Neuropharmacology Lab, Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain.
Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
Br J Pharmacol. 2019 Oct;176(20):3939-3955. doi: 10.1111/bph.14794. Epub 2019 Sep 12.
Osteoarthritic pain is a chronic disabling condition lacking effective treatment. Continuous use of opioid drugs during osteoarthritic pain induces tolerance and may result in dose escalation and abuse. Sigma-1 (σ1) receptors, a chaperone expressed in key areas for pain control, modulates μ-opioid receptor activity and represents a promising target to tackle these problems. The present study investigates the efficacy of the σ1 receptor antagonist E-52862 to inhibit pain sensitization, morphine tolerance, and associated electrophysiological and molecular changes in a murine model of osteoarthritic pain.
Mice received an intra-knee injection of monoiodoacetate followed by 14-day treatment with E-52862, morphine, or vehicle, and mechanical sensitivity was assessed before and after the daily doses.
Monoiodoacetate-injected mice developed persistent mechanical hypersensitivity, which was dose-dependently inhibited by E-52862. Mechanical thresholds assessed before the daily E-52862 dose showed gradual recovery, reaching complete restoration by the end of the treatment. When repeated treatment started 15 days after knee injury, E-52862 produced enhanced short-term analgesia, but recovery to baseline threshold was slower. Both a σ1 receptor agonist and a μ receptor antagonist blocked the analgesic effects of E-52862. An acute, sub-effective dose of E-52862 restored morphine analgesia in opioid-tolerant mice. Moreover, E-52862 abolished spinal sensitization in osteoarthritic mice and inhibited pain-related molecular changes.
These findings show dual effects of σ1 receptor antagonism alleviating both short- and long-lasting antinociception during chronic osteoarthritis pain. They identify E-52862 as a promising pharmacological agent to treat chronic pain and avoid opioid tolerance.
骨关节炎疼痛是一种慢性致残性疾病,缺乏有效治疗方法。在骨关节炎疼痛期间持续使用阿片类药物会导致耐受,并可能导致剂量增加和滥用。σ1(σ1)受体是在疼痛控制的关键区域表达的伴侣蛋白,调节μ-阿片受体活性,代表了解决这些问题的有前途的靶点。本研究调查了 σ1 受体拮抗剂 E-52862 抑制骨关节炎疼痛模型中疼痛敏化、吗啡耐受以及相关电生理和分子变化的疗效。
小鼠膝关节内注射单碘乙酸后,用 E-52862、吗啡或载体治疗 14 天,并在每日剂量前后评估机械敏感性。
单碘乙酸注射小鼠产生持续的机械性超敏反应,E-52862 呈剂量依赖性抑制。在每日 E-52862 剂量前评估的机械阈值逐渐恢复,在治疗结束时完全恢复。膝关节损伤 15 天后重复治疗开始时,E-52862 产生增强的短期镇痛作用,但恢复到基线阈值的速度较慢。σ1 受体激动剂和 μ 受体拮抗剂均阻断了 E-52862 的镇痛作用。单次、亚有效剂量的 E-52862 恢复了吗啡耐受小鼠的镇痛作用。此外,E-52862 消除了骨关节炎小鼠的脊髓敏化,并抑制了与疼痛相关的分子变化。
这些发现表明 σ1 受体拮抗作用具有双重作用,可缓解慢性骨关节炎疼痛期间的短期和长期镇痛作用。它们确定 E-52862 是一种有前途的治疗慢性疼痛和避免阿片类药物耐受的药物。