Hydra Biosciences, Cambridge, MA, USA.
Clinical Laboratories, Baptist Medical Center, Jacksonville, FL, USA.
Br J Pharmacol. 2018 Jun;175(12):2185-2203. doi: 10.1111/bph.14044. Epub 2017 Nov 6.
Control of chronic pain is frequently inadequate and/or associated with intolerable adverse effects, prompting a frantic search for new therapeutics and new therapeutic targets. Nearly two decades of preclinical and clinical research supports the involvement of transient receptor potential (TRP) channels in temperature perception, nociception and sensitization. Although there has been considerable excitement around the therapeutic potential of this channel family since the cloning and identification of TRPV1 cation channels as the capsaicin receptor more than 20 years ago, only modulators of a few channels have been tested clinically. TRPV1 channel antagonists have suffered from side effects related to the channel's role in temperature sensation; however, high dose formulations of capsaicin have reached the market and shown therapeutic utility. A number of potent, small molecule antagonists of TRPA1 channels have recently advanced into clinical trials for the treatment of inflammatory and neuropathic pain, and TRPM8 antagonists are following closely behind for cold allodynia. TRPV3, TRPV4, TRPM2 and TRPM3 channels have also been of significant interest. This review discusses the preclinical promise and status of novel analgesic agents that target TRP channels and the challenges that these compounds may face in development and clinical practice.
This article is part of a themed section on Recent Advances in Targeting Ion Channels to Treat Chronic Pain. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.12/issuetoc.
慢性疼痛的控制常常不充分和/或伴有无法忍受的不良反应,这促使人们疯狂地寻找新的治疗方法和新的治疗靶点。近二十年来的临床前和临床研究支持瞬时受体电位(TRP)通道参与温度感知、伤害感受和敏化。尽管自从二十多年前克隆和鉴定 TRPV1 阳离子通道作为辣椒素受体以来,该通道家族的治疗潜力引起了相当大的兴奋,但只有少数几种通道的调节剂在临床上进行了测试。TRPV1 通道拮抗剂因该通道在温度感觉中的作用而遭受与副作用相关的困扰;然而,高剂量的辣椒素配方已进入市场并显示出治疗效果。最近,一些有效的小分子 TRPA1 通道拮抗剂已进入临床试验,用于治疗炎症性和神经性疼痛,TRPM8 拮抗剂也紧随其后用于治疗冷感觉过敏。TRPV3、TRPV4、TRPM2 和 TRPM3 通道也引起了极大的兴趣。这篇综述讨论了靶向 TRP 通道的新型镇痛剂的临床前前景和现状,以及这些化合物在开发和临床实践中可能面临的挑战。
本文是关于靶向离子通道治疗慢性疼痛的最新进展的专题部分的一部分。要查看本部分中的其他文章,请访问 http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.12/issuetoc.