Department of Medical Neurobiology, Institute for Medical Research Israel-Canada, Hadassah School of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel.
Inflamm Bowel Dis. 2024 Oct 3;30(10):1843-1851. doi: 10.1093/ibd/izae036.
Transient receptor potential vanilloid 1 (TRPV1) cation channels, expressed on nociceptors, are well established as key contributors to abdominal pain in inflammatory bowel disease (IBD). Previous attempts at blocking these channels have been riddled with side effects. Here, we propose a novel treatment strategy, utilizing the large pore of TRPV1 channels as a drug delivery system to selectively inhibit visceral nociceptors.
We induced colitis in rats using intrarectal dinitrobenzene sulfonic acid. Visceral hypersensitivity, spontaneous pain, and responsiveness of the hind paws to noxious heat stimuli were examined before and after the intrarectal application of membrane-impermeable sodium channel blocker (QX-314) alone or together with TRPV1 channel activators or blockers.
Intrarectal co-application of QX-314 with TRPV1 channel activator capsaicin significantly inhibited colitis-induced gut hypersensitivity. Furthermore, in the model of colitis, but not in naïve rats, QX-314 alone was sufficient to reverse gut hypersensitivity. The blockade of TRPV1 channels prevented this effect of QX-314. Finally, applying QX-314 alone to the inflamed gut inhibited colitis-induced ongoing pain.
Selective silencing of gut nociceptors by a membrane-impermeable sodium channel blocker entering via exogenously or endogenously activated TRPV1 channels diminishes IBD-induced gut hypersensitivity. The lack of effect on naïve rats suggests a selective analgesic effect in the inflamed gut. Our results suggest that in the colitis model, TRPV1 channels are tonically active. Furthermore, our results emphasize the role of TRPV1-expressing nociceptive fibers in colitis-induced pain. These findings provide proof of concept for using charged activity blockers for the blockade of IBD-associated abdominal pain.
瞬时受体电位香草酸 1(TRPV1)阳离子通道,表达于伤害感受器上,被认为是炎症性肠病(IBD)中腹痛的关键贡献者。以前尝试阻断这些通道的方法都存在副作用。在这里,我们提出了一种新的治疗策略,利用 TRPV1 通道的大孔作为药物传递系统,选择性地抑制内脏伤害感受器。
我们使用直肠内二硝基苯磺酸诱导大鼠结肠炎。在直肠内单独应用或与 TRPV1 通道激活剂或阻滞剂一起应用膜不可渗透的钠离子通道阻滞剂(QX-314)前后,检测内脏超敏反应、自发性疼痛以及对有害热刺激的后爪反应。
直肠内共同应用 TRPV1 通道激活剂辣椒素与 QX-314 显著抑制结肠炎诱导的肠道高敏反应。此外,在结肠炎模型中,但不在正常大鼠中,QX-314 本身足以逆转肠道高敏反应。TRPV1 通道的阻断阻止了 QX-314 的这种作用。最后,将 QX-314 单独应用于发炎的肠道可抑制结肠炎引起的持续性疼痛。
通过外源性或内源性激活的 TRPV1 通道进入的膜不可渗透的钠离子通道阻滞剂选择性沉默肠道伤害感受器,可减轻 IBD 诱导的肠道高敏反应。对正常大鼠没有影响表明在发炎的肠道中具有选择性镇痛作用。我们的结果表明,在结肠炎模型中,TRPV1 通道呈紧张性激活。此外,我们的结果强调了 TRPV1 表达的伤害感受器纤维在结肠炎引起的疼痛中的作用。这些发现为使用带电活性阻滞剂阻断与 IBD 相关的腹痛提供了概念验证。