Centre for Integrated Preclinical Drug Development, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany.
Clin Exp Pharmacol Physiol. 2020 Dec;47(12):1912-1922. doi: 10.1111/1440-1681.13383. Epub 2020 Aug 4.
Chronic mechanical low back pain (cLBP) is a leading cause of disability and a major socio-economic burden internationally. The lifetime prevalence of non-specific LBP is approximately 84%, with the prevalence of cLBP at about 23%. Clinically available analgesic/adjuvant medications often provide inadequate pain relief in patients experiencing cLBP. Hence, the urgency for discovery of effective and better tolerated medications. Fourteen days after the induction of five shallow annular punctures (5X) in the lumbar intervertebral discs at L4/L5 and L5/L6 in male Sprague-Dawley rats, mechanical hyperalgesia was fully developed in the lumbar axial deep tissues at L4/L5 (primary) and L1 (secondary). Importantly, mechanical allodynia in the hindpaws was absent. From day 28, we assessed the face validity of our mild to moderate LBP-5X rat model using four clinically available analgesic/adjuvant drugs, namely gabapentin, morphine, meloxicam and amitriptyline relative to vehicle. Additionally, the anti-hyperalgesic effects of J-2156, a highly selective small molecule somatostatin type 4 receptor agonist was assessed. Single i.p. bolus doses of gabapentin and meloxicam at the highest doses tested (100 and 30 mg/kg, respectively) alleviated secondary hyperalgesia (L1) but not primary hyperalgesia (L4/5). Morphine at 1 mg/kg alleviated both primary and secondary hyperalgesia in these tissues, whereas amitriptyline at the doses tested, lacked efficacy. These findings attest to the face validity of our model. J-2156 at 10 and 30 mg/kg alleviated secondary hyperalgesia in the lumbar axial deep tissues at L1 with a non-significant trend for relief of primary hyperalgesia in the corresponding tissues at L4/L5 in these animals.
慢性机械性下背痛(cLBP)是国际上导致残疾和主要社会经济负担的主要原因。非特异性 LBP 的终生患病率约为 84%,cLBP 的患病率约为 23%。临床上可用的镇痛/辅助药物在患有 cLBP 的患者中常常提供不足的疼痛缓解。因此,迫切需要发现有效且更耐受的药物。在雄性 Sprague-Dawley 大鼠的 L4/L5 和 L5/L6 腰椎间盘进行五次浅层环形穿刺(5X)诱导后 14 天,L4/L5(原发性)和 L1(继发性)的腰椎轴向深部组织出现完全发展的机械性痛觉过敏。重要的是,后足的机械性感觉过敏不存在。从第 28 天开始,我们使用四种临床上可用的镇痛/辅助药物,即加巴喷丁、吗啡、美洛昔康和阿米替林相对于载体,评估我们的轻度至中度 LBP-5X 大鼠模型的表面效度。此外,还评估了高度选择性的小分子生长抑素 4 型受体激动剂 J-2156 的抗痛觉过敏作用。在最高测试剂量(分别为 100 和 30mg/kg)下,单次腹腔内推注加巴喷丁和美洛昔康可缓解继发性痛觉过敏(L1),但不能缓解原发性痛觉过敏(L4/5)。1mg/kg 的吗啡可缓解这些组织中的原发性和继发性痛觉过敏,而在测试剂量下的阿米替林缺乏疗效。这些发现证明了我们模型的表面效度。J-2156 在 10 和 30mg/kg 时可缓解 L1 腰椎轴向深部组织的继发性痛觉过敏,在这些动物的相应 L4/L5 组织中,原发性痛觉过敏有缓解的非显著性趋势。