脂肪酸酰胺水解酶(FAAH)抑制剂对HIV感觉神经病变大鼠模型中持续性疼痛相关行为的缓解作用
Attenuation of persistent pain-related behavior by fatty acid amide hydrolase (FAAH) inhibitors in a rat model of HIV sensory neuropathy.
作者信息
Nasirinezhad Farinaz, Jergova Stanislava, Pearson James P, Sagen Jacqueline
机构信息
The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA.
Ironwood Pharmaceuticals, Inc., Cambridge, MA, USA.
出版信息
Neuropharmacology. 2015 Aug;95:100-9. doi: 10.1016/j.neuropharm.2014.11.024. Epub 2014 Dec 5.
Distal sensory neuropathies are a hallmark of HIV infections and can result in persistent and disabling pain despite advances in antiretroviral therapies. HIV-sensory neuropathic (HIV-SN) pain may be amenable to cannabinoid treatment, but currently available agonist treatments are limited by untoward side effects and potential for abuse in this patient population. Fatty acid amide hydrolase (FAAH) inhibitors may offer an alternative approach by inhibiting the degradation of endocannabinoids with purportedly fewer untoward CNS side effects. In order to evaluate this potential approach in the management of HIV-SN pain, the recombinant HIV envelope protein gp120 was applied epineurally to the rat sciatic nerve to induce an HIV-SN-like pain syndrome. Two distinct FAAH inhibitory compounds, URB597 and PF-3845 were tested, and contrasted with standard antinociceptive gabapentin or vehicle treatment, for attenuation of tactile allodynia, cold allodynia, and mechanical hyperalgesia. Both FAAH inhibitors markedly reduced cold and tactile allodynia with limited anti-hyperalgesic effects. Peak antinociceptive effects produced by both agents were more modest than gabapentin in reducing tactile allodynia with similar potency ranges. URB597 produced comparable cold anti-allodynic effects to gabapentin, and the effects of both FAAH inhibitors were longer lasting than gabapentin. To assess the contribution of cannabinoid receptors in these antinociceptive effects, CB1 antagonist AM251 or CB2 antagonist SR144528 were tested in conjunction with FAAH inhibitors. Results suggested a contribution of both CB1- and CB2-mediated effects, particularly in reducing tactile allodynia. In summary, these findings support inhibition of endocannabinoid degradation as a promising target for management of disabling persistent HIV-SN pain syndromes.
远端感觉神经病是HIV感染的一个标志,尽管抗逆转录病毒疗法取得了进展,但仍可能导致持续且致残的疼痛。HIV感觉神经性(HIV-SN)疼痛可能适合用大麻素治疗,但目前可用的激动剂治疗受到该患者群体中不良副作用和滥用可能性的限制。脂肪酸酰胺水解酶(FAAH)抑制剂可能提供一种替代方法,通过抑制内源性大麻素的降解,据称其对中枢神经系统的不良副作用较少。为了评估这种潜在方法在治疗HIV-SN疼痛中的作用,将重组HIV包膜蛋白gp120经神经外膜应用于大鼠坐骨神经,以诱导类似HIV-SN的疼痛综合征。测试了两种不同的FAAH抑制化合物URB597和PF-3845,并与标准抗伤害感受药物加巴喷丁或赋形剂治疗进行对比,以减轻触觉异常性疼痛、冷异常性疼痛和机械性痛觉过敏。两种FAAH抑制剂均显著减轻了冷和触觉异常性疼痛,抗痛觉过敏作用有限。在减轻触觉异常性疼痛方面,两种药物产生的最大抗伤害感受作用比加巴喷丁更适度,效力范围相似。URB597产生的冷抗异常性疼痛作用与加巴喷丁相当,两种FAAH抑制剂的作用持续时间均比加巴喷丁长。为了评估大麻素受体在这些抗伤害感受作用中的贡献,将CB1拮抗剂AM251或CB2拮抗剂SR144528与FAAH抑制剂联合测试。结果表明CB1和CB2介导的作用均有贡献,特别是在减轻触觉异常性疼痛方面。总之,这些发现支持抑制内源性大麻素降解作为治疗致残性持续性HIV-SN疼痛综合征的一个有前景的靶点。
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