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一种瞬时受体电位阳离子通道亚家族 V 成员 1 拮抗剂经皮微剂量给药对健康志愿者正常和紫外线-C 暴露皮肤热诱发疼痛和热阈值的影响。

The effect of intradermal microdosing of a transient receptor potential cation channel subfamily V member 1 antagonist on heat evoked pain and thermal thresholds in normal and ultraviolet-C exposed skin in healthy volunteers.

机构信息

Department of Pharmacy, Uppsala University, Uppsala, Sweden.

CLINTEC, Karolinska University Hospital Huddinge, Karolinska Institute, Solna, Sweden.

出版信息

Eur J Pain. 2019 Nov;23(10):1767-1779. doi: 10.1002/ejp.1451. Epub 2019 Aug 14.

Abstract

BACKGROUND

Three TRPV1 (Transient Receptor Potential Vanilloid Receptor 1) antagonists were developed for testing in situ in human skin (Sjögren et al., 2016; Sjögren et al., 2018; Sjögren et al., 2018). The first human study using these compounds and capsaicin, was performed to determine the required local antagonist concentrations needed for target engagement (Proof of Mechanism, PoM) (Sjögren et al., 2018). In this paper, the aim was to address a TRPV1 antagonist's ability to inhibit a more complex pain signal and to define translational endpoints that could be used in further drug development, when progressing orally bioavailable TRPV1 antagonists as novel analgesic medications.

METHOD

This was a single centre, placebo-controlled, clinical proof of principle (PoP) study in 25 healthy volunteers. The subjects were exposed to UV irradiation, causing a local tissue inflammation. Three different doses of AZ12048189 were administered to assess pain perception through quantitative sensory testing (QST) and erythema using Laser Doppler scanning.

RESULTS

AZ12048189 increased the warmth detection threshold (WDT) and the heat pain threshold (HPT) and decreased the intensity of supra threshold heat pain (STHP). AZ12048189 did not, however, have any significant effects as assessed using mechanical stimulation or Laser Doppler.

CONCLUSIONS

This study validated translational tools to confirm target engagement for TRPV1 antagonists; WDT, HPT and STHP have utility in this respect, after oral administration of a TRPV1 antagonist. This study also proved that TRPV1 antagonists can inhibit a more complex, non-capsaicin dependent thermally induced pain signal.

摘要

背景

为了在人体皮肤中进行原位测试,开发了三种 TRPV1(瞬时受体电位香草素受体 1)拮抗剂(Sjögren 等人,2016 年;Sjögren 等人,2018 年;Sjögren 等人,2018 年)。首次使用这些化合物和辣椒素进行的人体研究是为了确定目标结合所需的局部拮抗剂浓度(机制验证,PoM)(Sjögren 等人,2018 年)。在本文中,目的是确定 TRPV1 拮抗剂抑制更复杂疼痛信号的能力,并定义在进一步开发药物时可以使用的转化终点,当进展为口服生物利用的 TRPV1 拮抗剂作为新型镇痛药物时。

方法

这是一项在 25 名健康志愿者中进行的单中心、安慰剂对照、临床原理验证(PoP)研究。受试者暴露于紫外线辐射下,导致局部组织炎症。给予三种不同剂量的 AZ12048189,通过定量感觉测试(QST)和激光多普勒扫描评估红斑来评估疼痛感知。

结果

AZ12048189 增加了温暖感觉阈值(WDT)和热痛阈值(HPT),降低了超阈值热痛(STHP)的强度。然而,AZ12048189 在用机械刺激或激光多普勒评估时没有任何显著影响。

结论

本研究验证了转化工具,以确认 TRPV1 拮抗剂的靶标结合;在口服 TRPV1 拮抗剂后,WDT、HPT 和 STHP 在这方面具有实用性。本研究还证明 TRPV1 拮抗剂可以抑制更复杂、非辣椒素依赖性热诱导疼痛信号。

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