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Martinez-Torres S, Mesquida-Veny F, Del Rio JA, Hervera A. Injury-induced activation of the endocannabinoid system promotes axon regeneration. iScience 2023; 26:106814. [PMID: 37235048 PMCID: PMC10205787 DOI: 10.1016/j.isci.2023.106814] [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: 02/13/2023] [Revised: 03/31/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023] Open
Abstract
Regeneration after a peripheral nerve injury still remains a challenge, due to the limited regenerative potential of axons after injury. While the endocannabinoid system (ECS) has been widely studied for its neuroprotective and analgesic effects, its role in axonal regeneration and during the conditioning lesion remains unexplored. In this study, we observed that a peripheral nerve injury induces axonal regeneration through an increase in the endocannabinoid tone. We also enhanced the regenerative capacity of dorsal root ganglia (DRG) neurons through the inhibition of endocannabinoid degradative enzyme MAGL or a CB1R agonist. Our results suggest that the ECS, via CB1R and PI3K-pAkt pathway activation, plays an important role in promoting the intrinsic regenerative capacity of sensory neurons after injury.
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Affiliation(s)
- Sara Martinez-Torres
- Molecular and Cellular Neurobiotechnology, Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, University of Barcelona, Barcelona, Spain
- Network Centre of Biomedical Research of Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Francina Mesquida-Veny
- Molecular and Cellular Neurobiotechnology, Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, University of Barcelona, Barcelona, Spain
- Network Centre of Biomedical Research of Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - José Antonio Del Rio
- Molecular and Cellular Neurobiotechnology, Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, University of Barcelona, Barcelona, Spain
- Network Centre of Biomedical Research of Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Arnau Hervera
- Molecular and Cellular Neurobiotechnology, Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, University of Barcelona, Barcelona, Spain
- Network Centre of Biomedical Research of Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Clinical Neuroimmunology Group, Vall Hebron Research Institute (VHIR), Barcelona, Spain
- Multiple Sclerosis Centre of Catalonia (CEM-CAT), Barcelona, Spain
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2
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Jaiswal S, Akhilesh, Tiwari V, Ayyannan SR. Anti-nociceptive potential of an isatin-derived dual fatty acid amide hydrolase-monoacylglycerol lipase inhibitor. Pharmacol Rep 2023; 75:737-745. [PMID: 36913176 DOI: 10.1007/s43440-023-00468-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Recently, we have reported an isatin-derived carbohydrazone, 5-chloro-N'-(6-chloro-2-oxoindolin-3-ylidene)-2-hydroxybenzohydrazide (SIH 3) as dual nanomolar FAAH (fatty acid amide hydrolase)-MAGL (monoacylglycerol lipase) inhibitor with good CNS penetration and neuroprotective activity profile. In this study, we further investigated the pharmacological profile of compound SIH 3 in the neuropathic pain model along with acute toxicity and ex vivo studies. METHODS Chronic constrictive injury (CCI) was used to induce neuropathic pain in male Sprague-Dawley rats and the anti-nociceptive activity of the compound SIH 3 was investigated at 25, 50, and 100 mg/kg ip. Subsequently, locomotor activity was measured by rotarod and actophotometer experiments. The acute oral toxicity of the compound was assessed as per the OECD guidelines 423. RESULTS Compound SIH 3 showed significant anti-nociceptive activity in the CCI-induced neuropathic pain model without altering the locomotor activity. Furthermore, compound SIH 3 showed an excellent safety profile (up to 2000 mg/kg, po) in the acute oral toxicity study and was also non-hepatotoxic. Further, ex vivo studies revealed that the compound SIH 3 produces a significant antioxidant effect in oxidative stress induced by CCI. CONCLUSION Our findings suggest that the investigated compound SIH 3 has the potential to be developed as an anti-nociceptive agent.
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Affiliation(s)
- Shivani Jaiswal
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India
- Institute of Pharmaceutical Research, GLA University, Mathura, UP, 281406, India
| | - Akhilesh
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India
| | - Vinod Tiwari
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India
| | - Senthil Raja Ayyannan
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi, UP, 221005, India.
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3
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Jaiswal S, Akhilesh, Uniyal A, Tiwari V, Raja Ayyannan S. Synthesis and evaluation of dual fatty acid amide hydrolase-monoacylglycerol lipase inhibition and antinociceptive activities of 4-methylsulfonylaniline-derived semicarbazones. Bioorg Med Chem 2022; 60:116698. [PMID: 35296453 DOI: 10.1016/j.bmc.2022.116698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/10/2022] [Accepted: 03/02/2022] [Indexed: 12/31/2022]
Abstract
Fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL) are promising targets for neuropathic pain and other CNS disorders. Based on our previous lead compound SIH 3, we designed and synthesized a series of 4-methylsulfonylphenyl semicarbazones and evaluated for FAAH and MAGL inhibition properties. Most of the compounds showed potency towards both enzymes with leading FAAH selectivity. Compound (Z)-2-(2,6-dichlorobenzylidene)-N-(4-(methylsulfonyl)phenyl)hydrazine-1-carboxamide emerged as the lead inhibitor against both FAAH (IC50 = 11 nM) and MAGL (IC50 = 36 nM). The lead inhibitor inhibited FAAH by non-competitive mode, but showed a mixed-type inhibition against MAGL. Molecular docking study unveiled that the docked ligands bind favorably to the active sites of FAAH and MAGL. The lead inhibitor interacted with FAAH and MAGL via π-π stacking via phenyl ring and hydrogen bonding through sulfonyl oxygen atoms or amide NH. Moreover, the stability of docked complexes was rationalized by molecular simulation studies. PAMPA assay revealed that the lead compound is suitable for blood-brain penetration. The lead compound showed better cell viability in lipopolysaccharide-induced neurotoxicity assay in SH-SY5Y cell lines. Further, in-vivo experiments unveiled that dual inhibitor was safe up to 2000 mg/kg with no hepatotoxicity. The dual FAAH-MAGL inhibitor produced significant anti-nociceptive effect in the CCI model of neuropathic pain without altering locomotion activity. Lastly, the lead compound exhibited promising ex-vivo FAAH/MAGL inhibition activity at the dose of 10 mg/kg and 20 mg/kg. Thus, these findings suggest that the semicarbazone-based lead compound can be a potential template for the development of agents for neuropathic pain.
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Affiliation(s)
- Shivani Jaiswal
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi - 221005, Uttar Pradesh, India
| | - Akhilesh
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, Uttar Pradesh, India
| | - Ankit Uniyal
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, Uttar Pradesh, India
| | - Vinod Tiwari
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, Uttar Pradesh, India
| | - Senthil Raja Ayyannan
- Pharmaceutical Chemistry Research Laboratory II, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi - 221005, Uttar Pradesh, India.
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4
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Muller C, Reggio PH. An Analysis of the Putative CBD Binding Site in the Ionotropic Cannabinoid Receptors. Front Cell Neurosci 2020; 14:615811. [PMID: 33362478 PMCID: PMC7755602 DOI: 10.3389/fncel.2020.615811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 11/18/2020] [Indexed: 12/22/2022] Open
Abstract
Cannabinoids have been long studied for their therapeutic properties, particularly for their use in the treatment of pain. As new therapies are sought after to treat conditions of chronic pain, so is a better understanding of the ligands and their target receptors or channels. A recently published cryo-EM structure showed the putative binding location of a well-known cannabinoid ligand, cannabidiol (CBD), in TRPV2, a channel that has been implicated in inflammation and chronic pain. TRPV2, along with TRPV1, TRPV3, TRPV4, TRPA1, and TRPM8 all have the capability to be modulated by cannabinoid ligands and are located in the peripheral nervous system. Here, we analyze the putative CBD binding site in each of these channels and compare structural and sequential information with experimental data.
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Affiliation(s)
| | - Patricia H. Reggio
- Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, Greensboro, NC, United States
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5
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Sarnelli G, Pesce M, Seguella L, Lu J, Efficie E, Tack J, Elisa De Palma FD, D’Alessandro A, Esposito G. Impaired Duodenal Palmitoylethanolamide Release Underlies Acid-Induced Mast Cell Activation in Functional Dyspepsia. Cell Mol Gastroenterol Hepatol 2020; 11:841-855. [PMID: 33065341 PMCID: PMC7858681 DOI: 10.1016/j.jcmgh.2020.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Acid hypersensitivity is claimed to be a symptomatic trigger in functional dyspepsia (FD); however, the neuroimmune pathway(s) and the mediators involved in this process have not been investigated systematically. Palmitoylethanolamide (PEA) is an endogenous compound, able to modulate nociception and inflammation, but its role in FD has not been assessed. METHODS Duodenal biopsy specimens from FD and control subjects, and peroxisome proliferator-activated receptor-α (PPARα) null mice were cultured at a pH of 3.0 and 7.4. Mast cell (MC) number, the release of their mediators, and the expression of transient receptor potential vanilloid receptor (TRPV)1 and TRPV4, were evaluated. All measurements also were performed in the presence of a selective blocker of neuronal action potential (tetradotoxin). FD and control biopsy specimens in acidified medium also were incubated in the presence of different PEA concentrations, alone or combined with a selective PPARα or PPAR-γ antagonist. RESULTS An acid-induced increase in MC density and the release of their mediators were observed in both dyspeptic patients and controls; however, this response was amplified significantly in FD. This effect was mediated by submucosal nerve fibers and up-regulation of TRPV1 and TRPV4 receptors because pretreatment with tetradotoxin significantly reduced MC infiltration. The acid-induced endogenous release of PEA was impaired in FD and its exogenous administration counteracts MC activation and TRPV up-regulation. CONCLUSIONS Duodenal acid exposure initiates a cascade of neuronal-mediated events culminating in MC activation and TRPV overexpression. These phenomena are consequences of an impaired release of endogenous PEA. PEA might be regarded as an attractive therapeutic strategy for the treatment of FD.
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Affiliation(s)
- Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, Naples, Italy,United Nations Educational, Scientific and Cultural Organization Chair, University of Naples "Federico II," Naples, Italy,Correspondence Address correspondence to: Giovanni Sarnelli, MD, PhD, Department of Clinical Medicine and Surgery, University of Naples "Federico II," Via Pansini 5 80131, Naples, Italy. fax: (39) 0817463892.
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, Naples, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Jie Lu
- Department of Human Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang City, Liaoning, China
| | | | - Jan Tack
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Fatima Domenica Elisa De Palma
- Centro Ingegneria Genetica-Biotecnologie Avanzate s.c.a rl, Department of Molecular Medicine and Medical Biotechnologies, Naples, Italy
| | | | - Giuseppe Esposito
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
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6
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Wagner KM, Gomes A, McReynolds CB, Hammock BD. Soluble Epoxide Hydrolase Regulation of Lipid Mediators Limits Pain. Neurotherapeutics 2020; 17:900-916. [PMID: 32875445 PMCID: PMC7609775 DOI: 10.1007/s13311-020-00916-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The role of lipids in pain signaling is well established and built on decades of knowledge about the pain and inflammation produced by prostaglandin and leukotriene metabolites of cyclooxygenase and lipoxygenase metabolism, respectively. The analgesic properties of other lipid metabolites are more recently coming to light. Lipid metabolites have been observed to act directly at ion channels and G protein-coupled receptors on nociceptive neurons as well as act indirectly at cellular membranes. Cytochrome P450 metabolism of specifically long-chain fatty acids forms epoxide metabolites, the epoxy-fatty acids (EpFA). The biological role of these metabolites has been found to mediate analgesia in several types of pain pathology. EpFA act through a variety of direct and indirect mechanisms to limit pain and inflammation including nuclear receptor agonism, limiting endoplasmic reticulum stress and blocking mitochondrial dysfunction. Small molecule inhibitors of the soluble epoxide hydrolase can stabilize the EpFA in vivo, and this approach has demonstrated relief in preclinical modeled pain pathology. Moreover, the ability to block neuroinflammation extends the potential benefit of targeting soluble epoxide hydrolase to maintain EpFA for neuroprotection in neurodegenerative disease.
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Affiliation(s)
- Karen M Wagner
- Department of Entomology and Nematology and University of California Davis Comprehensive Cancer Center, University of California Davis, One Shields Avenue, Davis, California, 95616, USA
| | - Aldrin Gomes
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis, California, USA
| | - Cindy B McReynolds
- Department of Entomology and Nematology and University of California Davis Comprehensive Cancer Center, University of California Davis, One Shields Avenue, Davis, California, 95616, USA
| | - Bruce D Hammock
- Department of Entomology and Nematology and University of California Davis Comprehensive Cancer Center, University of California Davis, One Shields Avenue, Davis, California, 95616, USA.
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7
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Targeting Peripherally Restricted Cannabinoid Receptor 1, Cannabinoid Receptor 2, and Endocannabinoid-Degrading Enzymes for the Treatment of Neuropathic Pain Including Neuropathic Orofacial Pain. Int J Mol Sci 2020; 21:ijms21041423. [PMID: 32093166 PMCID: PMC7073137 DOI: 10.3390/ijms21041423] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 02/06/2023] Open
Abstract
Neuropathic pain conditions including neuropathic orofacial pain (NOP) are difficult to treat. Contemporary therapeutic agents for neuropathic pain are often ineffective in relieving pain and are associated with various adverse effects. Finding new options for treating neuropathic pain is a major priority in pain-related research. Cannabinoid-based therapeutic strategies have emerged as promising new options. Cannabinoids mainly act on cannabinoid 1 (CB1) and 2 (CB2) receptors, and the former is widely distributed in the brain. The therapeutic significance of cannabinoids is masked by their adverse effects including sedation, motor impairment, addiction and cognitive impairment, which are thought to be mediated by CB1 receptors in the brain. Alternative approaches have been developed to overcome this problem by selectively targeting CB2 receptors, peripherally restricted CB1 receptors and endocannabinoids that may be locally synthesized on demand at sites where their actions are pertinent. Many preclinical studies have reported that these strategies are effective for treating neuropathic pain and produce no or minimal side effects. Recently, we observed that inhibition of degradation of a major endocannabinoid, 2-arachydonoylglycerol, can attenuate NOP following trigeminal nerve injury in mice. This review will discuss the above-mentioned alternative approaches that show potential for treating neuropathic pain including NOP.
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8
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Moore BR, Islam B, Ward S, Jackson O, Armitage R, Blackburn J, Haider S, McHugh PC. Repurposing of Tranilast for Potential Neuropathic Pain Treatment by Inhibition of Sepiapterin Reductase in the BH 4 Pathway. ACS OMEGA 2019; 4:11960-11972. [PMID: 31460307 PMCID: PMC6682008 DOI: 10.1021/acsomega.9b01228] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/26/2019] [Indexed: 05/08/2023]
Abstract
Tetrahydrobiopterin (BH4) is a cofactor in the production of various signaling molecules including nitric oxide, dopamine, adrenaline, and noradrenaline. BH4 levels are critical for processes associated with cardiovascular function, inflammation, mood, pain, and neurotransmission. Increasing pieces of evidence suggest that BH4 is upregulated in chronic pain. Sepiapterin reductase (SPR) catalyzes both the reversible reduction of sepiapterin to dihydrobiopterin (BH2) and 6-pyruvoyl-tetrahydrobiopterin to BH4 within the BH4 pathway. Therefore, inhibition of SPR by small molecules can be used to control BH4 production and ultimately alleviate chronic pain. Here, we have used various in silico and in vitro experiments to show that tranilast, licensed for use in bronchial asthma, can inhibit sepiapterin reduction by SPR. Docking and molecular dynamics simulations suggest that tranilast can bind to human SPR (hSPR) at the same site as sepiapterin including S157, one of the catalytic triad residues of hSPR. Colorimetric assays revealed that tranilast was nearly twice as potent as the known hSPR inhibitor, N-acetyl serotonin. Tranilast was able to inhibit hSPR activity both intracellularly and extracellularly in live cells. Triple quad mass spectrophotometry of cell lysates showed a proportional decrease of BH4 in cells treated with tranilast. Our results suggest that tranilast can act as a potent hSPR inhibitor and therefore is a valid candidate for drug repurposing in the treatment of chronic pain.
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Affiliation(s)
- Benjamin
J. R. Moore
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Barira Islam
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Sean Ward
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Olivia Jackson
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Rebecca Armitage
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Jack Blackburn
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Shozeb Haider
- UCL
School of Pharmacy, 29−39 Brunswick Square, London WC1N 1AX, U.K.
| | - Patrick C. McHugh
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
- E-mail: . Phone: +(44) 1484 472074. Fax: +(44) 1484 472182
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Glare P, Aubrey KR, Myles PS. Transition from acute to chronic pain after surgery. Lancet 2019; 393:1537-1546. [PMID: 30983589 DOI: 10.1016/s0140-6736(19)30352-6] [Citation(s) in RCA: 407] [Impact Index Per Article: 81.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/20/2018] [Accepted: 02/07/2019] [Indexed: 12/14/2022]
Abstract
Over the past decade there has been an increasing reliance on strong opioids to treat acute and chronic pain, which has been associated with a rising epidemic of prescription opioid misuse, abuse, and overdose-related deaths. Deaths from prescription opioids have more than quadrupled in the USA since 1999, and this pattern is now occurring globally. Inappropriate opioid prescribing after surgery, particularly after discharge, is a major cause of this problem. Chronic postsurgical pain, occurring in approximately 10% of patients who have surgery, typically begins as acute postoperative pain that is difficult to control, but soon transitions into a persistent pain condition with neuropathic features that are unresponsive to opioids. Research into how and why this transition occurs has led to a stronger appreciation of opioid-induced hyperalgesia, use of more effective and safer opioid-sparing analgesic regimens, and non-pharmacological interventions for pain management. This Series provides an overview of the epidemiology and societal effect, basic science, and current recommendations for managing persistent postsurgical pain. We discuss the advances in the prevention of this transitional pain state, with the aim to promote safer analgesic regimens to better manage patients with acute and chronic pain.
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Affiliation(s)
- Paul Glare
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Karin R Aubrey
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia; Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital, Melbourne, VIC.
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10
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Pesce M, Esposito G, Sarnelli G. Endocannabinoids in the treatment of gasytrointestinal inflammation and symptoms. Curr Opin Pharmacol 2018; 43:81-86. [PMID: 30218940 DOI: 10.1016/j.coph.2018.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/22/2018] [Indexed: 01/02/2023]
Abstract
The evolving policies regarding the use of therapeutic Cannabis have steadily increased the public interest in its use as a complementary and alternative medicine in several disorders, including inflammatory bowel disease. Endocannabinoids represent both an appealing therapeutic strategy and a captivating scientific dilemma. Results from clinical trials have to be carefully interpreted owing to possible reporting-biases related to cannabinoids psychotropic effects. Moreover, discriminating between symptomatic improvement and the real gain on the underlying inflammatory process is often challenging. This review summarizes the advances and latest discovery in this ever-changing field of investigation, highlighting the main limitations in the current use of these drugs in clinical practice and the possible future perspectives to overcome these flaws.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy; GI Physiology Unit, University College London Hospital, London, UK
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology, `Vittorio Erspamer', La Sapienza University of Rome, Rome, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy.
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11
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Brindisi M, Borrelli G, Brogi S, Grillo A, Maramai S, Paolino M, Benedusi M, Pecorelli A, Valacchi G, Di Cesare Mannelli L, Ghelardini C, Allarà M, Ligresti A, Minetti P, Campiani G, di Marzo V, Butini S, Gemma S. Development of Potent Inhibitors of Fatty Acid Amide Hydrolase Useful for the Treatment of Neuropathic Pain. ChemMedChem 2018; 13:2090-2103. [DOI: 10.1002/cmdc.201800397] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/05/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Margherita Brindisi
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Giuseppe Borrelli
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Simone Brogi
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Alessandro Grillo
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Samuele Maramai
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Marco Paolino
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Mascia Benedusi
- Department of Life Sciences and Biotechnology; University of Ferrara; Via Borsari 46 441212 Ferrara Italy
| | - Alessandra Pecorelli
- Department of Animal Science; North Carolina State University; NC Research Campus, PHHI Building, 600 Laureate Way Kannapolis NC 28081 USA
| | - Giuseppe Valacchi
- Department of Life Sciences and Biotechnology; University of Ferrara; Via Borsari 46 441212 Ferrara Italy
- Department of Animal Science; North Carolina State University; NC Research Campus, PHHI Building, 600 Laureate Way Kannapolis NC 28081 USA
| | - Lorenzo Di Cesare Mannelli
- Department of Neuroscience, Psychology; Drug Research and Child Health; Section of Pharmacology and Toxicology (NEUROFARBA); University of Florence; Viale G. Pieraccini, 6 50139 Firenze Italy
| | - Carla Ghelardini
- Department of Neuroscience, Psychology; Drug Research and Child Health; Section of Pharmacology and Toxicology (NEUROFARBA); University of Florence; Viale G. Pieraccini, 6 50139 Firenze Italy
| | - Marco Allarà
- Endocannabinoid Research Group; Institute of Biomolecular Chemistry; CNR; Via Campi Flegrei 80078 Pozzuoli (Napoli) Italy
- EPITECH Group SpA; Via Egadi 7 20144 Milano Italy
| | - Alessia Ligresti
- Endocannabinoid Research Group; Institute of Biomolecular Chemistry; CNR; Via Campi Flegrei 80078 Pozzuoli (Napoli) Italy
| | | | - Giuseppe Campiani
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Vincenzo di Marzo
- Endocannabinoid Research Group; Institute of Biomolecular Chemistry; CNR; Via Campi Flegrei 80078 Pozzuoli (Napoli) Italy
- Département de Médecine; Université Laval; 1050, Avenue de la Médecine Québec City QC G1V 0A6 Canada
| | - Stefania Butini
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
| | - Sandra Gemma
- European Research Centre for Drug Discovery and Development (NatSynDrugs); Department of Biotechnology, Chemistry, and Pharmacy (DoE 2018-2020); University of Siena; Via Aldo Moro 2 53100 Siena Italy
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12
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The endocannabinoid system of the skin. A potential approach for the treatment of skin disorders. Biochem Pharmacol 2018; 157:122-133. [PMID: 30138623 DOI: 10.1016/j.bcp.2018.08.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/16/2018] [Indexed: 12/31/2022]
Abstract
The skin is the largest organ of the body and has a complex and very active structure that contributes to homeostasis and provides the first line defense against injury and infection. In the past few years it has become evident that the endocannabinoid system (ECS) plays a relevant role in healthy and diseased skin. Specifically, we review how the dysregulation of ECS has been associated to dermatological disorders such as atopic dermatitis, psoriasis, scleroderma and skin cancer. Therefore, the druggability of the ECS could open new research avenues for the treatment of the pathologies mentioned. Numerous studies have reported that phytocannabinoids and their biological analogues modulate a complex network pharmacology involved in the modulation of ECS, focusing on classical cannabinoid receptors, transient receptor potential channels (TRPs), and peroxisome proliferator-activated receptors (PPARs). The combined targeting of several end-points seems critical to provide better chances of therapeutically success, in sharp contrast to the one-disease-one-target dogma that permeates current drug discovery campaigns.
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13
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Chidambaran V, Pilipenko V, Spruance K, Venkatasubramanian R, Niu J, Fukuda T, Mizuno T, Zhang K, Kaufman K, Vinks AA, Martin LJ, Sadhasivam S. Fatty acid amide hydrolase-morphine interaction influences ventilatory response to hypercapnia and postoperative opioid outcomes in children. Pharmacogenomics 2016; 18:143-156. [PMID: 27977335 DOI: 10.2217/pgs-2016-0147] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Fatty acid amide hydrolase (FAAH) degrades anandamide, an endogenous cannabinoid. We hypothesized that FAAH variants will predict risk of morphine-related adverse outcomes due to opioid-endocannabinoid interactions. PATIENTS & METHODS In 101 postsurgical adolescents receiving morphine analgesia, we prospectively studied ventilatory response to 5% CO2 (HCVR), respiratory depression (RD) and vomiting. Blood was collected for genotyping and morphine pharmacokinetics. RESULTS We found significant FAAH-morphine interaction for missense (rs324420) and several regulatory variants, with HCVR (p < 0.0001) and vomiting (p = 0.0339). HCVR was more depressed in patients who developed RD compared with those who did not (p = 0.0034), thus FAAH-HCVR association predicts risk of impending RD from morphine use. CONCLUSION FAAH genotypes predict risk for morphine-related adverse outcomes.
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Affiliation(s)
- Vidya Chidambaran
- Department of Anesthesia, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Valentina Pilipenko
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Kristie Spruance
- Department of Anesthesia, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Raja Venkatasubramanian
- Department of Anesthesia, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Jing Niu
- Department of Anesthesia, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA.,Division of Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Tsuyoshi Fukuda
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA.,Division of Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Tomoyuki Mizuno
- Division of Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Kejian Zhang
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Kenneth Kaufman
- Center for Autoimmune Genomics and Etiology (CAGE), Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Alexander A Vinks
- Division of Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Lisa J Martin
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA.,Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Senthilkumar Sadhasivam
- Department of Anesthesia, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
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14
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Kaur R, Sidhu P, Singh S. What failed BIA 10-2474 Phase I clinical trial? Global speculations and recommendations for future Phase I trials. J Pharmacol Pharmacother 2016; 7:120-6. [PMID: 27651707 PMCID: PMC5020770 DOI: 10.4103/0976-500x.189661] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Rimplejeet Kaur
- Department of Pharmacology, AIIMS, Jodhpur, Rajasthan, India
| | - Preeti Sidhu
- Department of Medicine, S.N. Medical College and Hospital, Jodhpur, Rajasthan, India
| | - Surjit Singh
- Department of Pharmacology, AIIMS, Jodhpur, Rajasthan, India
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15
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Clark IA, Vissel B. Excess cerebral TNF causing glutamate excitotoxicity rationalizes treatment of neurodegenerative diseases and neurogenic pain by anti-TNF agents. J Neuroinflammation 2016; 13:236. [PMID: 27596607 PMCID: PMC5011997 DOI: 10.1186/s12974-016-0708-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/30/2016] [Indexed: 02/06/2023] Open
Abstract
The basic mechanism of the major neurodegenerative diseases, including neurogenic pain, needs to be agreed upon before rational treatments can be determined, but this knowledge is still in a state of flux. Most have agreed for decades that these disease states, both infectious and non-infectious, share arguments incriminating excitotoxicity induced by excessive extracellular cerebral glutamate. Excess cerebral levels of tumor necrosis factor (TNF) are also documented in the same group of disease states. However, no agreement exists on overarching mechanism for the harmful effects of excess TNF, nor, indeed how extracellular cerebral glutamate reaches toxic levels in these conditions. Here, we link the two, collecting and arguing the evidence that, across the range of neurodegenerative diseases, excessive TNF harms the central nervous system largely through causing extracellular glutamate to accumulate to levels high enough to inhibit synaptic activity or kill neurons and therefore their associated synapses as well. TNF can be predicted from the broader literature to cause this glutamate accumulation not only by increasing glutamate production by enhancing glutaminase, but in addition simultaneously reducing glutamate clearance by inhibiting re-uptake proteins. We also discuss the effects of a TNF receptor biological fusion protein (etanercept) and the indirect anti-TNF agents dithio-thalidomides, nilotinab, and cannabinoids on these neurological conditions. The therapeutic effects of 6-diazo-5-oxo-norleucine, ceptriaxone, and riluzole, agents unrelated to TNF but which either inhibit glutaminase or enhance re-uptake proteins, but do not do both, as would anti-TNF agents, are also discussed in this context. By pointing to excess extracellular glutamate as the target, these arguments greatly strengthen the case, put now for many years, to test appropriately delivered ant-TNF agents to treat neurodegenerative diseases in randomly controlled trials.
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Affiliation(s)
- Ian A Clark
- Biomedical Sciences and Biochemistry, Research School of Biology, Australian National University, Acton, Canberra, Australian Capital Territory, 0200, Australia.
| | - Bryce Vissel
- Neurodegeneration Research Group, Garvan Institute, 384 Victoria Street, Sydney, New South Wales, 2010, Australia
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16
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Caterina MJ. TRP channel cannabinoid receptors in skin sensation, homeostasis, and inflammation. ACS Chem Neurosci 2014; 5:1107-16. [PMID: 24915599 PMCID: PMC4240254 DOI: 10.1021/cn5000919] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
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In
the skin, cannabinoid lipids, whether of endogenous or exogenous
origin, are capable of regulating numerous sensory, homeostatic, and
inflammatory events. Although many of these effects are mediated by
metabotropic cannabinoid receptors, a growing body of evidence has
revealed that multiple members of the transient receptor potential
(TRP) ion channel family can act as “ionotropic cannabinoid
receptors”. Furthermore, many of these same TRP channels are
intimately involved in cutaneous processes that include the initiation
of pain, temperature, and itch perception, the maintenance of epidermal
homeostasis, the regulation of hair follicles and sebaceous glands,
and the modulation of dermatitis. Ionotropic cannabinoid receptors
therefore represent potentially attractive targets for the therapeutic
use of cannabinoids to treat sensory and dermatological diseases.
Furthermore, the interactions between neurons and other cell types
that are mediated by cutaneous ionotropic cannabinoid receptors are
likely to be recapitulated during physiological and pathophysiological
processes in the central nervous system and elsewhere, making the
skin an ideal setting in which to dissect general complexities of
cannabinoid signaling.
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Affiliation(s)
- Michael J. Caterina
- Departments of Neurosurgery,
Biological Chemistry, and Neuroscience, Neurosurgery Pain Research
Institute, Center for Sensory Biology, Johns Hopkins School of Medicine, 725 N. Wolfe St., Baltimore, Maryland 21205, United States
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