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Greenwood-Van Meerveld B, Mohammadi E, Tyler K, Pietra C, Bee LA, Dickenson A. Synergistic effect of 5-hydroxytryptamine 3 and neurokinin 1 receptor antagonism in rodent models of somatic and visceral pain. J Pharmacol Exp Ther 2014; 351:146-52. [PMID: 25077526 DOI: 10.1124/jpet.114.216028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Synergistic activity has been observed between serotonergic 5-hydroxytryptamine 3 (5-HT3) and tachykinergic neurokinin 1 (NK1) receptor-mediated responses. This study investigated the efficacy of a 5-HT3 antagonist, palonosetron, and a NK1 antagonist, netupitant, alone or in combination in rodent models of somatic and visceral colonic hypersensitivity. In a rat model of experimental neuropathic pain, somatic hypersensitivity was quantified by the number of ipsilateral paw withdrawals to a von Frey filament (6g). Electrophysiologic responses were recorded in the dorsal horn neurons after mechanical or thermal stimuli. Acute colonic hypersensitivity was induced experimentally in rats by infusing dilute acetic acid (0.6%) directly into the colon. Colonic sensitivity was assessed by a visceromotor behavioral response quantified as the number of abdominal contractions in response to graded isobaric pressures (0-60 mm Hg) of colorectal distension. Palonosetron or netupitant was administered alone or in combination via oral gavage. When dosed alone, both significantly reduced somatic sensitivity, decreased the evoked response of spinal dorsal horn neurons to mechanical or thermal stimulation, and caused significant (P < 0.05) inhibition of colonic hypersensitivity in a dose-dependent manner. The combined administration of palonosetron and netupitant at doses that were ineffective alone significantly reduced both somatic and visceral sensitivity and decreased the evoked response of spinal dorsal horn neurons to mechanical or thermal stimulation. In summary, the combination of palonosetron with a NK1 receptor antagonist showed synergistic analgesic activity in rodent models of somatic and visceral hypersensitivity, and may prove to be a useful therapeutic approach to treat pain associated with irritable bowel syndrome.
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Affiliation(s)
- Beverley Greenwood-Van Meerveld
- Department of Physiology (B.G.-V.M.), Veterans Affairs Medical Center (B.G.-V.M.), Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center (B.G.-V.M., E.M., K.T.), Oklahoma City, Oklahoma; Research and Preclinical Department, Helsinn Healthcare SA, Lugano, Switzerland (C.P.); and Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom (L.A.B., A.D.)
| | - Ehsan Mohammadi
- Department of Physiology (B.G.-V.M.), Veterans Affairs Medical Center (B.G.-V.M.), Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center (B.G.-V.M., E.M., K.T.), Oklahoma City, Oklahoma; Research and Preclinical Department, Helsinn Healthcare SA, Lugano, Switzerland (C.P.); and Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom (L.A.B., A.D.)
| | - Karl Tyler
- Department of Physiology (B.G.-V.M.), Veterans Affairs Medical Center (B.G.-V.M.), Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center (B.G.-V.M., E.M., K.T.), Oklahoma City, Oklahoma; Research and Preclinical Department, Helsinn Healthcare SA, Lugano, Switzerland (C.P.); and Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom (L.A.B., A.D.)
| | - Claudio Pietra
- Department of Physiology (B.G.-V.M.), Veterans Affairs Medical Center (B.G.-V.M.), Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center (B.G.-V.M., E.M., K.T.), Oklahoma City, Oklahoma; Research and Preclinical Department, Helsinn Healthcare SA, Lugano, Switzerland (C.P.); and Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom (L.A.B., A.D.)
| | - Lucy A Bee
- Department of Physiology (B.G.-V.M.), Veterans Affairs Medical Center (B.G.-V.M.), Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center (B.G.-V.M., E.M., K.T.), Oklahoma City, Oklahoma; Research and Preclinical Department, Helsinn Healthcare SA, Lugano, Switzerland (C.P.); and Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom (L.A.B., A.D.)
| | - Anthony Dickenson
- Department of Physiology (B.G.-V.M.), Veterans Affairs Medical Center (B.G.-V.M.), Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center (B.G.-V.M., E.M., K.T.), Oklahoma City, Oklahoma; Research and Preclinical Department, Helsinn Healthcare SA, Lugano, Switzerland (C.P.); and Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom (L.A.B., A.D.)
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Gaman A, Bucur MC, Kuo B. Therapeutic advances in functional gastrointestinal disease: irritable bowel syndrome. Therap Adv Gastroenterol 2009; 2:169-181. [PMID: 19936327 PMCID: PMC2779541 DOI: 10.1177/1756283x08103656] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Reported prevalence rates of irritable bowel syndrome (IBS) are between 8% to 20% in the US general population with an average medical expenditure of US$1.35 billion direct and US$205 million indirect costs. Current pathophysiologic theories are based on abnormalities of both the brain and gut, thus setting a new stage for current and future therapeutic approaches. There are numerous treatment options in IBS acting centrally and peripherally by influencing motility and visceral sensitivity. Clinical evidence is variable; however, newer emerging treatments are being evaluated using better-designed clinical trials. Accurate assessment of IBS drug efficacy is still hampered by heterogeneity of the IBS population. Novel methods such as pharmacogenomics or brain imaging may be helpful in the future to better understand and characterize IBS patient subtypes, and this in turn will lead to more specific and efficient therapeutic options. Patient subpopulation measurement of side effects is also a clinical challenge and further understanding could improve treatment efficacy enhancing the patient compliance.
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Affiliation(s)
- Alexandru Gaman
- Massachusetts General Hospital, Gastrointestinal Unit, Harvard Medical
School, Boston, MA, USA
| | - Maria Cristina Bucur
- Massachusetts General Hospital, Gastrointestinal Unit, Harvard Medical
School, Boston, MA, USA
| | - Braden Kuo
- Massachusetts General Hospital, Gastrointestinal Unit, Harvard Medical
School, Boston, MA, USA
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