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