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大麻素激动剂 CB-13 在小鼠中产生外周介导的镇痛作用,但在重复给药时会产生耐受性和中枢神经系统活动的迹象。

The cannabinoid agonist CB-13 produces peripherally mediated analgesia in mice but elicits tolerance and signs of central nervous system activity with repeated dosing.

机构信息

Department of Anesthesiology, Washington University Pain Center, Washington University School of Medicine, St. Louis, MO, United States.

Neuroscience Graduate Program, Division of Biology & Biomedical Sciences, Washington University School of Medicine, St. Louis, MO, United States.

出版信息

Pain. 2022 Aug 1;163(8):1603-1621. doi: 10.1097/j.pain.0000000000002550. Epub 2021 Dec 27.

Abstract

Activation of cannabinoid receptor type 1 (CB 1 ) produces analgesia in a variety of preclinical models of pain; however, engagement of central CB 1 receptors is accompanied by unwanted side effects, such as psychoactivity, tolerance, and dependence. Therefore, some efforts to develop novel analgesics have focused on targeting peripheral CB 1 receptors to circumvent central CB 1 -related side effects. In the present study, we evaluated the effects of acute and repeated dosing with the peripherally selective CB 1 -preferring agonist CB-13 on nociception and central CB 1 -related phenotypes in a model of inflammatory pain in mice. We also evaluated cellular mechanisms underlying CB-13-induced antinociception in vitro using cultured mouse dorsal root ganglion neurons. CB-13 reduced inflammation-induced mechanical allodynia in male and female mice in a peripheral CB 1 -receptor-dependent manner and relieved inflammatory thermal hyperalgesia. In cultured mouse dorsal root ganglion neurons, CB-13 reduced TRPV1 sensitization and neuronal hyperexcitability induced by the inflammatory mediator prostaglandin E 2 , providing potential mechanistic explanations for the analgesic actions of peripheral CB 1 receptor activation. With acute dosing, phenotypes associated with central CB 1 receptor activation occurred only at a dose of CB-13 approximately 10-fold the ED 50 for reducing allodynia. Strikingly, repeated dosing resulted in both analgesic tolerance and CB 1 receptor dependence, even at a dose that did not produce central CB 1 -receptor-mediated phenotypes on acute dosing. This suggests that repeated CB-13 dosing leads to increased CNS exposure and unwanted engagement of central CB 1 receptors. Thus, caution is warranted regarding therapeutic use of CB-13 with the goal of avoiding CNS side effects. Nonetheless, the clear analgesic effect of acute peripheral CB 1 receptor activation suggests that peripherally restricted cannabinoids are a viable target for novel analgesic development.

摘要

大麻素受体 1 型(CB1)的激活可在多种疼痛的临床前模型中产生镇痛作用;然而,中枢 CB1 受体的参与伴随着不良的副作用,如精神活性、耐受性和依赖性。因此,一些开发新型镇痛药的努力集中在靶向外周 CB1 受体以避免与中枢 CB1 相关的副作用。在本研究中,我们评估了外周选择性 CB1 优先激动剂 CB-13 在炎性疼痛小鼠模型中急性和重复给药对痛觉和中枢 CB1 相关表型的影响。我们还评估了体外培养的小鼠背根神经节神经元中 CB-13 诱导镇痛的细胞机制。CB-13 以外周 CB1 受体依赖性方式减轻雄性和雌性小鼠炎症引起的机械性痛觉过敏,并缓解炎症性热痛觉过敏。在体外培养的小鼠背根神经节神经元中,CB-13 减少了炎症介质前列腺素 E2 引起的 TRPV1 敏化和神经元过度兴奋,为外周 CB1 受体激活的镇痛作用提供了潜在的机制解释。急性给药时,仅在 CB-13 剂量约为减轻痛觉过敏的 ED50 的 10 倍时,才会出现与中枢 CB1 受体激活相关的表型。引人注目的是,重复给药导致镇痛耐受和 CB1 受体依赖性,即使在急性给药时不会产生中枢 CB1 受体介导的表型的剂量下也是如此。这表明重复 CB-13 给药会导致 CNS 暴露增加和中枢 CB1 受体的意外参与。因此,在避免 CNS 副作用的情况下,使用 CB-13 进行治疗时需要谨慎。尽管如此,急性外周 CB1 受体激活的明确镇痛作用表明,限制在周围的大麻素是新型镇痛药物开发的可行目标。

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