Birrell Mark A, Belvisi Maria G, Grace Megan, Sadofsky Laura, Faruqi Shoaib, Hele David J, Maher Sarah A, Freund-Michel Véronique, Morice Alyn H
Respiratory Pharmacology Group, Imperial College London, Exhibition Road, London SW7 2AZ, UK.
Am J Respir Crit Care Med. 2009 Dec 1;180(11):1042-7. doi: 10.1164/rccm.200905-0665OC. Epub 2009 Sep 3.
Cough is the most frequent reason for consultation with a family doctor, or with a general or respiratory physician. Treatment options are limited and one meta-analysis concluded that over-the-counter remedies are ineffective. There is also increasing concern about their use in children. Environmental irritants such as air pollution and cigarette smoke are thought to evoke cough by stimulating airway sensory nerves; however, how this occurs is not fully understood.
We hypothesized that the TRPA1 (transient receptor potential cation channel, subfamily A, member 1) receptor may have a role as a novel target for tussive agents given that many potential irritants have been shown to activate this channel.
We investigated the effect of TRPA1 ligands on vagal sensory nerve activity in vitro and in guinea pig and human tussive challenge models.
We demonstrated that TRPA1 agonists such as acrolein activate cloned human TRPA1 channels in HEK293 cells and also vagal sensory nerves in murine, guinea pig, and human tissues. A role for TRPA1 was confirmed, using specific inhibitors and tissue from Trpa1(-/-) gene-deleted animals. Finally, TRPA1 ligands evoked reproducible tussive responses in both a guinea pig model and normal volunteers.
This study identifies the TRPA1 receptor as a promiscuous receptor, activated by a wide range of stimuli, making it a perfect target for triggering cough and as such one of the most promising targets currently identified for the development of antitussive drugs.
咳嗽是患者咨询家庭医生、普通医生或呼吸科医生的最常见原因。治疗选择有限,一项荟萃分析得出结论,非处方药物无效。人们也越来越关注其在儿童中的使用。空气污染和香烟烟雾等环境刺激物被认为通过刺激气道感觉神经引发咳嗽;然而,其发生机制尚未完全明确。
鉴于许多潜在刺激物已被证明可激活该通道,我们推测瞬时受体电位阳离子通道A1(TRPA1)受体可能作为镇咳药的新靶点发挥作用。
我们在体外以及豚鼠和人类咳嗽激发模型中研究了TRPA1配体对迷走感觉神经活动的影响。
我们证明,丙烯醛等TRPA1激动剂可激活HEK293细胞中克隆的人类TRPA1通道,以及小鼠、豚鼠和人类组织中的迷走感觉神经。使用特异性抑制剂和Trpa1基因敲除动物的组织证实了TRPA1的作用。最后,TRPA1配体在豚鼠模型和正常志愿者中均引发了可重复的咳嗽反应。
本研究确定TRPA1受体是一种多觉型受体,可被多种刺激激活,使其成为引发咳嗽的理想靶点,也是目前确定的最有前景的镇咳药物开发靶点之一。