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Gomez K, Santiago U, Nelson TS, Allen HN, Calderon-Rivera A, Hestehave S, Rodríguez Palma EJ, Zhou Y, Duran P, Loya-Lopez S, Zhu E, Kumar U, Shields R, Koseli E, McKiver B, Giuvelis D, Zuo W, Inyang KE, Dorame A, Chefdeville A, Ran D, Perez-Miller S, Lu Y, Liu X, Handoko, Arora PS, Patek M, Moutal A, Khanna M, Hu H, Laumet G, King T, Wang J, Damaj MI, Korczeniewska OA, Camacho CJ, Khanna R. A peptidomimetic modulator of the Ca V2.2 N-type calcium channel for chronic pain. Proc Natl Acad Sci U S A 2023; 120:e2305215120. [PMID: 37972067 PMCID: PMC10666126 DOI: 10.1073/pnas.2305215120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023] Open
Abstract
Transmembrane Cav2.2 (N-type) voltage-gated calcium channels are genetically and pharmacologically validated, clinically relevant pain targets. Clinical block of Cav2.2 (e.g., with Prialt/Ziconotide) or indirect modulation [e.g., with gabapentinoids such as Gabapentin (GBP)] mitigates chronic pain but is encumbered by side effects and abuse liability. The cytosolic auxiliary subunit collapsin response mediator protein 2 (CRMP2) targets Cav2.2 to the sensory neuron membrane and regulates their function via an intrinsically disordered motif. A CRMP2-derived peptide (CBD3) uncouples the Cav2.2-CRMP2 interaction to inhibit calcium influx, transmitter release, and pain. We developed and applied a molecular dynamics approach to identify the A1R2 dipeptide in CBD3 as the anchoring Cav2.2 motif and designed pharmacophore models to screen 27 million compounds on the open-access server ZincPharmer. Of 200 curated hits, 77 compounds were assessed using depolarization-evoked calcium influx in rat dorsal root ganglion neurons. Nine small molecules were tested electrophysiologically, while one (CBD3063) was also evaluated biochemically and behaviorally. CBD3063 uncoupled Cav2.2 from CRMP2, reduced membrane Cav2.2 expression and Ca2+ currents, decreased neurotransmission, reduced fiber photometry-based calcium responses in response to mechanical stimulation, and reversed neuropathic and inflammatory pain across sexes in two different species without changes in sensory, sedative, depressive, and cognitive behaviors. CBD3063 is a selective, first-in-class, CRMP2-based peptidomimetic small molecule, which allosterically regulates Cav2.2 to achieve analgesia and pain relief without negative side effect profiles. In summary, CBD3063 could potentially be a more effective alternative to GBP for pain relief.
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Affiliation(s)
- Kimberly Gomez
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Ulises Santiago
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, PA15261
| | - Tyler S. Nelson
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Heather N. Allen
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Aida Calderon-Rivera
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Sara Hestehave
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Erick J. Rodríguez Palma
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Yuan Zhou
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ85724
| | - Paz Duran
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Santiago Loya-Lopez
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Elaine Zhu
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY10016
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY10016
| | - Upasana Kumar
- Department of Diagnostic Sciences, Center for Orofacial Pain and Temporomandibular Disorders, Rutgers School of Dental Medicine, Newark, NJ07101
| | - Rory Shields
- Rutgers School of Graduate Studies, Newark Health Science Campus, Newark, NJ07101
| | - Eda Koseli
- Department of Pharmacology and Toxicology and Translational Research Initiative for Pain and Neuropathy, Virginia Commonwealth University, Richmond, VA23298
| | - Bryan McKiver
- Department of Pharmacology and Toxicology and Translational Research Initiative for Pain and Neuropathy, Virginia Commonwealth University, Richmond, VA23298
| | - Denise Giuvelis
- Department of Biomedical Sciences, College of Osteopathic Medicine, Center for Excellence in the Neurosciences, University of New England, Biddeford, ME04005
| | - Wanhong Zuo
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ07103
| | | | - Angie Dorame
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ85724
| | - Aude Chefdeville
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ85724
| | - Dongzhi Ran
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing400016, China
| | - Samantha Perez-Miller
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Yi Lu
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing400016, China
| | - Xia Liu
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing400016, China
| | - Handoko
- Department of Chemistry, New York University, New York, NY10003
| | | | - Marcel Patek
- Bright Rock Path Limited Liability Company, Tucson, AZ85724
| | - Aubin Moutal
- Department of Pharmacology and Physiology, School of Medicine, St. Louis University, St. Louis, MO63104
| | - May Khanna
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
| | - Huijuan Hu
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ07103
| | - Geoffroy Laumet
- Department of Physiology, Michigan State University, East Lansing, MI48824
| | - Tamara King
- Department of Biomedical Sciences, College of Osteopathic Medicine, Center for Excellence in the Neurosciences, University of New England, Biddeford, ME04005
| | - Jing Wang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY10016
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY10016
- Department of Neuroscience and Physiology and Neuroscience Institute, School of Medicine, New York University, New York, NY10010
| | - M. Imad Damaj
- Department of Pharmacology and Toxicology and Translational Research Initiative for Pain and Neuropathy, Virginia Commonwealth University, Richmond, VA23298
| | - Olga A. Korczeniewska
- Department of Diagnostic Sciences, Center for Orofacial Pain and Temporomandibular Disorders, Rutgers School of Dental Medicine, Newark, NJ07101
- Rutgers School of Graduate Studies, Newark Health Science Campus, Newark, NJ07101
| | - Carlos J. Camacho
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, PA15261
| | - Rajesh Khanna
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY10010
- New York University Pain Research Center, New York, NY10010
- Department of Neuroscience and Physiology and Neuroscience Institute, School of Medicine, New York University, New York, NY10010
- Chemical, and Biomolecular Engineering Department, Tandon School of Engineering, New York University, New York City, NY11201
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