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Gomez K, Tang C, Tan B, Perez-Miller S, Ran D, Loya S, Calderon-Rivera A, Stratton HJ, Duran P, Masterson KA, Gabrielsen AT, Alsbiei O, Dorame A, Serafini M, Moutal A, Wang J, Khanna R. Stereospecific Effects of Benzimidazolonepiperidine Compounds on T-Type Ca 2+ Channels and Pain. ACS Chem Neurosci 2022; 13:2035-2047. [PMID: 35671441 DOI: 10.1021/acschemneuro.2c00256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
T-type calcium channels activate in response to subthreshold membrane depolarizations and represent an important source of Ca2+ influx near the resting membrane potential. These channels regulate neuronal excitability and have been linked to pain. For this reason, T-type calcium channels are suitable molecular targets for the development of new non-opioid analgesics. Our previous work identified an analogue of benzimidazolonepiperidine, 5bk, that preferentially inhibited CaV3.2 channels and reversed mechanical allodynia. In this study, we synthesized and screened a small library of 47 compounds derived from 5bk. We found several compounds that inhibited the Ca2+ influx in DRG neurons of all sizes. After separating the enantiomers of each active compound, we found two compounds, 3-25-R and 3-14-3-S, that potently inhibited the Ca2+ influx. Whole-cell patch clamp recordings from small- to medium-sized DRG neurons revealed that both compounds decreased total Ca2+. Application of 3-14-3-S (but not 3-25-R) blocked transiently expressed CaV3.1-3.3 channels with a similar IC50 value. 3-14-3-S decreased T-type, but not N-type, Ca2+ currents in DRG neurons. Furthermore, intrathecal delivery of 3-14-3-S relieved tonic, neuropathic, and inflammatory pain in preclinical models. 3-14-3-S did not exhibit any activity against G protein-coupled opioid receptors. Preliminary docking studies also suggest that 3-14-3-S can bind to the central pore domain of T-type channels. Together, our chemical characterization and functional and behavioral data identify a novel T-type calcium channel blocker with in vivo efficacy in experimental models of tonic, neuropathic, and inflammatory pain.
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Affiliation(s)
- Kimberly Gomez
- Department of Molecular Pathobiology, College of Dentistry, New York University, 433 First Avenue, 8th Floor, New York, New York 10010, United States
| | - Cheng Tang
- Department of Molecular Pathobiology, College of Dentistry, New York University, 433 First Avenue, 8th Floor, New York, New York 10010, United States.,The National and Local Joint Engineering Laboratory of Animal Peptide Drug Development, College of Life Sciences, Hunan Normal University, Changsha 410081, China
| | - Bin Tan
- Department of Medicinal Chemistry, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, William Levine Hall, Room 320, 160 Frelinghuysen Road, Piscataway, New Jersey 0885, United States
| | - Samantha Perez-Miller
- Department of Molecular Pathobiology, College of Dentistry, New York University, 433 First Avenue, 8th Floor, New York, New York 10010, United States
| | - Dongzhi Ran
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Santiago Loya
- Department of Molecular Pathobiology, College of Dentistry, New York University, 433 First Avenue, 8th Floor, New York, New York 10010, United States
| | - Aida Calderon-Rivera
- Department of Molecular Pathobiology, College of Dentistry, New York University, 433 First Avenue, 8th Floor, New York, New York 10010, United States
| | - Harrison J Stratton
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Paz Duran
- Department of Molecular Pathobiology, College of Dentistry, New York University, 433 First Avenue, 8th Floor, New York, New York 10010, United States
| | - Kyleigh A Masterson
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Anna T Gabrielsen
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Omar Alsbiei
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Angie Dorame
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Maria Serafini
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Aubin Moutal
- School of Medicine, Department of Pharmacology and Physiology, Saint Louis University, 1402 S. Grand Blvd. Schwitalla Hall, Room 432, Saint Louis, Missouri 63104, United States
| | - Jun Wang
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona 85724, United States
| | - Rajesh Khanna
- Department of Molecular Pathobiology, College of Dentistry, New York University, 433 First Avenue, 8th Floor, New York, New York 10010, United States
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Kerckhove N, Pereira B, Soriot-Thomas S, Alchaar H, Deleens R, Hieng VS, Serra E, Lanteri-Minet M, Arcagni P, Picard P, Lefebvre-Kuntz D, Maindet C, Mick G, Balp L, Lucas C, Creach C, Letellier M, Martinez V, Navez M, Delbrouck D, Kuhn E, Piquet E, Bozzolo E, Brosse C, Lietar B, Marcaillou F, Hamdani A, Leroux-Bromberg N, Perier Y, Vergne-Salle P, Gov C, Delage N, Gillet D, Romettino S, Richard D, Mallet C, Bernard L, Lambert C, Dubray C, Duale C, Eschalier A. Efficacy and safety of a T-type calcium channel blocker in patients with neuropathic pain: A proof-of-concept, randomized, double-blind and controlled trial. Eur J Pain 2018; 22:1321-1330. [PMID: 29577519 DOI: 10.1002/ejp.1221] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND T-type calcium channels have been shown to play an important role in the initiation and maintenance of neuropathic pain and represent a promising therapeutic target for new analgesic treatments. Ethosuximide (ETX), an anticonvulsant and a T-type channel blocker has shown analgesic effect in several chronic pain models but has not yet been evaluated in patients with neuropathic pain. METHODS This proof-of-concept, multicentre, double-blind, controlled and randomized trial compared the efficacy and safety of ETX (given as add-on therapy) to an inactive control (IC) in 114 patients with non-diabetic peripheral neuropathic pain. After a 7-day run-in period, eligible patients aged over 18 years were randomly assigned (1:1) to ETX or IC for 6 weeks. The primary outcome was the difference between groups in the pain intensity (% of change from the baseline to end of treatment) assessed in the intention-to-treat population. This study is registered with EudraCT (2013-004801-26) and ClinicalTrials.gov (NCT02100046). RESULTS The study was stopped during the interim analysis due to the high number of adverse events in the active treatment group. ETX failed to reduce total pain and showed a poor tolerance in comparison to IC. In the per-protocol analysis, ETX significantly reduced pain intensity by 15.6% (95% CI -25.8; -5.4) from baseline compared to IC (-7.8%, 95% CI -14.3; -1.3; p = 0.033), but this result must be interpreted with caution because of a small subgroup of patients. CONCLUSION Ethosuximide did not reduce the severity of neuropathic pain and induces, at the doses used, many adverse events. SIGNIFICANCE This article shows that ETX is not effective to treat neuropathic pain. Nevertheless, per-protocol analysis suggests a possible analgesic effect of ETX. Thus, our work adds significant knowledge to preclinical and clinical data on the benefits of T-type calcium channel inhibition for the treatment of neuropathic pain.
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Affiliation(s)
- N Kerckhove
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
| | - B Pereira
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | | | - H Alchaar
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | | | | | - E Serra
- CHU Amiens Picardie, CETD, CRC, Amiens, France
| | - M Lanteri-Minet
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - P Arcagni
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | - P Picard
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | | | - C Maindet
- CHU Grenoble Alpes, CETD, Grenoble, France
| | - G Mick
- CH Voiron, UETD, Voiron, France
| | - L Balp
- CH Lons-le-Saunier, CETD, Lons-le-Saunier, France
| | - C Lucas
- Université Lille Nord de France, CHRU Lille, CETD, Lille, France
| | - C Creach
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | | | - V Martinez
- AP-HP - Hôpital Raymond Poincaré, CETD, Paris, France
| | - M Navez
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | | | - E Kuhn
- CHU Nantes, CETD, Nantes, France
| | - E Piquet
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - E Bozzolo
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - C Brosse
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | - B Lietar
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | - F Marcaillou
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - A Hamdani
- Cancer Centre Oscar-Lambret, Lille, France
| | | | - Y Perier
- CH Avranches, CETD, Avranches, France
| | | | - C Gov
- HCL - Hôpital Neurologique, CETD, Lyon, France
| | - N Delage
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | | | - S Romettino
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - D Richard
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - C Mallet
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - L Bernard
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - C Lambert
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - C Dubray
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
| | - C Duale
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
| | - A Eschalier
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
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