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选择性雄激素受体调节剂微粒制剂逆转了广泛性肌肉疼痛小鼠模型中的肌肉痛觉过敏。

Selective androgen receptor modulator microparticle formulation reverses muscle hyperalgesia in a mouse model of widespread muscle pain.

机构信息

Department of Physical Therapy and Rehabilitation Sciences, University of Iowa, Iowa City, IA, United States.

Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States.

出版信息

Pain. 2023 Jul 1;164(7):1512-1523. doi: 10.1097/j.pain.0000000000002841. Epub 2022 Dec 9.

Abstract

Chronic pain is a significant health problem associated with disability and reduced quality of life. Current management of chronic pain is inadequate with only modest effects of pharmacological interventions. Thus, there is a need for the generation of analgesics for treating chronic pain. Although preclinical and clinical studies demonstrate the analgesic effects of testosterone, clinical use of testosterone is limited by adverse androgenic effects. Selective androgen receptor modulators (SARMs) activate androgen receptors and overcome treatment limitations by minimizing androgenic side effects. Thus, we tested whether daily soluble SARMs or a SARM-loaded microparticle formulation alleviated muscle hyperalgesia in a mouse-model of widespread pain (male and female C57BL/6J mice). We tested whether the analgesic effects of the SARM-loaded microparticle formulation was mediated through androgen receptors by blocking androgen receptors with flutamide pellets. In vitro and in vivo release kinetics were determined for SARM-loaded microparticles. Safety and toxicity of SARM treatment was determined using serum cardiac and liver toxicity panels, heart histology, and conditioned place preference testing. Subcutaneous daily SARM administration, and 2 injections, 1 week apart, of SARM-loaded microparticles alleviated muscle hyperalgesia in both sexes and was prevented with flutamide treatment. Sustained release of SARM, from the microparticle formulation, was observed both in vitro and in vivo for 4 weeks. Selective androgen receptor modulator treatment produced no cardiac or liver toxicity and did not produce rewarding behaviors. These studies demonstrate that SARM-loaded microparticles, which release drug for a sustained period, alleviate muscle pain, are safe, and may serve as a potential therapeutic for chronic muscle pain.

摘要

慢性疼痛是一种与残疾和生活质量下降相关的重大健康问题。目前对慢性疼痛的管理效果不佳,药物干预的效果也只是适度的。因此,需要开发治疗慢性疼痛的镇痛药。尽管临床前和临床研究表明睾丸素有镇痛作用,但由于雄激素副作用,睾丸素的临床应用受到限制。选择性雄激素受体调节剂 (SARMs) 激活雄激素受体,并通过最小化雄激素副作用来克服治疗限制。因此,我们测试了每日可溶性 SARMs 或负载 SARMs 的微粒制剂是否能缓解广泛性疼痛模型(雄性和雌性 C57BL/6J 小鼠)中的肌肉痛觉过敏。我们通过使用氟他胺丸阻断雄激素受体来测试负载 SARMs 的微粒制剂的镇痛作用是否通过雄激素受体介导。对负载 SARMs 的微粒进行了体外和体内释放动力学测试。使用血清心脏和肝脏毒性小组、心脏组织学和条件性位置偏好测试来确定 SARMs 治疗的安全性和毒性。每日皮下 SARMs 给药,以及 1 周间隔的 2 次 SARMs 负载微粒注射,可缓解两性的肌肉痛觉过敏,并通过氟他胺治疗预防。在体外和体内观察到负载 SARMs 的微粒制剂在 4 周内持续释放 SARMs。SARMs 治疗没有心脏或肝脏毒性,也没有产生奖赏行为。这些研究表明,负载 SARMs 的微粒制剂可持续释放药物,缓解肌肉疼痛,安全且可能成为治疗慢性肌肉疼痛的潜在治疗方法。

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