State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing 100850, China.
State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing 100850, China.
Eur J Pharmacol. 2018 Mar 15;823:27-34. doi: 10.1016/j.ejphar.2018.01.041. Epub 2018 Feb 4.
Neuropathic pain is among the most common and difficult-to-treat types of chronic pain and is associated with sodium channel malfunction. The sodium channel blocker ralfinamide has exhibited potent analgesic effects in several preclinical pain models and in patients with mixed neuropathic pain syndromes (Phase II trials), but it failed to ameliorate neuropathic low back pain in Phase III trials. It is unclear whether ralfinamide is effective against neuropathic pain induced by specified etiologies. In the present study, the antinociceptive effects of ralfinamide in neuropathic pain models induced by spared nerve injury and chemotherapy were compared in a gabapentin-controlled manner. The effects of ralfinamide on physiological pain were evaluated in mechanical withdrawal, hot plate, and acetic acid writhing tests. We also investigated the effects of ralfinamide on cardiovascular function and locomotor activity. Oral ralfinamide dose-dependently alleviated spared nerve injury-induced allodynia in rats and mice. Ralfinamide increased mechanical withdrawal thresholds in oxaliplatin-induced and paclitaxel-induced neuropathic pain. Ralfinamide did not affect physiological pain, locomotion, or cardiovascular function. Together, ralfinamide attenuated mechanical allodynia in all the neuropathic pain models tested, with subtle differences in efficacy. The effect of ralfinamide is comparable to that of gabapentin, but with no interference in basal mechanical sensitivity. The present study supports the effectiveness of selective sodium channel blockade as an analgesic strategy, as well as the development of compounds similar to ralfinamide.
神经病理性疼痛是最常见和最难治疗的慢性疼痛类型之一,与钠离子通道功能障碍有关。钠离子通道阻滞剂 ralfinamide 在几种临床前疼痛模型和混合神经病理性疼痛综合征患者中表现出强大的镇痛作用(II 期试验),但在 III 期试验中未能改善神经病理性腰痛。尚不清楚 ralfinamide 是否对特定病因引起的神经病理性疼痛有效。在本研究中,以加巴喷丁为对照,比较了 ralfinamide 在 spared nerve injury 和化疗诱导的神经病理性疼痛模型中的镇痛作用。在机械退缩、热板和醋酸扭体试验中评估了 ralfinamide 对生理疼痛的影响。我们还研究了 ralfinamide 对心血管功能和运动活动的影响。ralfinamide 口服剂量依赖性地减轻大鼠和小鼠 spared nerve injury 引起的痛觉过敏。ralfinamide 增加了奥沙利铂和紫杉醇诱导的神经病理性疼痛的机械退缩阈值。ralfinamide 不影响生理疼痛、运动或心血管功能。总之,ralfinamide 减轻了所有测试的神经病理性疼痛模型中的机械性痛觉过敏,疗效略有差异。ralfinamide 的作用与加巴喷丁相当,但对基础机械敏感性没有干扰。本研究支持选择性钠离子通道阻断作为一种镇痛策略的有效性,以及类似 ralfinamide 的化合物的开发。
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