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Hohenwarter L, Böttger R, Li SD. Modification and Delivery of Enkephalins for Pain Modulation. Int J Pharm 2023; 646:123425. [PMID: 37739096 DOI: 10.1016/j.ijpharm.2023.123425] [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: 04/06/2023] [Revised: 08/23/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
Chronic pain negatively affects patient's quality of life and poses a significant economic burden. First line pharmaceutical treatment of chronic pain, including NSAIDs or antidepressants, is often inefficient to reduce pain, or produces intolerable adverse effects. In such cases, opioids are frequently prescribed for their potent analgesia, but chronic opioid use is also frequently associated with debilitating side effects that may offset analgesic benefits. Nonetheless, opioids continue to be widely utilized due to the lack of effective alternative analgesics. Since their discovery in 1975, a class of endogenous opioids called enkephalins (ENKs) have been investigated for their ability to relieve pain with significantly reduced adverse effects compared to conventional opioids. Their low metabolic stability and inability to cross biological membranes, however, make ENKs ineffective analgesics. Over past decades, much effort has been invested to overcome these limitations and develop ENK-based pain therapies. This review summarizes and describes chemical modifications and ENK delivery technologies utilizing ENK conjugates, nanoparticles and ENK gene delivery approaches and discusses valid lessons, challenges, and future directions of this evolving field.
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Affiliation(s)
- Lukas Hohenwarter
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Roland Böttger
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Shyh-Dar Li
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada.
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Benredjem B, Pineyro G. A type II cannabis extract and a 1:1 blend of Δ(9)-tetrahydrocannabinol and cannabidiol display distinct antinociceptive profiles and engage different endocannabinoid targets when administered into the subarachnoid space. Front Pharmacol 2023; 14:1235255. [PMID: 37745077 PMCID: PMC10514912 DOI: 10.3389/fphar.2023.1235255] [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: 06/06/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction: Cannabis extracts are being increasingly used to mitigate chronic pain. Current guidelines for their prescription rely on Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) content as well as the ratio of these major cannabinoids present in the blend. Here we assessed whether these descriptors were representative of product effectiveness to produce a desired outcome such as analgesia. Methods: In this study, we used a rat model of diabetic neuropathy and assessed the reduction in mechanical allodynia following intrathecal injection of pure THC, pure CBD, a 1:1 mix of these compounds and a "balanced" chemotype II cannabis extract. Engagement of endocannabinoid targets by different treatments was investigated using CB1 (AM251) and CB2 (AM630) receptor antagonists as well as a TRPV1 channel blocker (capsazepine). Results: Antinociceptive responses induced by an equivalent amount of THC administered in its pure form, as a THC:CBD mix or as a "balanced" extract were distinct. Furthermore, the 1:1 THC:CBD mix and the balanced extract had not only different response profiles but their relative engagement of CB1, CB2 receptors and TRPV1 channels was distinct. Discussion: These findings indicate that antinociceptive responses and targets engaged by blended cannabinoids are composition-specific, and cannot be simply inferred from THC and CBD contents. This information may have implications in relation to the way medicinal cannabis products are prescribed.
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Affiliation(s)
- Besma Benredjem
- Département de Pharmacologie, Université de Montréal, Montreal, QC, Canada
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | - Graciela Pineyro
- Département de Pharmacologie, Université de Montréal, Montreal, QC, Canada
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
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Abstract
This paper is the forty-third consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2020 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY, 11367, United States.
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Mansour A, Nagi K, Dallaire P, Lukasheva V, Le Gouill C, Bouvier M, Pineyro G. Comprehensive Signaling Profiles Reveal Unsuspected Functional Selectivity of δ-Opioid Receptor Agonists and Allow the Identification of Ligands with the Greatest Potential for Inducing Cyclase Superactivation. ACS Pharmacol Transl Sci 2021; 4:1483-1498. [PMID: 34661070 PMCID: PMC8506601 DOI: 10.1021/acsptsci.1c00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Indexed: 11/29/2022]
Abstract
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Prolonged exposure
to opioid receptor agonists triggers adaptations
in the adenylyl cyclase (AC) pathway that lead to enhanced production
of cyclic adenosine monophosphate (cAMP) upon withdrawal. This cellular
phenomenon contributes to withdrawal symptoms, hyperalgesia and analgesic
tolerance that interfere with clinical management of chronic pain
syndromes. Since δ-opioid receptors (DOPrs) are a promising
target for chronic pain management, we were interested in finding
out if cell-based signaling profiles as generated for drug discovery
purposes could inform us of the ligand potential to induce sensitization
of the cyclase path. For this purpose, signaling of DOPr agonists
was monitored at multiple effectors. The resulting signaling profiles
revealed marked functional selectivity, particularly for Met-enkephalin
(Met-ENK) whose signaling bias profile differed from those of synthetic
ligands like SNC-80 and ARM390. Signaling diversity among ligands
was systematized by clustering agonists according to similarities
in Emax and Log(τ) values for the
different responses. The classification process revealed that the
similarity in Gα/Gβγ, but not in β-arrestin
(βarr), responses was correlated with the potential of Met-ENK,
deltorphin II, (d-penicillamine2,5)-enkephalin (DPDPE), ARM390,
and SNC-80 to enhance cAMP production, all of which required Ca2+ mobilization to produce this response. Moreover, superactivation
by Met-ENK, which was the most-effective Ca2+ mobilizing
agonist, required Gαi/o activation, availability of Gβγ
subunits at the membrane, and activation of Ca2+ effectors
such as calmodulin and protein kinase C (PKC). In contrast, superactivation by (N-(l-tyrosyl)-(3S)-1,2,3,4-tetrahydroisoquinoline-3-carbonyl)-l-phenylalanyl-l-phenylalanine (TIPP), which was set
in a distinct category through clustering, required activation of
Gαi/o subunits but was independent of the Gβγ dimer
and Ca2+ mobilization, relying instead on Src and Raf-1
to induce this cellular adaptation.
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Affiliation(s)
- Ahmed Mansour
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montréal, Quebec H3T 1J4, Canada.,CHU Sainte-Justine Research Center, Montréal, Quebec H3T 1C5, Canada
| | - Karim Nagi
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Paul Dallaire
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montréal, Quebec H3T 1J4, Canada.,CHU Sainte-Justine Research Center, Montréal, Quebec H3T 1C5, Canada
| | - Viktoriya Lukasheva
- Institute for Research in Immunology and Cancer, Department of Biochemistry and Molecular Medicine, Université de Montréal, Montréal, Quebec H3T 1J4, Canada
| | - Christian Le Gouill
- Institute for Research in Immunology and Cancer, Department of Biochemistry and Molecular Medicine, Université de Montréal, Montréal, Quebec H3T 1J4, Canada
| | - Michel Bouvier
- Institute for Research in Immunology and Cancer, Department of Biochemistry and Molecular Medicine, Université de Montréal, Montréal, Quebec H3T 1J4, Canada
| | - Graciela Pineyro
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montréal, Quebec H3T 1J4, Canada.,CHU Sainte-Justine Research Center, Montréal, Quebec H3T 1C5, Canada
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Pineyro G, Nagi K. Signaling diversity of mu- and delta- opioid receptor ligands: Re-evaluating the benefits of β-arrestin/G protein signaling bias. Cell Signal 2020; 80:109906. [PMID: 33383156 DOI: 10.1016/j.cellsig.2020.109906] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/24/2020] [Accepted: 12/27/2020] [Indexed: 01/02/2023]
Abstract
Opioid analgesics are elective for treating moderate to severe pain but their use is restricted by severe side effects. Signaling bias has been proposed as a viable means for improving this situation. To exploit this opportunity, continuous efforts are devoted to understand how ligand-specific modulations of receptor functions could mediate the different in vivo effects of opioids. Advances in the field have led to the development of biased agonists based on hypotheses that allocated desired and undesired effects to specific signaling pathways. However, the prevalent hypothesis associating β-arrestin to opioid side effects was recently challenged and multiple of the newly developed biased drugs may not display the superior side effects profile that was sought. Moreover, biased agonism at opioid receptors is now known to be time- and cell-dependent, which adds a new layer of complexity for bias estimation. Here, we first review the signaling mechanisms underlying desired and undesired effects of opioids. We then describe biased agonism at opioid receptors and discuss the different perspectives that support the desired and undesired effects of opioids in view of exploiting biased signaling for therapeutic purposes. Finally, we explore how signaling kinetics and cellular background can influence the magnitude and directionality of bias at those receptors.
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Affiliation(s)
- Graciela Pineyro
- Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; CHU Sainte-Justine research center, Montreal, QC H3T 1C5, Canada
| | - Karim Nagi
- College of Medicine, QU Health, Qatar University, Doha, Qatar.
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Bagheri Tudashki H, Haddad Y, Charfi I, Couture R, Pineyro G. Ligand-specific recycling profiles determine distinct potential for chronic analgesic tolerance of delta-opioid receptor (DOPr) agonists. J Cell Mol Med 2020; 24:5718-5730. [PMID: 32279433 PMCID: PMC7214178 DOI: 10.1111/jcmm.15234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 12/25/2022] Open
Abstract
δ-opioid receptor (DOPr) agonists have analgesic efficacy in chronic pain models but development of tolerance limits their use for long-term pain management. Although agonist potential for inducing acute analgesic tolerance has been associated with distinct patterns of DOPr internalization, the association between trafficking and chronic tolerance remains ill-defined. In a rat model of streptozotocin (STZ)-induced diabetic neuropathy, deltorphin II and TIPP produced sustained analgesia following daily (intrathecal) i.t. injections over six days, whereas similar treatment with SNC-80 or SB235863 led to progressive tolerance and loss of the analgesic response. Trafficking assays in murine neuron cultures showed no association between the magnitude of ligand-induced sequestration and development of chronic tolerance. Instead, ligands that supported DOPr recycling were also the ones producing sustained analgesia over 6-day treatment. Moreover, endosomal endothelin-converting enzyme 2 (ECE2) blocker 663444 prevented DOPr recycling by deltorphin II and TIPP and precipitated tolerance by these ligands. In conclusion, agonists, which support DOPr recycling, avoid development of analgesic tolerance over repeated administration.
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Affiliation(s)
| | - Youssef Haddad
- Department of Pharmacology and PhysiologyFaculty of MedicineUniversité de MontréalMontréalQCCanada
| | - Iness Charfi
- Centre de RechercheCentre Hospitalier Universitaire Ste-JustineMontréalQCCanada
- Department of Pharmacology and PhysiologyFaculty of MedicineUniversité de MontréalMontréalQCCanada
| | - Rejean Couture
- Department of Pharmacology and PhysiologyFaculty of MedicineUniversité de MontréalMontréalQCCanada
| | - Graciela Pineyro
- Centre de RechercheCentre Hospitalier Universitaire Ste-JustineMontréalQCCanada
- Department of Pharmacology and PhysiologyFaculty of MedicineUniversité de MontréalMontréalQCCanada
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