Cenac N, Castro M, Desormeaux C, Colin P, Sie M, Ranger M, Vergnolle N
INSERM U1043, Toulouse, France.
CNRS U5282, Toulouse, France.
Eur J Pain. 2016 May;20(5):723-30. doi: 10.1002/ejp.798. Epub 2015 Nov 6.
Trimebutine maleate, a noncompetitive spasmolytic agent with some affinity for peripheral μ- and κ-opioid receptors has been evaluated as a treatment in a limited number of patients undergoing sedation-free full colonoscopy. The efficiency of such treatment was comparable to sedation-based colonoscopies to relieve from pain and discomfort.
A new and improved trimebutine salt capable of releasing in vivo hydrogen sulphide (H2S), a gaseous mediator known to reduce nociception, has been developed. This drug salt (GIC-1001) is composed of trimebutine bearing a H2S-releasing counterion (3-thiocarbamoylbenzoate, 3TCB), the latter having the ability to release H2S. GIC-1001 has been tested here in a mouse model of colorectal distension.
In mice, while orally given trimebutine (the maleate salt, non-H2 S-releaser) only slightly reduced the nociceptive response to increasing pressures of colorectal distension, oral administration of GIC-1001 (the H2S-releaser) was able to significantly reduce nociceptive response to all noxious stimuli, in a dose-dependent manner. This effect of GIC-1001 was significantly better than the effects of its parent compound trimebutine administered at equimolar doses.
Taken together, these results demonstrated increased antinociceptive properties for GIC-1001 compared to trimebutine, suggesting that this compound would be a better option to relieve from visceral pain and discomfort induced by lumenal distension.
马来酸曲美布汀是一种对外周μ-和κ-阿片受体具有一定亲和力的非竞争性解痉剂,已在少数接受无镇静全结肠镜检查的患者中进行了治疗评估。这种治疗的效果与基于镇静的结肠镜检查相当,可缓解疼痛和不适。
已开发出一种新型改良的曲美布汀盐,其能够在体内释放硫化氢(H₂S),硫化氢是一种已知可减轻伤害感受的气体介质。这种药物盐(GIC-1001)由带有释放H₂S抗衡离子(3-硫代氨基甲酰苯甲酸酯,3TCB)的曲美布汀组成,后者具有释放H₂S的能力。GIC-1001已在此处的结直肠扩张小鼠模型中进行了测试。
在小鼠中,口服曲美布汀(马来酸盐,非H₂S释放剂)仅略微降低了对逐渐增加的结直肠扩张压力的伤害感受反应,而口服GIC-1001(H₂S释放剂)能够以剂量依赖性方式显著降低对所有有害刺激的伤害感受反应。GIC-1001的这种效果明显优于等摩尔剂量给药的母体化合物曲美布汀的效果。
综上所述,这些结果表明GIC-1001与曲美布汀相比具有增强的抗伤害感受特性,表明该化合物将是缓解管腔扩张引起的内脏疼痛和不适的更好选择。