Trevisan Gabriela, Oliveira Sara Marchesan
Graduated Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, RS 97105-900, Brazil.
Graduated Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria (UFSM), Santa Maria, RS 97105-900, Brazil.
Curr Neuropharmacol. 2022;20(8):1579-1599. doi: 10.2174/1570159X19666210713121217.
Pain is a complex phenomenon that is usually unpleasant and aversive. It can range widely in intensity, quality, and duration and has diverse pathophysiologic mechanisms and meanings. Voltage-gated sodium and calcium channels are essential to transmitting painful stimuli from the periphery until the dorsal horn of the spinal cord. Thus, blocking voltage-gated calcium channels (VGCCs) can effectively control pain refractory to treatments currently used in the clinic, such as cancer and neuropathic pain. VGCCs blockers isolated of cobra Naja naja kaouthia (α-cobratoxin), spider Agelenopsis aperta (ω-Agatoxin IVA), spider Phoneutria nigriventer (PhTx3.3, PhTx3.4, PhTx3.5, PhTx3.6), spider Hysterocrates gigas (SNX-482), cone snails Conus geographus (GVIA), Conus magus (MVIIA or ziconotide), Conus catus (CVID, CVIE and CVIF), Conus striatus (SO- 3), Conus fulmen (FVIA), Conus moncuri (MoVIA and MoVIB), Conus regularis (RsXXIVA), Conus eburneus (Eu1.6), Conus victoriae (Vc1.1.), Conus regius (RgIA), and spider Ornithoctonus huwena (huwentoxin-I and huwentoxin-XVI) venoms caused antinociceptive effects in different acute and chronic pain models. Currently, ziconotide is the only clinical used N-type VGCCs blocker peptide for chronic intractable pain. However, ziconotide causes different adverse effects, and the intrathecal route of administration also impairs its use in a more significant number of patients. In this sense, peptides isolated from animal venoms or their synthetic forms that act by modulating or blocking VGCCs channels seem to be a relevant prototype for developing new analgesics efficacious and well tolerated by patients.
疼痛是一种复杂的现象,通常令人不适且具有厌恶感。其强度、性质和持续时间差异很大,并且具有多种病理生理机制和意义。电压门控钠通道和钙通道对于将疼痛刺激从外周传递至脊髓背角至关重要。因此,阻断电压门控钙通道(VGCCs)可有效控制目前临床所用治疗方法难治的疼痛,如癌症疼痛和神经性疼痛。从眼镜蛇舟山眼镜蛇(α - 银环蛇毒素)、蜘蛛黑寡妇蜘蛛(ω - 阿加毒素IVA)、巴西游走蛛(PhTx3.3、PhTx3.4、PhTx3.5、PhTx3.6)、巨大疣蛛(SNX - 482)、芋螺地纹芋螺(GVIA)、织锦芋螺(MVIIA或齐考诺肽)、卡氏芋螺(CVID、CVIE和CVIF)、细纹芋螺(SO - 3)、闪电芋螺(FVIA)、蒙氏芋螺(MoVIA和MoVIB)、规则芋螺(RsXXIVA)、象牙芋螺(Eu1.6)、维多利亚芋螺(Vc1.1.)、帝王芋螺(RgIA)以及虎纹捕鸟蛛(虎纹毒素 - I和虎纹毒素 - XVI)毒液中分离出的VGCCs阻滞剂在不同的急慢性疼痛模型中均产生了镇痛作用。目前,齐考诺肽是唯一临床使用的用于慢性顽固性疼痛的N型VGCCs阻滞剂肽。然而,齐考诺肽会引发不同的不良反应,并且鞘内给药途径也使更多患者无法使用该药物。从这个意义上讲,从动物毒液中分离出的肽或其合成形式,通过调节或阻断VGCCs通道发挥作用,似乎是开发新型镇痛药的相关原型,这类新型镇痛药对患者有效且耐受性良好。