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Szőke É, Bálint M, Hetényi C, Markovics A, Elekes K, Pozsgai G, Szűts T, Kéri G, Őrfi L, Sándor Z, Szolcsányi J, Pintér E, Helyes Z. Small molecule somatostatin receptor subtype 4 (sst 4) agonists are novel anti-inflammatory and analgesic drug candidates. Neuropharmacology 2020; 178:108198. [PMID: 32739276 DOI: 10.1016/j.neuropharm.2020.108198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/07/2020] [Accepted: 06/10/2020] [Indexed: 12/30/2022]
Abstract
We provided strong proof of concept evidence that somatostatin mediates potent analgesic and anti-inflammatory actions via its receptor subtype 4 (sst4) located both at the periphery and the central nervous system. Therefore, sst4 agonists are promising novel drug candidates for neuropathic pain and neurogenic inflammation, but rational drug design was not possible due to the lack of knowledge about its 3-dimensional structure. We modeled the sst4 receptor structure, described its agonist binding properties, and characterized the binding of our novel small molecule sst4 agonists (4-phenetylamino-7H-pyrrolo[2,3-d]pyrimidine derivatives) using an in silico platform. In addition to the in silico binding data, somatostatin displacement by Compound 1 was demonstrated in the competitive binding assay on sst4-expressing cells. In vivo effects were investigated in rat models of neurogenic inflammation and chronic traumatic neuropathic pain. We defined high- and low-affinity binding pockets of sst4 for our ligands, binding of the highest affinity compounds were similar to that of the reference ligand J-2156. We showed potent G-protein activation with the highest potency of 10 nM EC50 value and highest efficacy of 342%. Oral administration of 100 μg/kg of 5 compounds significantly inhibited acute neurogenic plasma protein extravasation in the paw skin by 40-60%, one candidate abolished and 3 others diminished sciatic nerve-ligation induced neuropathic hyperalgesia by 28-62%. The in silico predictions on sst4-ligands were tested in biological systems. Low oral dose of our novel agonists inhibit neurogenic inflammation and neuropathic pain, which opens promising drug developmental perspectives for these unmet medical need conditions.
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Affiliation(s)
- Éva Szőke
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary.
| | - Mónika Bálint
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary
| | - Csaba Hetényi
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary
| | - Adrienn Markovics
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary
| | - Krisztián Elekes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary
| | - Gábor Pozsgai
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary
| | | | - György Kéri
- Vichem Chemie Research Ltd, Budapest, Hungary
| | - László Őrfi
- Department of Pharmaceutical Chemistry, Pharmacy Faculty, Semmelweis University, Budapest, Hungary
| | - Zoltán Sándor
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary
| | - János Szolcsányi
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary
| | - Erika Pintér
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary; PharmInVivo Ltd, Pécs, Hungary; Algonist GmbH, Vienna, Austria
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary; János Szentágothai Research Center & Centre for Neuroscience, University of Pécs, Hungary; PharmInVivo Ltd, Pécs, Hungary; Algonist GmbH, Vienna, Austria
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Rajamäki TJ, Puolakka PA, Hietaharju A, Moilanen T, Jämsen E. Predictors of the use of analgesic drugs 1 year after joint replacement: a single-center analysis of 13,000 hip and knee replacements. Arthritis Res Ther 2020; 22:89. [PMID: 32317021 PMCID: PMC7175525 DOI: 10.1186/s13075-020-02184-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/07/2020] [Indexed: 12/27/2022] Open
Abstract
Background Pain persists in a moderate number of patients following hip or knee replacement surgery. Persistent pain may subsequently lead to the prolonged consumption of analgesics after surgery and expose patients to the adverse drug events of opioids and NSAIDs, especially in older patients and patients with comorbidities. This study aimed to identify risk factors for the increased use of opioids and other analgesics 1 year after surgery and focused on comorbidities and surgery-related factors. Methods All patients who underwent a primary hip or knee replacement for osteoarthritis from 2002 to 2013 were identified. Redeemed prescriptions for acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids (mild and strong) were collected from a nationwide Drug Prescription Register. The user rates of analgesics and the adjusted risks ratios for analgesic use 1 year after joint replacement were calculated. Results Of the 6238 hip replacement and 7501 knee replacement recipients, 3591 (26.1%) were still using analgesics 1 year after surgery. Significant predictors of overall analgesic use (acetaminophen, NSAID, or opioid) were (risk ratio (95% CI)) age 65–74.9 years (reference < 65), 1.1 (1.03–1.2); age > 75 years, 1.2 (1.1–1.3); female gender, 1.2 (1.1–1.3); BMI 30–34.9 kg/m2 (reference < 25 kg/m2), 1.1 (1.04–1.2); BMI > 35 kg/m2, 1.4 (1.3–1.6); and a higher number of comorbidities (according to the modified Charlson Comorbidity Index score), 1.2 (1.1–1.4). Diabetes and other comorbidities were not significant independent predictors. Of the other clinical factors, the preoperative use of analgesics, 2.6 (2.5–2.8), and knee surgery, 1.2 (1.1–1.3), predicted the use of analgesics, whereas simultaneous bilateral knee replacement (compared to unilateral procedure) was a protective factor, 0.86 (0.77–0.96). Opioid use was associated with obesity, higher CCI score, epilepsy, knee vs hip surgery, unilateral vs bilateral knee operation, total vs unicompartmental knee replacement, and the preoperative use of analgesics/opioids. Conclusions Obesity (especially BMI > 35 kg/m2) and the preoperative use of analgesics were the strongest predictors of an increased postoperative use of analgesics. It is remarkable that also older age and higher number of comorbidities predicted analgesic use despite these patients being the most vulnerable to adverse drug events.
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Affiliation(s)
| | - Pia A Puolakka
- Department of Anaesthesia, Tampere University Hospital, Tampere, Finland
| | - Aki Hietaharju
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland.,Department of Neurology, Tampere University Hospital, Tampere, Finland
| | | | - Esa Jämsen
- Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland.,Coxa, Hospital for Joint Replacement, Tampere, Finland
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Mofatteh MR, Salehi F, Hosseini M, Hassanzadeh-Taheri M, Meghdadi S, Hassanzadeh-Taheri M. Postoperative Outcomes in Cold Dissection Versus Bipolar Electrocautery Tonsillectomy: A Randomized Double-Blind Controlled Study. Indian J Otolaryngol Head Neck Surg 2019; 71:182-187. [PMID: 31741957 DOI: 10.1007/s12070-017-1204-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/06/2017] [Indexed: 11/26/2022] Open
Abstract
Tonsillectomy is one of the oldest and most common procedures worldwide. This surgery is performed by different methods include cold dissection technique (CDT) and bipolar electrocautery technique (BET). Assessment and comparison of postoperative outcomes in cold dissection and bipolar electrocautery is the aim of present study. This randomized controlled clinical trial study was conducted as double-blind on 534 patients. The enrolled patients underwent tonsillectomy in Vali-e-Asr Hospital of Birjand city from Oct. 2013-Oct. 2015. Al patients systematically allocated into two groups treated with cold dissection or bipolar electrocautery methods. Intensity of throat pain scores, Otalgia, analgesic consumption, resume normal diet, body temperature and also wound healing on 10th day after operation were measured and compared between the two groups. The gathered data were analyzed by SPSS software (Ver-22) and using necessary tests. The differences between studied groups less than 0.5 (p < 0.05) considered significant statically. 51.7 and 50.6% in the CDT and the BET groups were male respectively. In comparison between the groups the mean of pain scores 4 and 24 h after operation in the BET group were higher significantly (p < 0.001). Otalgia only 4 h after surgery was higher significantly in the BET group (p = 0.008). All the other studied parameters were significantly more desirable in the CDT group (p < 0.001). According to the findings of present study it seems that the CDT is safer and more favorable than the BET in tonsillectomy.
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Affiliation(s)
- Mohammad Reza Mofatteh
- 1Vali-e-Asr Hospital, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Forod Salehi
- 1Vali-e-Asr Hospital, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mehran Hosseini
- 2Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Seddigheh Meghdadi
- 2Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Luh JJ, Huang WT, Lin KH, Huang YY, Kuo PL, Chen WS. Effects of Extracorporeal Shock Wave-Mediated Transdermal Local Anesthetic Drug Delivery on Rat Caudal Nerves. Ultrasound Med Biol 2018; 44:214-222. [PMID: 29107354 DOI: 10.1016/j.ultrasmedbio.2017.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 09/12/2017] [Accepted: 09/12/2017] [Indexed: 06/07/2023]
Abstract
Cavitation plays a substantial role in the clinical effects of extracorporeal shock wave therapy (ESWT). It is also generally accepted as a major mechanism in sonophoresis. To identify the enhancing effect of extracorporeal shock wave-mediated transdermal drug delivery, 24 Wistar rats were randomly assigned to four groups: (i) topical application of a eutectic mixture of local anesthetics (EMLA); (ii) 1-MHz ultrasound; (iii) ESWT pre-treatment combined with EMLA application; (iv) ESWT concurrent with EMLA application on rat tails. The degree of anesthesia was assessed using the amplitude and latency of sensory nerve action potentials within 5 min after a 60-min EMLA application. The results indicated that ESWT pre-treatment and concurrent ESWT accelerated the anesthetic effects of the EMLA cream on the tail nerve (p < 0.05). This finding might indicate that shock wave-mediated transdermal drug delivery is possible during the ESWT period.
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Affiliation(s)
- Jer-Junn Luh
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan, ROC; Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan, ROC
| | - Wan-Ting Huang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan, ROC; Department of Physical Medicine & Rehabilitation, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC
| | - Kwan-Hwa Lin
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan, ROC; Department of Physical Therapy, Tzu Chi University, Hualien City, Taiwan, ROC
| | - Yi-You Huang
- Institute of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan, ROC
| | - Po-Ling Kuo
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan, ROC; Department of Electrical Engineering, National Taiwan University, Taipei City, Taiwan, ROC
| | - Wen-Shiang Chen
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan, ROC; Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei City, Taiwan, ROC.
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Nakao S, Mabuchi M, Wang S, Kogure Y, Shimizu T, Noguchi K, Tanaka A, Dai Y. Synthesis of resveratrol derivatives as new analgesic drugs through desensitization of the TRPA1 receptor. Bioorg Med Chem Lett 2017; 27:3167-3172. [PMID: 28576617 DOI: 10.1016/j.bmcl.2017.05.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 11/28/2022]
Abstract
A series of 31 resveratrol derivatives was designed, synthesized and evaluated for activation and inhibition of the TRPA1 channel. Most acted as activators and desensitizers of TRPA1 channels like resveratrol or allyl isothiocyanate (AITC). Compound 4z (HUHS029) exhibited higher inhibitory activity than resveratrol with an IC50 value of 16.1μM. The activity of 4z on TRPA1 was confirmed in TRPA1-expressing HEK293 cells, as well as in rat dorsal root ganglia neurons by a whole cell patch clamp recording. Furthermore, pretreatment with 4z exhibited an analgesic effect on AITC-evoked TRPA1-related pain behavior in vivo.
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Affiliation(s)
- Syuhei Nakao
- Advanced Medical Research Center, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan; School of Pharmacy, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan
| | - Miyuki Mabuchi
- Advanced Medical Research Center, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan
| | - Shenglan Wang
- School of Pharmacy, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan; Traditional Medicine Research Center, Chinese Medicine Confucius Institute at Hyogo College of Medicine, Kobe 650-8530, Japan
| | - Yoko Kogure
- School of Pharmacy, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan
| | - Tadashi Shimizu
- Advanced Medical Research Center, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan; School of Pharmacy, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan
| | - Koichi Noguchi
- Department of Anatomy and Neuroscience, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Akito Tanaka
- Advanced Medical Research Center, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan; School of Pharmacy, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan.
| | - Yi Dai
- School of Pharmacy, Hyogo University of Health Sciences, 1-3-6 Minatojima, Kobe 650-8530, Japan; Traditional Medicine Research Center, Chinese Medicine Confucius Institute at Hyogo College of Medicine, Kobe 650-8530, Japan; Department of Anatomy and Neuroscience, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
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