Université Clermont Auvergne, INSERM, CHU, NEURO-DOL Basics & Clinical Pharmacology of Pain, F-63000 Clermont-Ferrand, France.
ANALGESIA Institute, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France.
Br J Pharmacol. 2019 Apr;176(7):950-963. doi: 10.1111/bph.14608. Epub 2019 Mar 11.
Abdominal pain associated with low-grade inflammation is frequently encountered in irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) during remission. Current treatments are not very effective and new therapeutic approaches are needed. The role of Ca 3.2 channels, which are important in other chronic pain contexts, was investigated in a murine model of colonic hypersensitivity (CHS) associated with low-grade inflammation.
Low doses of dextran sulfate sodium (DSS; 0.5%) were chronically administered to C57BL/6j mice in drinking water. Their inflammatory state was assessed by systemic and local measures of IL-6, myeloperoxidase, and lipocalin-2 using elisa. Colonic sensitivity was evaluated by the visceromotor responses to colorectal distension. Functional involvement of Ca 3.2 channels was assessed with different pharmacological (TTA-A2, ABT-639, and ethosuximide) and genetic tools.
DSS induced low-grade inflammation associated with CHS in mice. Genetic or pharmacological inhibition of Ca 3.2 channels reduced CHS. Cav3.2 channel deletion in primary nociceptive neurons in dorsal root ganglia (Ca 3.2 KO mice) suppressed CHS. Spinal, but not systemic, administration of ABT-639, a peripherally acting T-type channel blocker, reduced CHS. ABT-639 given intrathecally to Ca 3.2 KO mice had no effect, demonstrating involvement of Ca 3.2 channels located presynaptically in afferent fibre terminals. Finally, ethosuximide, which is a T-type channel blocker used clinically, reduced CHS.
These results suggest that ethosuximide represents a promising drug reposition strategy and that inhibition of Ca 3.2 channels is an attractive therapeutic approach for relieving CHS in IBS or IBD.
在缓解期的肠易激综合征(IBS)和炎症性肠病(IBD)中,常伴有低度炎症的腹痛。目前的治疗方法不是很有效,需要新的治疗方法。在与低度炎症相关的结肠高敏性(CHS)的小鼠模型中,研究了在其他慢性疼痛情况下起重要作用的 Ca 3.2 通道的作用。
在饮用水中,给 C57BL/6j 小鼠慢性给予低剂量的葡聚糖硫酸钠(DSS;0.5%)。通过酶联免疫吸附试验(ELISA),使用全身和局部测量白细胞介素 6(IL-6)、髓过氧化物酶和脂钙蛋白-2 来评估其炎症状态。通过对直肠扩张的内脏运动反应来评估结肠敏感性。使用不同的药理学(TTA-A2、ABT-639 和 ethosuximide)和遗传工具来评估 Ca 3.2 通道的功能参与。
DSS 在小鼠中诱导了与 CHS 相关的低度炎症。Ca 3.2 通道的遗传或药理学抑制可减少 CHS。在背根神经节(Ca 3.2 KO 小鼠)的初级伤害性神经元中删除 Cav3.2 通道可抑制 CHS。ABT-639 鞘内给药(一种外周作用的 T 型通道阻滞剂),而不是全身给药,可减少 CHS。ABT-639 鞘内给予 Ca 3.2 KO 小鼠无作用,表明 Ca 3.2 通道位于传入纤维末端的突触前。最后,ethosuximide 是一种临床上使用的 T 型通道阻滞剂,可减少 CHS。
这些结果表明,ethosuximide 代表了一种有前途的药物再定位策略,抑制 Ca 3.2 通道是缓解 IBS 或 IBD 中 CHS 的一种有吸引力的治疗方法。