Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, United States.
Neuroscience Drug Discovery, Ionis Pharmaceuticals, Carlsbad, CA 92010, United States.
Brain Behav Immun. 2018 Aug;72:34-44. doi: 10.1016/j.bbi.2017.11.007. Epub 2017 Nov 8.
p38 mitogen-activated protein kinase (MAPK) consists of two major isoforms: p38α and p38β; however, it remains unclear which isoform is more important for chronic pain development. Recently, we developed potent, long-lasting, and p38 MAPK subtype-specific antisense oligonucleotides (ASOs). We examined the therapeutic effects of isoform-specific ASOs in several chronic pain models following single intrathecal injection (300 μg/10 μl) in CD1 mice. In the chronic constriction injury (CCI) model, p38α MAPK ASO, given on post-operative day 5, reduced CCI-induced mechanical allodynia in male but not female mice. In contrast, mechanical allodynia after CCI in both sexes was not affected by p38β MAPK ASO. Intrathecal injection of p38α or p38β ASO resulted in a partial reduction (≈ 50%) of spinal p38α or p38β mRNA level, respectively, in both sexes at two weeks. In contrast, intrathecal injection of the ASOs did not affect p38α and p38β MAPK mRNA levels in dorsal root ganglia. Intrathecal p38α ASO also reduced postoperative pain (mechanical and cold allodynia) in male mice after tibia fracture. However, intrathecal p38α ASO had no effect on mechanical allodynia in male mice after paclitaxel treatment. Intrathecal p38α MAPK ASO pre-treatment also prevented TLR4-mediated mechanical allodynia and downregulated levels of p38α MAPK and phosphorylated p38 MAPK following intrathecal treatment of lipopolysaccharide. In summary, our findings suggest that p38α MAPK is the major p38 MAPK isoform in the spinal cord and regulates chronic pain in a sex and model-dependent manner. Intrathecal p38α MAPK ASO may offer a new treatment for some chronic pain conditions.
p38 丝裂原活化蛋白激酶 (MAPK) 由两个主要亚型组成:p38α 和 p38β;然而,哪种亚型对慢性疼痛的发展更为重要仍不清楚。最近,我们开发了强效、持久且具有 p38 MAPK 亚型特异性的反义寡核苷酸 (ASO)。我们在 CD1 小鼠鞘内注射(300μg/10μl)后,在几种慢性疼痛模型中检查了亚型特异性 ASO 的治疗效果。在慢性缩窄性损伤 (CCI) 模型中,p38α MAPK ASO 在术后第 5 天给予时,可减轻雄性而非雌性小鼠 CCI 诱导的机械性痛觉过敏。相比之下,CCI 后两性的机械性痛觉过敏均不受 p38β MAPK ASO 的影响。鞘内注射 p38α 或 p38β ASO 可使两性的脊髓 p38α 或 p38β mRNA 水平分别在两周内降低约 50%。相比之下,鞘内注射 ASO 不会影响背根神经节中 p38α 和 p38β MAPK mRNA 水平。鞘内 p38α ASO 还可减轻雄性小鼠胫骨骨折术后的疼痛(机械性和冷痛觉过敏)。然而,鞘内 p38α ASO 对紫杉醇治疗后雄性小鼠的机械性痛觉过敏没有影响。鞘内 p38α MAPK ASO 预处理还可防止 TLR4 介导的机械性痛觉过敏,并下调鞘内给予脂多糖后 p38α MAPK 和磷酸化 p38α MAPK 的水平。综上所述,我们的研究结果表明,p38α MAPK 是脊髓中主要的 p38 MAPK 亚型,以性别和模型依赖的方式调节慢性疼痛。鞘内 p38α MAPK ASO 可能为某些慢性疼痛疾病提供新的治疗方法。
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