IRCCS Neuromed, 86077 Pozzilli, Italy.
Department of Physiology and Pharmacology, Sapienza University, 00185 Rome, Italy.
Int J Mol Sci. 2022 Jul 20;23(14):8018. doi: 10.3390/ijms23148018.
Breakthrough cancer pain (BTcP) refers to a sudden and transient exacerbation of pain, which develops in patients treated with opioid analgesics. Fast-onset analgesia is required for the treatment of BTcP. Light-activated drugs offer a novel potential strategy for the rapid control of pain without the typical adverse effects of systemic analgesic drugs. mGlu5 metabotropic glutamate receptor antagonists display potent analgesic activity, and light-induced activation of one of these compounds (JF-NP-26) in the thalamus was found to induce analgesia in models of inflammatory and neuropathic pain. We used an established mouse model of BTcP based on the injection of cancer cells into the femur, followed, 16 days later, by systemic administration of morphine. BTcP was induced by injection of endothelin-1 (ET-1) into the tumor, 20 min after morphine administration. Mice were implanted with optic fibers delivering light in the visible spectrum (405 nm) in the thalamus or prelimbic cortex to locally activate systemically injected JF-NP-26. Light delivery in the thalamus caused rapid and substantial analgesia, and this effect was specific because light delivery in the prelimbic cortex did not relieve BTcP. This finding lays the groundwork for the use of optopharmacology in the treatment of BTcP.
突破性癌痛 (BTcP) 是指在接受阿片类镇痛药治疗的患者中突然出现的短暂性疼痛加剧。BTcP 的治疗需要快速起效的镇痛药物。光激活药物为快速控制疼痛提供了一种新的潜在策略,而不会产生全身镇痛药物的典型不良反应。代谢型谷氨酸受体 5 (mGlu5) 别构谷氨酸受体拮抗剂具有很强的镇痛活性,研究发现,在丘脑内光诱导激活其中一种化合物 (JF-NP-26) 可在炎症和神经病理性疼痛模型中诱导镇痛。我们使用了一种基于将癌细胞注射到股骨中的已建立的 BTcP 小鼠模型,16 天后,通过系统给予吗啡。BTcP 通过在吗啡给药后 20 分钟向肿瘤内注射内皮素-1 (ET-1) 来诱导。将光纤植入小鼠丘脑或额前皮质,用可见光谱 (405nm) 的光来局部激活系统注射的 JF-NP-26。丘脑内的光传递可迅速产生显著的镇痛作用,并且这种作用是特异性的,因为额前皮质内的光传递不能缓解 BTcP。这一发现为光药理学在 BTcP 治疗中的应用奠定了基础。