtypes will have disproportionate benefits over adverse effects. Here we demonstrate that the α2 /α3 selective positive allosteric modulator (PAM) AZD7325 preferentially potentiates hippocampal inhibitory responses at synapses proximal to the soma of CA1 neurons. The effect of AZD7325 on synaptic responses was more prominent in mice on the 129S6/SvEvTac background strain, which have been demonstrated to be seizure resistant in the model of Dravet syndrome (Scn1a+/- ), and in which the α2 GABAA receptor subunits are expressed at higher levels relative to in the seizure prone C57BL/6J background strain. Consistent with this, treatment of Scn1a+/- mice with AZD7325 elevated the temperature threshold for hyperthermia-induced seizures without apparent sedative effects. Our results in a model system indicate that selectively targeting α2 is a potential therapeutic option for Dravet syndrome.
Collapse
Affiliation(s)
- Toshihiro Nomura
- Department of Physiology, Northwestern University, Chicago, IL, 60611, USA
| | - Nicole A Hawkins
- Department of Pharmacology Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Jennifer A Kearney
- Department of Pharmacology Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Alfred L George
- Department of Pharmacology Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Anis Contractor
- Department of Physiology, Northwestern University, Chicago, IL, 60611, USA.,Department of Neurobiology Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL, 60611, USA
| |
Collapse
|
10
|
Witkin JM, Cerne R, Davis PG, Freeman KB, do Carmo JM, Rowlett JK, Methuku KR, Okun A, Gleason SD, Li X, Krambis MJ, Poe M, Li G, Schkeryantz JM, Jahan R, Yang L, Guo W, Golani LK, Anderson WH, Catlow JT, Jones TM, Porreca F, Smith JL, Knopp KL, Cook JM. The α2,3-selective potentiator of GABA A receptors, KRM-II-81, reduces nociceptive-associated behaviors induced by formalin and spinal nerve ligation in rats. Pharmacol Biochem Behav 2019; 180:22-31. [PMID: 30825491 PMCID: PMC6529285 DOI: 10.1016/j.pbb.2019.02.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/24/2019] [Accepted: 02/25/2019] [Indexed: 02/03/2023]
Abstract
Clinical evidence indicates that positive allosteric modulators (PAMs) of GABAA receptors have analgesic benefit in addition to efficacy in anxiety disorders. However, the utility of GABAA receptor PAMs as analgesics is compromised by the central nervous system side effects of non-selective potentiators. A selective potentiator of GABAA receptors associated with α2/3 subunits, KRM-II-81(5-(8-ethynyl-6-(pyridin-2-yl)-4H-benzo[f]imidazo[1,5-a][1,4]diazepin-3-yl)oxazole), has demonstrated anxiolytic, anticonvulsant, and antinociceptive effects in rodents with reduced motoric side effects. The present study evaluated the potential of KRM-II-81 as a novel analgesic. Oral administration of KRM-II-81 attenuated formalin-induced flinching; in contrast, diazepam was not active. KRM-II-81 attenuated nociceptive-associated behaviors engendered by chronic spinal nerve ligation (L5/L6). Diazepam decreased locomotion of rats at the dose tested in the formalin assay (10 mg/kg) whereas KRM-II-81 produced small decreases that were not dose-dependent (10-100 mg/kg). Plasma and brain levels of KRM-II-81 were used to demonstrate selectivity for α2/3- over α1-associated GABAA receptors and to define the degree of engagement of these receptors. Plasma and brain concentrations of KRM-II-81 were positively-associated with analgesic efficacy. GABA currents from isolated rat dorsal-root ganglion cultures were potentiated by KRM-II-81 with an ED50 of 32 nM. Measures of respiratory depression were reduced by alprazolam whereas KRM-II-81 was either inactive or produced effects with lower potency and efficacy. These findings add to the growing body of data supporting the idea that α2/3-selective GABAA receptor PAMs will have efficacy and tolerability as pain medications including those for neuropathic pain. Given their predicted anxiolytic effects, α2/3-selective GABAA receptor PAMs offer an additional inroad into the management of pain.
Collapse
Affiliation(s)
- J M Witkin
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA; Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Laboratory of Antiepileptic Drug Discovery, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - R Cerne
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - K B Freeman
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - J M do Carmo
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - J K Rowlett
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - K R Methuku
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - A Okun
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - S D Gleason
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - X Li
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - M J Krambis
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - M Poe
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - G Li
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - J M Schkeryantz
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - R Jahan
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - L Yang
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - W Guo
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - L K Golani
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - W H Anderson
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - J T Catlow
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - T M Jones
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - F Porreca
- Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - J L Smith
- Laboratory of Antiepileptic Drug Discovery, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K L Knopp
- The Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - J M Cook
- Department of Chemistry & Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| |
Collapse
|
11
|
Vasović D, Divović B, Treven M, Knutson DE, Steudle F, Scholze P, Obradović A, Fabjan J, Brković B, Sieghart W, Ernst M, Cook JM, Savić MM. Trigeminal neuropathic pain development and maintenance in rats are suppressed by a positive modulator of α6 GABA A receptors. Eur J Pain 2019; 23:973-984. [PMID: 30633839 PMCID: PMC6461498 DOI: 10.1002/ejp.1365] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 12/13/2018] [Accepted: 12/19/2018] [Indexed: 01/06/2023]
Abstract
γ-Aminobutyric acid type A (GABAA ) receptors containing the α6 subunit are located in trigeminal ganglia, and their reduction by small interfering RNA increases inflammatory temporomandibular and myofascial pain in rats. We thus hypothesized that enhancing their activity may help in neuropathic syndromes originating from the trigeminal system. Here, we performed a detailed electrophysiological and pharmacokinetic analysis of two recently developed deuterated structurally similar pyrazoloquinolinone compounds. DK-I-56-1 at concentrations below 1 µM enhanced γ-aminobutyric acid (GABA) currents at recombinant rat α6β3γ2, α6β3δ and α6β3 receptors, whereas it was inactive at most GABAA receptor subtypes containing other α subunits. DK-I-87-1 at concentrations below 1 µM was inactive at α6-containing receptors and only weakly modulated other GABAA receptors investigated. Both plasma and brain tissue kinetics of DK-I-56-1 were relatively slow, with half-lives of 6 and 13 hr, respectively, enabling the persistence of estimated free brain concentrations in the range 10-300 nM throughout a 24-hr period. Results obtained in two protocols of chronic constriction injury of the infraorbital nerve in rats dosed intraperitoneally with DK-I-56-1 during 14 days after surgery or with DK-I-56-1 or DK-I-87-1 during 14 days after trigeminal neuropathy were already established, demonstrated that DK-I-56-1 but not DK-I-87-1 significantly reduced the hypersensitivity response to von Frey filaments. SIGNIFICANCE: Neuropathic pain induced by trigeminal nerve damage is poorly controlled by current treatments. DK-I-56-1 that positively modulates α6 GABAA receptors is appropriate for repeated administration and thus may represent a novel treatment option against the development and maintenance of trigeminal neuropathic pain.
Collapse
Affiliation(s)
- Dina Vasović
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Branka Divović
- Faculty of Pharmacy, Department of Pharmacology, University of Belgrade, Belgrade, Serbia
| | - Marco Treven
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Daniel E Knutson
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Friederike Steudle
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Petra Scholze
- Department of Pathobiology of the Nervous System, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Aleksandar Obradović
- Faculty of Pharmacy, Department of Pharmacology, University of Belgrade, Belgrade, Serbia
| | - Jure Fabjan
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Božidar Brković
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Werner Sieghart
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Margot Ernst
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - James M Cook
- Department of Chemistry and Biochemistry, Milwaukee Institute of Drug Discovery, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Miroslav M Savić
- Faculty of Pharmacy, Department of Pharmacology, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
12
|
van Amerongen G, Siebenga PS, Gurrell R, Dua P, Whitlock M, Gorman D, Okkerse P, Hay JL, Butt RP, Groeneveld GJ. Analgesic potential of PF-06372865, an α2/α3/α5 subtype-selective GABA A partial agonist, in humans. Br J Anaesth 2019; 123:e194-e203. [PMID: 30915991 DOI: 10.1016/j.bja.2018.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study investigated the analgesic effects of two doses (15 and 65 mg) of PF-06372865, a novel α2/α3/α5 gamma-aminobutyric acid A (GABAA) subunit selective partial positive allosteric modulator (PAM), compared with placebo and pregabalin (300 mg) as a positive control. METHODS We performed a randomised placebo-controlled crossover study (NCT02238717) in 20 healthy subjects, using a battery of pain tasks (electrical, pressure, heat, cold and inflammatory pain, including a paradigm of conditioned pain modulation). Pharmacodynamic measurements were performed at baseline and up to 10 h after dose. RESULTS A dose of 15 mg PF-06372865 increased pain tolerance thresholds (PTTs) for pressure pain at a ratio of 1.11 (90% confidence interval [CI]: 1.02, 1.22) compared with placebo. A dose of 65 mg PF-06372865 led to an increase in PTT for the cold pressor at a ratio of 1.17 (90% CI: 1.03, 1.32), and pressure pain task: 1.11 (90% CI: 1.01, 1.21). Pregabalin showed an increase in PTT for pressure pain at a ratio of 1.15 (95% CI: 1.06, 1.26) and cold pressor task: 1.31 (90% CI: 1.16, 1.48). CONCLUSION We conclude that PF-06372865 has analgesic potential at doses that do not induce significant sedation or other intolerable adverse events limiting its clinical use. In addition, the present study established the potential role for this battery of pain tasks as a tool in the development of analgesics with a novel mechanism of action, for the treatment of various pain states including neuropathic pain and to establish proof-of-concept. CLINICAL TRIALS REGISTRATION NCT0223871.
Collapse
Affiliation(s)
| | | | | | - Pinky Dua
- Early Clinical Development, Pfizer WRD, Cambridge, UK
| | - Mark Whitlock
- Early Clinical Development, Pfizer WRD, Cambridge, UK
| | - Donal Gorman
- Early Clinical Development, Pfizer WRD, Cambridge, UK
| | - Pieter Okkerse
- Centre for Human Drug Research (CHDR), Leiden, the Netherlands
| | - Justin L Hay
- Centre for Human Drug Research (CHDR), Leiden, the Netherlands
| | | | | |
Collapse
|
13
|
TP003 is a non-selective benzodiazepine site agonist that induces anxiolysis via α2GABAA receptors. Neuropharmacology 2018; 143:71-78. [DOI: 10.1016/j.neuropharm.2018.09.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/27/2018] [Accepted: 09/17/2018] [Indexed: 01/09/2023]
|
14
|
Huddart R, Leeder JS, Altman RB, Klein TE. PharmGKB summary: clobazam pathway, pharmacokinetics. Pharmacogenet Genomics 2018; 28:110-115. [PMID: 29517622 PMCID: PMC5914180 DOI: 10.1097/fpc.0000000000000327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - J Steven Leeder
- Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Russ B Altman
- Biomedical Engineering
- Genetics, Stanford University, Stanford, California
| | | |
Collapse
|
15
|
|
16
|
Zhou F, Liu S, Xing J, Liu Z, Song F. Fast analysis of benzodiazepines using argon direct analysis in real time mass spectrometry on-line coupled with a thermal-assisted gasification injector. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2017; 31:1073-1076. [PMID: 28384380 DOI: 10.1002/rcm.7871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/31/2017] [Accepted: 03/31/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Feng Zhou
- National Center of Mass Spectrometry in Changchun & Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
- University of Chinese Academy of Sciences, Beijing, 100039, China
| | - Shu Liu
- National Center of Mass Spectrometry in Changchun & Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
| | - Junpeng Xing
- National Center of Mass Spectrometry in Changchun & Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
| | - Zhiqiang Liu
- National Center of Mass Spectrometry in Changchun & Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
| | - Fengrui Song
- National Center of Mass Spectrometry in Changchun & Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
| |
Collapse
|
17
|
Differential depression of neuronal network activity by midazolam and its main metabolite 1-hydroxymidazolam in cultured neocortical slices. Sci Rep 2017; 7:3503. [PMID: 28615640 PMCID: PMC5471240 DOI: 10.1038/s41598-017-03154-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 04/25/2017] [Indexed: 11/12/2022] Open
Abstract
The benzodiazepine midazolam is widely used in critical care medicine. Midazolam has a clinically active metabolite, 1-hydroxymidazolam. The contribution of 1-hydroxymidazolam to the effects of midazolam is controversial. The aim of the current study was to compare the actions of midazolam and 1-hydroxymidazolam on network activity of cortical neurons. Midazolam depressed neuronal activity at a low concentration of 5 nM. When midazolam concentration was increased, it depressed neuronal discharge rates in a biphasic manner. In comparison, 1-hydroxymidazolam did not depress the cortical network activity at low nanomolar concentrations. Higher concentrations of 1-hydroxymidazolam consistently inhibited neuronal activity. Moreover, midazolam shortened cortical up states at low, but not at high concentrations, while the opposite effect was observed with 1-hydroxymidazolam. The network depressant action of midazolam at low concentrations was absent in slices from GABAA receptor α1(H101R)mutant mice. The α1(H101R)mutation renders α1-subunit containing GABAA receptors insensitive towards benzodiazepines. This GABAA receptor subtype is thought to mediate sedation. As midazolam is more potent than its metabolite 1-hydroxymidazolam, the major clinical effects are thus likely caused by midazolam itself. However, 1-hydroxymidazolam could add to the effects of midazolam, especially after the application of high doses of midazolam, and in case of impaired drug metabolism.
Collapse
|
18
|
Müller Herde A, Benke D, Ralvenius WT, Mu L, Schibli R, Zeilhofer HU, Krämer SD. GABAA receptor subtypes in the mouse brain: Regional mapping and diazepam receptor occupancy by in vivo [18F]flumazenil PET. Neuroimage 2017; 150:279-291. [DOI: 10.1016/j.neuroimage.2017.02.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/22/2017] [Accepted: 02/09/2017] [Indexed: 12/19/2022] Open
|