Department of Medical Science, Graduate School, Chungnam National University, Daejeon 35015, Republic of Korea; Department of Physiology, College of Medicine and Brain Research Institute, Chungnam National University, Daejeon 35015, Republic of Korea; Department of Histo-Pathology, Hai Phong University of Medicine & Pharmacy, Hai Phong 042-12, Vietnam.
Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea.
J Pain. 2022 Dec;23(12):2092-2109. doi: 10.1016/j.jpain.2022.07.010. Epub 2022 Aug 5.
MAO-B inhibitors have been implicated to reverse neuropathic pain behaviors. Our previous study has demonstrated that KDS2010 (KDS), a newly developed reversible MAO-B inhibitor, could attenuate Paclitaxel (PTX)-induced tactile hypersensitivity in mice through suppressing reactive oxidant species (ROS)-decreased inhibitory GABA synaptic transmission in the spinal cord. In this study, we evaluated the analgesic effect of KDS under a new approach, in which KDS acts on dorsal horn sensory neurons to reduce excitatory transmission. Oral administration of KDS effectively enhanced mechanical thresholds in the spinal nerve ligation (SNL) induced neuropathic pain in rats. Moreover, we discovered that although treatment with KDS increased brain-derived neurotrophic factor (BDNF) levels, KDS inhibited Tropomyosin receptor kinase B (TrkB) receptor activation, suppressing increased p-NR2B-induced hyperexcitability in spinal dorsal horn sensory neurons after nerve injury. In addition, KDS showed its anti-inflammatory effects by reducing microgliosis and astrogliosis and the activation of MAPK and NF-ᴋB inflammatory pathways in these glial cells. The levels of ROS production in the spinal cords after the SNL procedure were also decreased with KDS treatment. Taken together, our results suggest that KDS may represent a promising therapeutic option for treating neuropathic pain. PERSPECTIVE: Our study provides evidence suggesting the mechanisms by which KDS, a novel MAO-B inhibitor, can be effective in pain relief. KDS, by targeting multiple mechanisms involved in BDNF/TrkB/NR2B-related excitatory transmission and neuroinflammation, may represent the next future of pain medicine.
MAO-B 抑制剂已被证明可以逆转神经性疼痛行为。我们之前的研究表明,一种新开发的可逆 MAO-B 抑制剂 KDS2010(KDS)可以通过抑制脊髓中反应性氧化物质(ROS)减少抑制性 GABA 突触传递来减轻紫杉醇(PTX)诱导的小鼠触觉过敏。在这项研究中,我们评估了 KDS 的镇痛作用,方法是 KDS 作用于背角感觉神经元以减少兴奋性传递。KDS 的口服给药可有效增强脊神经结扎(SNL)诱导的神经性疼痛大鼠的机械阈值。此外,我们发现尽管 KDS 增加了脑源性神经营养因子(BDNF)水平,但 KDS 抑制了 Tropomyosin receptor kinase B(TrkB)受体的激活,抑制了神经损伤后脊髓背角感觉神经元中 p-NR2B 诱导的过度兴奋。此外,KDS 通过减少小胶质细胞和星形胶质细胞的增生以及这些神经胶质细胞中 MAPK 和 NF-κB 炎症途径的激活,显示出其抗炎作用。SNL 手术后脊髓中 ROS 产生的水平也随着 KDS 治疗而降低。总之,我们的结果表明,KDS 可能是治疗神经性疼痛的一种有前途的治疗选择。观点:我们的研究提供了证据,表明新型 MAO-B 抑制剂 KDS 可以缓解疼痛的机制。KDS 通过靶向 BDNF/TrkB/NR2B 相关兴奋性传递和神经炎症涉及的多个机制,可能代表未来疼痛医学的发展方向。