Zhang Liping, Kline Robert H, McNearney Terry A, Johnson Michael P, Westlund Karin N
Department of Physiology, MS-508 College of Medicine, University of Kentucky, 40526-0298 Lexington, KY, USA.
Mol Pain. 2014 Nov 17;10:66. doi: 10.1186/1744-8069-10-66.
Chronic Pancreatitis (CP) is a complex and multifactorial syndrome. Many contributing factors result in development of dysfunctional pain in a significant number of patients. Drugs developed to treat a variety of pain states fall short of providing effective analgesia for patients with chronic pancreatitis, often providing minimal to partial pain relief over time with significant side effects. Recently, availability of selective pharmacological tools has enabled great advances in our knowledge of the role of the cannabinoid receptors in pathophysiology. In particular, cannabinoid receptor 2 (CB2) has emerged as an attractive target for management of chronic pain, as demonstrated in several studies with inflammatory and neuropathic preclinical pain models. In this study, the analgesic efficacy of a novel, highly selective CB2 receptor agonist, LY3038404 HCl, is investigated in a chronic pancreatitis pain model, induced with an alcohol/high fat (AHF) diet.
Rats fed the AHF diet developed visceral pain-like behaviors detectable by week 3 and reached a maximum at week 5 that persists as long as the diet is maintained. Rats with AHF induced chronic pancreatitis were treated with LY3038404 HCl (10 mg/kg, orally, twice a day for 9 days). The treated animals demonstrated significantly alleviated pain related behaviors after 3 days of dosing, including increased paw withdrawal thresholds (PWT), prolonged abdominal withdrawal latencies (ABWL), and decreased nocifensive responses to noxious 44°C hotplate stimuli. Terminal histological analysis of pancreatic tissue sections from the AHF chronic pancreatitis animals demonstrated extensive injury, including a global pancreatic gland degeneration (cellular atrophy), vacuolization (fat deposition), and fibrosis. After the LY3038404 HCl treatment, pancreatic tissue was significantly protected from severe damage and fibrosis. LY3038404 HCl affected neither open field exploratory behaviors nor dark/light box preferences as measures of higher brain and motor functions.
LY3038404 HCl, a potent CB2 receptor agonist, possesses tissue protective and analgesic properties without effects on higher brain function. Thus, activation of CB2 receptors is suggested as a potential therapeutic target for visceral inflammation and pain management.
慢性胰腺炎(CP)是一种复杂的多因素综合征。许多促成因素导致大量患者出现功能失调性疼痛。用于治疗各种疼痛状态的药物未能为慢性胰腺炎患者提供有效的镇痛效果,随着时间的推移,往往只能提供轻微到部分的疼痛缓解,且伴有明显的副作用。最近,选择性药理学工具的出现使我们对大麻素受体在病理生理学中的作用有了很大进展。特别是,大麻素受体2(CB2)已成为慢性疼痛管理的一个有吸引力的靶点,在几项炎症性和神经性临床前疼痛模型研究中得到了证实。在本研究中,在酒精/高脂肪(AHF)饮食诱导的慢性胰腺炎疼痛模型中,研究了一种新型、高度选择性的CB2受体激动剂盐酸LY3038404的镇痛效果。
喂食AHF饮食的大鼠在第3周时出现可检测到的内脏痛样行为,并在第5周达到最大值,只要维持该饮食,这种行为就会持续存在。用盐酸LY3038404(10 mg/kg,口服,每天两次,共9天)治疗AHF诱导的慢性胰腺炎大鼠。给药3天后,治疗组动物的疼痛相关行为明显减轻,包括爪部退缩阈值(PWT)增加、腹部退缩潜伏期(ABWL)延长以及对44°C有害热板刺激的伤害性反应减少。对AHF慢性胰腺炎动物的胰腺组织切片进行的终末组织学分析显示有广泛损伤,包括全胰腺腺泡变性(细胞萎缩)、空泡化(脂肪沉积)和纤维化。盐酸LY3038404治疗后,胰腺组织受到显著保护,免受严重损伤和纤维化。盐酸LY3038404对旷场探索行为和暗/明箱偏好均无影响,而这两种行为是衡量高级脑功能和运动功能的指标。
强效CB2受体激动剂盐酸LY3038404具有组织保护和镇痛特性,且对高级脑功能无影响。因此,CB2受体的激活被认为是内脏炎症和疼痛管理的一个潜在治疗靶点。