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1.
J Pain ; 15(4): 387.e1-14, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24374196

RESUMEN

UNLABELLED: Voltage-gated Ca(2+) channels play an important role in nociceptive transmission. There is significant evidence supporting a role for N-, T- and P/Q-type Ca(2+) channels in chronic pain. Here, we report that A-1264087, a structurally novel state-dependent blocker, inhibits each of these human Ca(2+) channels with similar potency (IC50 = 1-2 µM). A-1264087 was also shown to inhibit the release of the pronociceptive calcitonin gene-related peptide from rat dorsal root ganglion neurons. Oral administration of A-1264087 produces robust antinociceptive efficacy in monoiodoacetate-induced osteoarthritic, complete Freund adjuvant-induced inflammatory, and chronic constrictive injury of sciatic nerve-induced, neuropathic pain models with ED50 values of 3.0, 5.7, and 7.8 mg/kg (95% confidence interval = 2.2-3.5, 3.7-10, and 5.5-12.8 mg/kg), respectively. Further analysis revealed that A-1264087 also suppressed nociceptive-induced p38 and extracellular signal-regulated kinase 1/2 phosphorylation, which are biochemical markers of engagement of pain circuitry in chronic pain states. Additionally, A-1264087 inhibited both spontaneous and evoked neuronal activity in the spinal cord dorsal horn in complete Freund adjuvant-inflamed rats, providing a neurophysiological basis for the observed antihyperalgesia. A-1264087 produced no alteration of body temperature or motor coordination and no learning impairment at therapeutic plasma concentrations. PERSPECTIVE: The present results demonstrate that the neuronal Ca(2+) channel blocker A-1264087 exhibits broad-spectrum efficacy through engagement of nociceptive signaling pathways in preclinical pain models in the absence of effects on psychomotor and cognitive function.


Asunto(s)
Analgésicos/farmacología , Compuestos de Azabiciclo/farmacología , Bloqueadores de los Canales de Calcio/farmacología , Leucina/análogos & derivados , Neuronas/metabolismo , Nocicepción/efectos de los fármacos , Médula Espinal/efectos de los fármacos , Animales , Modelos Animales de Enfermedad , Inmunohistoquímica , Leucina/farmacología , Masculino , Neuronas/efectos de los fármacos , Dolor/metabolismo , Técnicas de Placa-Clamp , Ratas Sprague-Dawley , Médula Espinal/metabolismo
2.
J Peripher Nerv Syst ; 17(3): 324-30, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22971094

RESUMEN

Chemotherapy-induced peripheral neuropathy (CIPN) is a major toxicity of chemotherapy treatment for which no therapy is approved. Poly(ADP-ribose) polymerase (PARP)1/2 are nuclear enzymes activated upon DNA damage, and PARP1/2 inhibition provides resistance against DNA damage. A role for PARP inhibition in sensory neurotransmission has also been established. PARP inhibitors attenuate pain-like behaviors and neuropathy-associated decreased peripheral nerve function in diabetic models. The hypothesis tested was that PARP inhibition protects against painful neuropathy. The objective of this study was to investigate whether the novel, selective PARP1/2 inhibitors (ABT-888 and related analogues) would attenuate development of mechanical allodynia in vincristine-treated rats. PARP inhibitors were dosed for 2 days, and then co-administered with vincristine for 12 days. Mechanical allodynia was observed in rats treated with vincristine. PARP1/2 inhibition significantly attenuated development of mechanical allodynia and reduced poly ADP-ribose (PAR) activation in rat skin. The data presented here show that PARP inhibition attenuates vincristine-induced mechanical allodynia in rats, and supports that PARP inhibition may represent a novel therapeutic approach for CIPN.


Asunto(s)
Antineoplásicos Fitogénicos/toxicidad , Bencimidazoles/uso terapéutico , Neuralgia/inducido químicamente , Neuralgia/prevención & control , Inhibidores de Poli(ADP-Ribosa) Polimerasas , Animales , Bencimidazoles/farmacología , Inhibidores Enzimáticos/farmacología , Inhibidores Enzimáticos/uso terapéutico , Masculino , Neuralgia/enzimología , Poli(ADP-Ribosa) Polimerasa-1 , Poli(ADP-Ribosa) Polimerasas/metabolismo , Ratas , Ratas Sprague-Dawley
3.
Bioorg Med Chem ; 20(13): 4128-39, 2012 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-22626552

RESUMEN

A novel 4-aminocyclopentapyrrolidine series of N-type Ca(2+) channel blockers have been discovered. Enantioselective synthesis of the 4-aminocyclopentapyrrolidines was enabled using N-tert-butyl sulfinamide chemistry. SAR studies demonstrate selectivity over L-type Ca(2+) channels. N-type Ca(2+) channel blockade was confirmed using electrophysiological recording techniques. Compound 25 is an N-type Ca(2+) channel blocker that produces antinociception in inflammatory and nociceptive pain models without exhibiting cardiovascular or motor liabilities.


Asunto(s)
Acetamidas/síntesis química , Analgésicos/síntesis química , Bloqueadores de los Canales de Calcio/síntesis química , Canales de Calcio Tipo N/química , Pirrolidinas/química , Pirrolidinas/síntesis química , Acetamidas/farmacología , Acetamidas/uso terapéutico , Analgésicos/farmacología , Analgésicos/uso terapéutico , Animales , Conducta Animal/efectos de los fármacos , Bloqueadores de los Canales de Calcio/farmacología , Bloqueadores de los Canales de Calcio/uso terapéutico , Canales de Calcio Tipo N/metabolismo , Modelos Animales de Enfermedad , Masculino , Dolor/tratamiento farmacológico , Pirrolidinas/farmacología , Pirrolidinas/uso terapéutico , Ratas , Ratas Sprague-Dawley , Relación Estructura-Actividad
4.
Biochem Pharmacol ; 83(3): 406-18, 2012 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-22153861

RESUMEN

Blockade of voltage-gated Ca²âº channels on sensory nerves attenuates neurotransmitter release and membrane hyperexcitability associated with chronic pain states. Identification of small molecule Ca²âº channel blockers that produce significant antinociception in the absence of deleterious hemodynamic effects has been challenging. In this report, two novel structurally related compounds, A-686085 and A-1048400, were identified that potently block N-type (IC50=0.8 µM and 1.4 µM, respectively) and T-type (IC50=4.6 µM and 1.2 µM, respectively) Ca²âº channels in FLIPR based Ca²âº flux assays. A-686085 also potently blocked L-type Ca²âº channels (EC50=0.6 µM), however, A-1048400 was much less active in blocking this channel (EC50=28 µM). Both compounds dose-dependently reversed tactile allodynia in a model of capsaicin-induced secondary hypersensitivity with similar potencies (EC50=300-365 ng/ml). However, A-686085 produced dose-related decreases in mean arterial pressure at antinociceptive plasma concentrations in the rat, while A-1048400 did not significantly alter hemodynamic function at supra-efficacious plasma concentrations. Electrophysiological studies demonstrated that A-1048400 blocks native N- and T-type Ca²âº currents in rat dorsal root ganglion neurons (IC50=3.0 µM and 1.6 µM, respectively) in a voltage-dependent fashion. In other experimental pain models, A-1048400 dose-dependently attenuated nociceptive, neuropathic and inflammatory pain at doses that did not alter psychomotor or hemodynamic function. The identification of A-1048400 provides further evidence that voltage-dependent inhibition of neuronal Ca²âº channels coupled with pharmacological selectivity vs. L-type Ca²âº channels can provide robust antinociception in the absence of deleterious effects on hemodynamic or psychomotor function.


Asunto(s)
Analgésicos/administración & dosificación , Bloqueadores de los Canales de Calcio/administración & dosificación , Hemodinámica/fisiología , Neuronas/fisiología , Dimensión del Dolor , Piperidonas/administración & dosificación , Piperidonas/química , Administración Oral , Animales , Relación Dosis-Respuesta a Droga , Células HEK293 , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Neuronas/efectos de los fármacos , Dimensión del Dolor/efectos de los fármacos , Dimensión del Dolor/métodos , Ratas , Ratas Sprague-Dawley
5.
Biochem Pharmacol ; 82(8): 967-76, 2011 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-21620806

RESUMEN

Positive modulation of the neuronal nicotinic acetylcholine receptor (nAChR) α4ß2 subtype by selective positive allosteric modulator NS-9283 has shown to potentiate the nAChR agonist ABT-594-induced anti-allodynic activity in preclinical neuropathic pain. To determine whether this benefit can be extended beyond neuropathic pain, the present study examined the analgesic activity and adverse effect profile of co-administered NS-9283 and ABT-594 in a variety of preclinical models in rats. The effect of the combined therapy on drug-induced brain activities was also determined using pharmacological magnetic resonance imaging. In carrageenan-induced thermal hyperalgesia, co-administration of NS-9283 (3.5 µmol/kg, i.p.) induced a 6-fold leftward shift of the dose-response of ABT-594 (ED(50)=26 vs. 160 nmol/kg, i.p.). In the paw skin incision model of post-operative pain, co-administration of NS-9283 similarly induced a 6-fold leftward shift of ABT-594 (ED(50)=26 vs. 153 nmol/kg). In monoiodo-acetate induced knee joint pain, co-administration of NS-9283 enhanced the potency of ABT-594 by 5-fold (ED(50)=1.0 vs. 4.6 nmol/kg). In pharmacological MRI, co-administration of NS-9283 was shown to lead to a leftward shift of ABT-594 dose-response for cortical activation. ABT-594 induced CNS-related adverse effects were not exacerbated in presence of an efficacious dose of NS-9283 (3.5 µmol/kg). Acute challenge of NS-9283 produced no cross sensitization in nicotine-conditioned animals. These results demonstrate that selective positive allosteric modulation at the α4ß2 nAChR potentiates nAChR agonist-induced analgesic activity across neuropathic and nociceptive preclinical pain models without potentiating ABT-594-mediated adverse effects, suggesting that selective positive modulation of α4ß2 nAChR by PAM may represent a novel analgesic approach.


Asunto(s)
Analgésicos/uso terapéutico , Azetidinas/uso terapéutico , Agonistas Nicotínicos/uso terapéutico , Oxadiazoles/uso terapéutico , Dolor/tratamiento farmacológico , Piridinas/uso terapéutico , Receptores Nicotínicos/metabolismo , Regulación Alostérica , Analgésicos/administración & dosificación , Analgésicos/efectos adversos , Animales , Azetidinas/administración & dosificación , Azetidinas/efectos adversos , Conducta Animal/efectos de los fármacos , Temperatura Corporal/efectos de los fármacos , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Modelos Animales de Enfermedad , Quimioterapia Combinada , Imagen por Resonancia Magnética , Masculino , Agonistas Nicotínicos/administración & dosificación , Agonistas Nicotínicos/efectos adversos , Osteoartritis/tratamiento farmacológico , Osteoartritis/metabolismo , Oxadiazoles/administración & dosificación , Oxadiazoles/efectos adversos , Dolor/metabolismo , Piridinas/administración & dosificación , Piridinas/efectos adversos , Ratas , Ratas Sprague-Dawley
6.
Pain ; 152(5): 1165-1172, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21402443

RESUMEN

Despite the increasing interest in TRPA1 channel as a pain target, its role in cold sensation and body temperature regulation is not clear; the efficacy and particularly side effects resulting from channel blockade remain poorly understood. Here we use a potent, selective, and bioavailable antagonist to address these issues. A-967079 potently blocks human (IC(50): 51 nmol/L, electrophysiology, 67 nmol/L, Ca(2+) assay) and rat TRPA1 (IC(50): 101 nmol/L, electrophysiology, 289 nmol/L, Ca(2+) assay). It is >1000-fold selective over other TRP channels, and is >150-fold selective over 75 other ion channels, enzymes, and G-protein-coupled receptors. Oral dosing of A-967079 produces robust drug exposure in rodents, and exhibits analgesic efficacy in allyl isothiocyanate-induced nocifensive response and osteoarthritic pain in rats (ED(50): 23.2 mg/kg, p.o.). A-967079 attenuates cold allodynia produced by nerve injury but does not alter noxious cold sensation in naive animals, suggesting distinct roles of TRPA1 in physiological and pathological states. Unlike TRPV1 antagonists, A-967079 does not alter body temperature. It also does not produce locomotor or cardiovascular side effects. Collectively, these data provide novel insights into TRPA1 function and suggest that the selective TRPA1 blockade may present a viable strategy for alleviating pain without untoward side effects.


Asunto(s)
Regulación de la Temperatura Corporal/efectos de los fármacos , Canales de Calcio/metabolismo , Frío/efectos adversos , Hiperalgesia/tratamiento farmacológico , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Proteínas del Tejido Nervioso/metabolismo , Dolor/fisiopatología , Sensación/fisiología , Canales de Potencial de Receptor Transitorio/antagonistas & inhibidores , Canales de Potencial de Receptor Transitorio/metabolismo , Animales , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Temperatura Corporal/efectos de los fármacos , Temperatura Corporal/fisiología , Regulación de la Temperatura Corporal/genética , Regulación de la Temperatura Corporal/fisiología , Péptido Relacionado con Gen de Calcitonina/metabolismo , Calcio/metabolismo , Canales de Calcio/genética , Células Cultivadas , Modelos Animales de Enfermedad , Interacciones Farmacológicas , Ganglios Espinales/patología , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Humanos , Hiperalgesia/fisiopatología , Concentración 50 Inhibidora , Isotiocianatos/farmacología , Imagen por Resonancia Magnética/métodos , Masculino , Ratones , Proteínas del Tejido Nervioso/genética , Neuronas/efectos de los fármacos , Oximas/farmacología , Oximas/uso terapéutico , Dolor/tratamiento farmacológico , Dolor/genética , Dolor/metabolismo , Dimensión del Dolor/métodos , Ratas , Ratas Sprague-Dawley , Tiempo de Reacción/efectos de los fármacos , Sensación/efectos de los fármacos , Umbral Sensorial/efectos de los fármacos , Canal Catiónico TRPA1 , Canales Catiónicos TRPV/genética , Canales Catiónicos TRPV/metabolismo , Canales de Potencial de Receptor Transitorio/genética , Tritio
7.
Bioorg Med Chem Lett ; 21(5): 1338-41, 2011 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-21315587

RESUMEN

Novel chroman and tetrahydroquinoline ureas were synthesized and evaluated for their activity as TRPV1 antagonists. It was found that aryl substituents on the 7- or 8-position of both bicyclic scaffolds imparted the best in vitro potency at TRPV1. The most potent chroman ureas were assessed in chronic and acute pain models, and compounds with the ability to cross the blood-brain barrier were shown to be highly efficacious. The tetrahydroquinoline ureas were found to be potent CYP3A4 inhibitors, but replacement of bulky substituents at the nitrogen atom of the tetrahydroisoquinoline moiety with small groups such as methyl can minimize the inhibition.


Asunto(s)
Cromanos , Quinolinas , Canales Catiónicos TRPV/antagonistas & inhibidores , Urea/farmacología , Cromanos/síntesis química , Cromanos/química , Cromanos/farmacología , Humanos , Concentración 50 Inhibidora , Estructura Molecular , Quinolinas/química , Urea/síntesis química , Urea/química
8.
Bioorg Med Chem Lett ; 20(22): 6812-5, 2010 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-20855211

RESUMEN

A series of aryl-substituted nicotinamide derivatives with selective inhibitory activity against the Na(v)1.8 sodium channel is reported. Replacement of the furan nucleus and homologation of the anilide linker in subtype-selective blocker A-803467 (1) provided potent, selective derivatives with improved aqueous solubility and oral bioavailability. Representative compounds from this series displayed efficacy in rat models of inflammatory and neuropathic pain.


Asunto(s)
Niacinamida/farmacología , Bloqueadores de los Canales de Sodio/farmacología , Administración Oral , Animales , Disponibilidad Biológica , Niacinamida/química , Niacinamida/farmacocinética , Ratas , Bloqueadores de los Canales de Sodio/administración & dosificación , Bloqueadores de los Canales de Sodio/química , Bloqueadores de los Canales de Sodio/farmacocinética , Relación Estructura-Actividad
9.
Neuropharmacology ; 58(2): 537-43, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19703478

RESUMEN

Most animal models of pain cannot separate the sensory and affective components of pain. One model that has been used to assess affective pain is the place escape avoidance paradigm (PEAP). The aim of the current study is two-fold. First, validate PEAP with Complete Freund's Adjuvant (CFA)-induced inflammation for the assessment of the affective component of pain using the reference analgesics celecoxib, diclofenac and duloxetine; fluoxetine and scopolamine were tested as negative controls. Secondly, determine if there is a difference in efficacy in PEAP in comparison to the effects of the same compounds on von Frey-evoked mechanical allodynia in CFA animals. All compounds were tested in mechanical allodynia, place escape/avoidance, and for potentially confounding side effects in locomotor activity. Results show that celecoxib, diclofenac, and duloxetine significantly increased the time spent on the side associated with stimulation of the injured paw, whereas fluoxetine and scopolamine had no effect. Higher doses of celecoxib, diclofenac, duloxetine, and fluoxetine were required to attenuate von Frey-evoked mechanical allodynia. In the side effect assays, only fluoxetine decreased locomotor activity at doses used in PEAP. These results show that in inflammatory pain induced by CFA injection, PEAP is more sensitive to the effects of pain relieving compounds than mechanical allodynia. Fluoxetine showed efficacy in the mechanical allodynia test, but not PEAP, whereas duloxetine showed efficacy in mechanical allodynia and PEAP. These studies show that methods other than reflex based measures of pain such as affective pain models could be more predictive of efficacy/potency in the clinic.


Asunto(s)
Modelos Animales de Enfermedad , Inflamación/psicología , Dolor/psicología , Analgésicos no Narcóticos/administración & dosificación , Analgésicos no Narcóticos/uso terapéutico , Animales , Conducta Animal/efectos de los fármacos , Celecoxib , Fármacos del Sistema Nervioso Central/administración & dosificación , Fármacos del Sistema Nervioso Central/uso terapéutico , Diclofenaco/administración & dosificación , Diclofenaco/uso terapéutico , Relación Dosis-Respuesta a Droga , Clorhidrato de Duloxetina , Reacción de Fuga/efectos de los fármacos , Fluoxetina/administración & dosificación , Fluoxetina/uso terapéutico , Inflamación/fisiopatología , Masculino , Actividad Motora/efectos de los fármacos , Pruebas Neuropsicológicas , Dolor/inducido químicamente , Dolor/tratamiento farmacológico , Dimensión del Dolor , Estimulación Física , Pirazoles/administración & dosificación , Pirazoles/uso terapéutico , Ratas , Ratas Sprague-Dawley , Escopolamina/administración & dosificación , Escopolamina/uso terapéutico , Sulfonamidas/administración & dosificación , Sulfonamidas/uso terapéutico , Tiofenos/administración & dosificación , Tiofenos/uso terapéutico , Resultado del Tratamiento
10.
Behav Brain Res ; 204(1): 77-81, 2009 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-19464323

RESUMEN

The pro-inflammatory cytokine interleukin-1beta (IL-1beta) has been implicated in both inflammatory processes and nociceptive neurotransmission. Activation of P2X7 receptors is the mechanism by which ATP stimulates the rapid maturation and release of IL-1beta from macrophages and microglial cells. Recently, selective P2X7 receptor antagonists have been shown to reduce inflammatory and neuropathic pain in animal models. However, the mechanisms underlying these analgesic effects are unknown. The present studies characterize the pharmacology and antinociceptive effects of a structurally novel P2X7 antagonist. A-839977 potently (IC50=20-150 nM) blocked BzATP-evoked calcium influx at recombinant human, rat and mouse P2X7 receptors. A-839977 also potently blocked agonist-evoked YO-PRO uptake and IL-1beta release from differentiated human THP-1 cells. Systemic administration of A-839977 dose-dependently reduced thermal hyperalgesia produced by intraplantar administration of complete Freund's adjuvant (CFA) (ED50=100 micromol/kg, i.p.) in rats. A-839977 also produced robust antihyperalgesia in the CFA model of inflammatory pain in wild-type mice (ED50=40 micromol/kg, i.p.), but the antihyperalgesic effects of A-839977 were completely absent in IL-1alphabeta knockout mice. These data demonstrate that selective blockade of P2X7 receptors in vivo produces significant antinociception in animal models of inflammatory pain and suggest that the antihyperalgesic effects of P2X7 receptor blockade in an inflammatory pain model in mice are mediated by blocking the release of IL-1beta.


Asunto(s)
Analgésicos no Narcóticos/farmacología , Interleucina-1alfa/metabolismo , Interleucina-1beta/metabolismo , Dolor/tratamiento farmacológico , Piridinas/farmacología , Receptores Purinérgicos P2/metabolismo , Tetrazoles/farmacología , Adenosina Trifosfato/análogos & derivados , Adenosina Trifosfato/metabolismo , Analgésicos no Narcóticos/química , Animales , Calcio/metabolismo , Línea Celular , Relación Dosis-Respuesta a Droga , Adyuvante de Freund , Calor , Humanos , Interleucina-1alfa/genética , Interleucina-1beta/genética , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Noqueados , Dolor/inducido químicamente , Dolor/metabolismo , Antagonistas del Receptor Purinérgico P2 , Piridinas/química , Ratas , Ratas Sprague-Dawley , Receptores Purinérgicos P2/biosíntesis , Receptores Purinérgicos P2X7 , Proteínas Recombinantes/antagonistas & inhibidores , Proteínas Recombinantes/biosíntesis , Proteínas Recombinantes/metabolismo , Tetrazoles/química
11.
Pain ; 142(1-2): 27-35, 2009 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19135797

RESUMEN

Transient receptor potential vanilloid type 1 (TRPV1) is a ligand-gated ion channel that functions as an integrator of multiple pain stimuli including heat, acid, capsaicin and a variety of putative endogenous lipid ligands. TRPV1 antagonists have been shown to decrease inflammatory pain in animal models and to produce limited hyperthermia at analgesic doses. Here, we report that ABT-102, which is a potent and selective TRPV1 antagonist, is effective in blocking nociception in rodent models of inflammatory, post-operative, osteoarthritic, and bone cancer pain. ABT-102 decreased both spontaneous pain behaviors and those evoked by thermal and mechanical stimuli in these models. Moreover, we have found that repeated administration of ABT-102 for 5-12 days increased its analgesic activity in models of post-operative, osteoarthritic, and bone cancer pain without an associated accumulation of ABT-102 concentration in plasma or brain. Similar effects were also observed with a structurally distinct TRPV1 antagonist, A-993610. Although a single dose of ABT-102 produced a self-limiting increase in core body temperature that remained in the normal range, the hyperthermic effects of ABT-102 effectively tolerated following twice-daily dosing for 2 days. Therefore, the present data demonstrate that, following repeated administration, the analgesic activity of TRPV1 receptor antagonists is enhanced, while the associated hyperthermic effects are attenuated. The analgesic efficacy of ABT-102 supports its advancement into clinical studies.


Asunto(s)
Analgésicos/administración & dosificación , Fiebre/tratamiento farmacológico , Indazoles/administración & dosificación , Umbral del Dolor/efectos de los fármacos , Dolor/tratamiento farmacológico , Canales Catiónicos TRPV/metabolismo , Urea/análogos & derivados , Animales , Temperatura Corporal/efectos de los fármacos , Neoplasias Óseas/complicaciones , Calcio/metabolismo , Modelos Animales de Enfermedad , Interacciones Farmacológicas , Fiebre/inducido químicamente , Inflamación/complicaciones , Masculino , Ratones , Ratones Endogámicos C3H , Actividad Motora/efectos de los fármacos , Osteoartritis/complicaciones , Dolor/etiología , Dimensión del Dolor , Ratas , Ratas Sprague-Dawley , Canales Catiónicos TRPV/antagonistas & inhibidores , Urea/administración & dosificación
12.
J Pharmacol Exp Ther ; 328(1): 141-51, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18931146

RESUMEN

Studies demonstrating the antihyperalgesic and antiallodynic effects of cannabinoid CB(2) receptor activation have been largely derived from the use of receptor-selective ligands. Here, we report the identification of A-836339 [2,2,3,3-tetramethyl-cyclopropanecarboxylic acid [3-(2-methoxy-ethyl)-4,5-dimethyl-3H-thiazol-(2Z)-ylidene]-amide], a potent and selective CB(2) agonist as characterized in in vitro pharmacological assays and in in vivo models of pain and central nervous system (CNS) behavior models. In radioligand binding assays, A-836339 displays high affinities at CB(2) receptors and selectivity over CB(1) receptors in both human and rat. Likewise, A-836339 exhibits high potencies at CB(2) and selectivity over CB(1) receptors in recombinant fluorescence imaging plate reader and cyclase functional assays. In addition A-836339 exhibits a profile devoid of significant affinity at other G-protein-coupled receptors and ion channels. A-836339 was characterized extensively in various animal pain models. In the complete Freund's adjuvant model of inflammatory pain, A-836339 exhibits a potent CB(2) receptor-mediated antihyperalgesic effect that is independent of CB(1) or mu-opioid receptors. A-836339 has also demonstrated efficacies in the chronic constrain injury (CCI) model of neuropathic pain, skin incision, and capsaicin-induced secondary mechanical hyperalgesia models. Furthermore, no tolerance was developed in the CCI model after subchronic treatment with A-836339 for 5 days. In assessing CNS effects, A-836339 exhibited a CB(1) receptor-mediated decrease of spontaneous locomotor activities at a higher dose, a finding consistent with the CNS activation pattern observed by pharmacological magnetic resonance imaging. These data demonstrate that A-836339 is a useful tool for use of studying CB(2) receptor pharmacology and for investigation of the role of CB(2) receptor modulation for treatment of pain in preclinical animal models.


Asunto(s)
Amidas/farmacología , Ciclopropanos/farmacología , Inflamación/fisiopatología , Dolor/fisiopatología , Receptor Cannabinoide CB1/fisiología , Receptor Cannabinoide CB2/fisiología , Animales , Células CHO , Línea Celular , Cricetinae , Cricetulus , Procedimientos Quirúrgicos Dermatologicos , Miembro Posterior , Humanos , Hiperalgesia/fisiopatología , Riñón/embriología , Imagen por Resonancia Magnética/métodos , Masculino , Dolor Postoperatorio/fisiopatología , Desempeño Psicomotor/efectos de los fármacos , Desempeño Psicomotor/fisiología , Ratas , Ratas Sprague-Dawley , Receptor Cannabinoide CB2/agonistas
13.
J Neurophysiol ; 100(6): 3158-66, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18829846

RESUMEN

TRPV1 receptors are activated and/or modulated by noxious heat, capsaicin, protons and other endogenous agents released following tissue injury. There is a growing appreciation that this molecular integrator may also have a role in mechanosensation. To further understand this role, we investigated the systemic and site-specific effects of a selective TRPV1 receptor antagonist, A-889425, on low-intensity mechanical stimulation in inflamed rats. Systemic administration of A-889425 (30 and 100 micromol/kg po) reduced mechanical allodynia in complete Freund's adjuvant (CFA)-inflamed rats. Systemic A-889425 (3 and 10 micromol/kg iv) also decreased the responses of spinal wide dynamic range (WDR) neurons to low-intensity mechanical stimulation in CFA-inflamed but not uninjured rats. This effect of A-889425 was likely mediated via multiple sites since local injection of A-889425 into the spinal cord (1-3 nmol), ipsilateral hindpaw (200 nmol), and cerebral ventricles (30-300 nmol) all attenuated WDR responses to low-intensity mechanical stimulation. In addition to an effect on mechanotransmission, systemic administration of A-889425 reduced the spontaneous firing of WDR neurons in inflamed but not uninjured rats. Spontaneous firing is elevated after injury and may reflect ongoing pain in the animal. Local injection experiments indicated that this effect of A-889425 on spontaneous firing was mainly mediated via TRPV1 receptors in the spinal cord. Thus the current data demonstrate that TRPV1 receptors have an enhanced role after an inflammatory injury, impacting both low-intensity mechanotransmission and possibly spontaneous pain. Furthermore this study delineates the differential contribution of central and peripheral TRPV1 receptors to affect spontaneous or mechanically evoked firing of WDR neurons.


Asunto(s)
Potenciales de Acción/fisiología , Inflamación/patología , Neuronas/fisiología , Médula Espinal/patología , Canales Catiónicos TRPV/fisiología , Potenciales de Acción/efectos de los fármacos , Animales , Conducta Animal/efectos de los fármacos , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Potenciales Evocados Somatosensoriales/efectos de los fármacos , Adyuvante de Freund/farmacología , Inflamación/inducido químicamente , Masculino , Neuronas/efectos de los fármacos , Umbral del Dolor/efectos de los fármacos , Estimulación Física/métodos , Piridinas/química , Piridinas/farmacología , Ratas , Ratas Sprague-Dawley , Canales Catiónicos TRPV/antagonistas & inhibidores
14.
J Pain ; 9(5): 449-56, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18337184

RESUMEN

UNLABELLED: The pituitary adenylate cyclase-activating polypeptide type 1 receptor (PAC(1)-R) is a member of the 7-transmembrane domain, group 2 G-protein coupled receptor family. PAC(1)-Rs modulate neurotransmission and neurotrophic actions and have been implicated in both pronociception and antinociception. To better understand the role of PAC(1)-Rs in pain, PACAP 6-38, a PAC(1)-R antagonist, was evaluated in several inflammatory and neuropathic pain models after intrathecal (i.t.) administration. PACAP 6-38 potently reduced mechanical allodynia in a neuropathic spinal nerve ligation model (77% +/- 15% maximal effect at 12 nmol, P < .01) and was also effective in reducing thermal hyperalgesia in the carrageenan model of inflammatory pain (89% +/- 17% maximal effect at 12 nmol, P < .01). Although nociceptive responses were also attenuated with PACAP 6-38 in a dose-dependent manner in models of chronic inflammatory and persistent pain, no effects on motor performance were observed at analgesic doses. Taken together, these data demonstrate that blockade of the PAC(1)-R/PACAP complex by PACAP 6-38 can effectively attenuate thermal hyperalgesia and mechanical allodynia associated with inflammatory and neuropathic pain states. These results further emphasize that at the level of the spinal cord, PAC(1)-R activation is pronociceptive. PERSPECTIVE: This article presents the analgesic profile generated by the blockade, at the spinal cord level, of the PAC-1 receptor by a potent peptide antagonist. This comprehensive data set demonstrates that if small molecule PAC-1 receptor antagonists could be identified, they would potentially produce broad-spectrum analgesia in both inflammatory and neuropathic pain states.


Asunto(s)
Inflamación/metabolismo , Neuralgia/metabolismo , Nociceptores/metabolismo , Enfermedades del Sistema Nervioso Periférico/metabolismo , Receptores del Polipéptido Activador de la Adenilato-Ciclasa Hipofisaria/metabolismo , Animales , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Hiperalgesia/tratamiento farmacológico , Hiperalgesia/metabolismo , Hiperalgesia/fisiopatología , Inflamación/tratamiento farmacológico , Inflamación/fisiopatología , Inyecciones Espinales , Ligadura , Masculino , Neuralgia/tratamiento farmacológico , Neuralgia/fisiopatología , Neuronas Aferentes/efectos de los fármacos , Neuronas Aferentes/metabolismo , Nociceptores/efectos de los fármacos , Nociceptores/fisiopatología , Dimensión del Dolor , Fragmentos de Péptidos/farmacología , Nervios Periféricos/efectos de los fármacos , Nervios Periféricos/metabolismo , Nervios Periféricos/fisiopatología , Enfermedades del Sistema Nervioso Periférico/tratamiento farmacológico , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Polipéptido Hipofisario Activador de la Adenilato-Ciclasa/agonistas , Polipéptido Hipofisario Activador de la Adenilato-Ciclasa/metabolismo , Polipéptido Hipofisario Activador de la Adenilato-Ciclasa/farmacología , Ratas , Ratas Sprague-Dawley , Receptores del Polipéptido Activador de la Adenilato-Ciclasa Hipofisaria/antagonistas & inhibidores
15.
J Med Chem ; 51(3): 407-16, 2008 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-18176998

RESUMEN

Nav1.8 (also known as PN3) is a tetrodotoxin-resistant (TTx-r) voltage-gated sodium channel (VGSC) that is highly expressed on small diameter sensory neurons and has been implicated in the pathophysiology of inflammatory and neuropathic pain. Recent studies using an Nav1.8 antisense oligonucleotide in an animal model of chronic pain indicated that selective blockade of Nav1.8 was analgesic and could provide effective analgesia with a reduction in the adverse events associated with nonselective VGSC blocking therapeutic agents. Herein, we describe the preparation and characterization of a series of 5-substituted 2-furfuramides, which are potent, voltage-dependent blockers (IC50 < 10 nM) of the human Nav1.8 channel. Selected derivatives, such as 7 and 27, also blocked TTx-r sodium currents in rat dorsal root ganglia (DRG) neurons with comparable potency and displayed >100-fold selectivity versus human sodium (Nav1.2, Nav1.5, Nav1.7) and human ether-a-go-go (hERG) channels. Following systemic administration, compounds 7 and 27 dose-dependently reduced neuropathic and inflammatory pain in experimental rodent models.


Asunto(s)
Amidas/síntesis química , Analgésicos/síntesis química , Antiinflamatorios no Esteroideos/síntesis química , Furanos/síntesis química , Bloqueadores de los Canales de Sodio/síntesis química , Canales de Sodio/fisiología , Amidas/química , Amidas/farmacología , Analgésicos/farmacocinética , Analgésicos/farmacología , Animales , Antiinflamatorios no Esteroideos/farmacocinética , Antiinflamatorios no Esteroideos/farmacología , Línea Celular , Cricetinae , Cricetulus , Furanos/química , Furanos/farmacocinética , Furanos/farmacología , Ganglios Espinales/citología , Humanos , Técnicas In Vitro , Masculino , Ratones , Canal de Sodio Activado por Voltaje NAV1.8 , Proteínas del Tejido Nervioso/fisiología , Neuronas/efectos de los fármacos , Neuronas/fisiología , Dolor/tratamiento farmacológico , Dolor/etiología , Técnicas de Placa-Clamp , Enfermedades del Sistema Nervioso Periférico/tratamiento farmacológico , Ratas , Ratas Sprague-Dawley , Proteínas Recombinantes/antagonistas & inhibidores , Bloqueadores de los Canales de Sodio/farmacocinética , Bloqueadores de los Canales de Sodio/farmacología , Relación Estructura-Actividad
16.
Proc Natl Acad Sci U S A ; 104(20): 8520-5, 2007 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-17483457

RESUMEN

Activation of tetrodotoxin-resistant sodium channels contributes to action potential electrogenesis in neurons. Antisense oligonucleotide studies directed against Na(v)1.8 have shown that this channel contributes to experimental inflammatory and neuropathic pain. We report here the discovery of A-803467, a sodium channel blocker that potently blocks tetrodotoxin-resistant currents (IC(50) = 140 nM) and the generation of spontaneous and electrically evoked action potentials in vitro in rat dorsal root ganglion neurons. In recombinant cell lines, A-803467 potently blocked human Na(v)1.8 (IC(50) = 8 nM) and was >100-fold selective vs. human Na(v)1.2, Na(v)1.3, Na(v)1.5, and Na(v)1.7 (IC(50) values >or=1 microM). A-803467 (20 mg/kg, i.v.) blocked mechanically evoked firing of wide dynamic range neurons in the rat spinal dorsal horn. A-803467 also dose-dependently reduced mechanical allodynia in a variety of rat pain models including: spinal nerve ligation (ED(50) = 47 mg/kg, i.p.), sciatic nerve injury (ED(50) = 85 mg/kg, i.p.), capsaicin-induced secondary mechanical allodynia (ED(50) approximately 100 mg/kg, i.p.), and thermal hyperalgesia after intraplantar complete Freund's adjuvant injection (ED(50) = 41 mg/kg, i.p.). A-803467 was inactive against formalin-induced nociception and acute thermal and postoperative pain. These data demonstrate that acute and selective pharmacological blockade of Na(v)1.8 sodium channels in vivo produces significant antinociception in animal models of neuropathic and inflammatory pain.


Asunto(s)
Compuestos de Anilina/farmacología , Compuestos de Anilina/farmacocinética , Furanos/farmacología , Furanos/farmacocinética , Mononeuropatías/terapia , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Manejo del Dolor , Dolor/patología , Bloqueadores de los Canales de Sodio/farmacología , Canales de Sodio/metabolismo , Potenciales de Acción/efectos de los fármacos , Analgésicos/farmacología , Compuestos de Anilina/administración & dosificación , Compuestos de Anilina/química , Animales , Capsaicina/farmacología , Potenciales Evocados/efectos de los fármacos , Furanos/administración & dosificación , Furanos/química , Ganglios Espinales/citología , Ganglios Espinales/efectos de los fármacos , Humanos , Inflamación , Cinética , Masculino , Canal de Sodio Activado por Voltaje NAV1.8 , Neuronas/citología , Neuronas/efectos de los fármacos , Dolor/inducido químicamente , Ratas , Ratas Sprague-Dawley , Proteínas Recombinantes/metabolismo , Bloqueadores de los Canales de Sodio/administración & dosificación , Bloqueadores de los Canales de Sodio/química , Bloqueadores de los Canales de Sodio/farmacocinética
17.
J Pharmacol Exp Ther ; 319(3): 1376-85, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16982702

RESUMEN

ATP-sensitive P2X(7) receptors are localized on cells of immunological origin including glial cells in the central nervous system. Activation of P2X(7) receptors leads to rapid changes in intracellular calcium concentrations, release of the proinflammatory cytokine interleukin-1beta (IL-1beta), and following prolonged agonist exposure, cytolytic plasma membrane pore formation. P2X(7) knockout mice show reduced inflammation as well as decreased nociceptive sensitivity following peripheral nerve injury. A-740003 (N-(1-{[(cyanoimino)(5-quinolinylamino) methyl] amino}-2,2-dimethylpropyl)-2-(3,4-dimethoxyphenyl)acetamide) is a novel competitive antagonist of P2X(7) receptors (IC(50) values = 40 nM for human and 18 nM for rat) as measured by agonist-stimulated changes in intracellular calcium concentrations. A-740003 showed weak or no activity (IC(50) > 10 muM) at other P2 receptors and an array of other neurotransmitter and peptide receptors, ion channels, reuptake sites, and enzymes. A-740003 potently blocked agonist-evoked IL-1beta release (IC(50) = 156 nM) and pore formation (IC(50) = 92 nM) in differentiated human THP-1 cells. Systemic administration of A-740003 produced dose-dependent antinociception in a spinal nerve ligation model (ED(50) = 19 mg/kg i.p.) in the rat. A-740003 also attenuated tactile allodynia in two other models of neuropathic pain, chronic constriction injury of the sciatic nerve and vincristine-induced neuropathy. In addition, A-740003 effectively reduced thermal hyperalgesia observed following intraplantar administration of carrageenan or complete Freund's adjuvant (ED(50) = 38-54 mg/kg i.p.). A-740003 was ineffective in attenuating acute thermal nociception in normal rats and did not alter motor performance at analgesic doses. These data demonstrate that selective blockade of P2X(7) receptors in vivo produces significant antinociception in animal models of neuropathic and inflammatory pain.


Asunto(s)
Acetamidas/farmacología , Analgésicos , Dolor/tratamiento farmacológico , Dolor/etiología , Enfermedades del Sistema Nervioso Periférico/complicaciones , Antagonistas del Receptor Purinérgico P2 , Quinolinas/farmacología , Animales , Antineoplásicos Fitogénicos/toxicidad , Calcio/metabolismo , Línea Celular , Colorantes , Relación Dosis-Respuesta a Droga , Edema/inducido químicamente , Edema/tratamiento farmacológico , Adyuvante de Freund/farmacología , Humanos , Hiperalgesia/inducido químicamente , Hiperalgesia/tratamiento farmacológico , Inflamación/inducido químicamente , Inflamación/complicaciones , Inflamación/tratamiento farmacológico , Interleucina-1beta/metabolismo , Masculino , Actividad Motora/efectos de los fármacos , Nociceptores/efectos de los fármacos , Equilibrio Postural/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Receptores Purinérgicos P2X7 , Neuropatía Ciática/prevención & control , Nervios Espinales/lesiones , Vincristina/toxicidad
18.
Pain ; 125(1-2): 136-42, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16781071

RESUMEN

Gabapentin and pregabalin have been demonstrated, both in animal pain models and clinically, to be effective analgesics particularly for the treatment of neuropathic pain. The precise mechanism of action for these two drugs is unknown, but they are generally believed to function via initially binding to the alpha2delta subunit of voltage-gated Ca2+ channels. In this study, we used a pharmacological approach to test the hypothesis whether high affinity interactions with the alpha2delta subunit alone could lead to attenuation of neuropathic pain in rats. The anti-allodynic effects of gabapentin and pregabalin, along with three other compounds--(L)-phenylglycine, m-chlorophenylglycine and 3-exo-aminobicyclo[2.2.1]heptane-2-exo-carboxylic acid (ABHCA)--discovered to be potent alpha2delta ligands, were tested in the rat spinal nerve ligation model of neuropathic pain. Gabapentin (Ki = 120 nM), pregabalin (180 nM) and (L)-phenylglycine (180 nM) were shown to be anti-allodynic, with respective ED50 values of 230, 90 and 80 micromol/kg (p.o.). (L)-Phenylglycine was as potent as pregabalin and equi-efficacious in reversing mechanical allodynia. In contrast, two ligands with comparable or superior alpha2delta binding affinities, m-chlorophenylglycine (Ki = 54 nM) and ABHCA (150 nM), exhibited no anti-allodynic effects at doses of 30-300 micromol/kg (p.o.), although these compounds achieved substantial brain levels. The data demonstrate that, at least in the rat spinal nerve ligation model of neuropathic pain, (L)-phenylglycine has an anti-allodynic effect, but two equally potent alpha2delta subunit ligands do not. These results suggest that additional mechanisms, besides alpha2delta interactions, may contribute to the effects of compounds like gabapentin, pregabalin and (L)-phenylglycine in neuropathic pain.


Asunto(s)
Encéfalo/metabolismo , Canales de Calcio/efectos de los fármacos , Canales de Calcio/metabolismo , Glicina/análogos & derivados , Neuralgia/metabolismo , Neuralgia/prevención & control , Analgésicos/administración & dosificación , Animales , Encéfalo/efectos de los fármacos , Bloqueadores de los Canales de Calcio/administración & dosificación , Canales de Calcio Tipo L , Relación Dosis-Respuesta a Droga , Glicina/administración & dosificación , Hiperestesia/metabolismo , Hiperestesia/prevención & control , Masculino , Ratas , Ratas Sprague-Dawley , Resultado del Tratamiento
19.
Behav Brain Res ; 167(2): 355-64, 2006 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-16256210

RESUMEN

The pro-inflammatory cytokine interleukin-1 (IL-1) has been implicated in both inflammatory processes and nociceptive neurotransmission. To further investigate the role of IL-1 in different pain states, gene-disrupted mice lacking both IL-1alpha and IL-1beta genes (IL-1alphabeta (-/-)) were characterized in inflammatory, neuropathic, and post-operative pain models. IL-1alphabeta (-/-) mice showed normal sensorimotor function as measured by the rotorod assay compared to control mice (BALB/c). Acute and persistent formalin-induced nocifensive behaviors were reduced by 20% in IL-1alphabeta (-/-) mice as compared to control mice. IL-1alphabeta (-/-) mice also showed reduced inflammatory thermal and mechanical hyperalgesia compared to controls following the intraplantar administration of carrageenan or complete Freund's adjuvant (CFA). The duration of inflammatory hyperalgesia was shortened in IL-1alphabeta (-/-) mice versus controls in the CFA model. In contrast, deletion of IL-1alphabeta did not change the extent or the duration of post-operative pain developing after skin incision of the hind paw. Finally, time to onset, duration, and magnitude of mechanical allodynia were reduced in two models of neuropathic pain, spinal nerve L5-L6 ligation and chronic constriction injury of the sciatic nerve, in IL-1alphabeta (-/-) mice versus controls. These results demonstrate that IL-1alphabeta modulates both the generation and the maintenance of inflammatory and chronic neuropathic pain and that IL-1 may modulate nociceptive sensitivity to a greater extent in conditions of chronic as compared to acute pain.


Asunto(s)
Hiperalgesia/fisiopatología , Inflamación/fisiopatología , Interleucina-1/fisiología , Umbral del Dolor/fisiología , Dolor/fisiopatología , Neuropatía Ciática/fisiopatología , Enfermedad Aguda , Animales , Enfermedad Crónica , Modelos Animales de Enfermedad , Hiperalgesia/genética , Inflamación/complicaciones , Interleucina-1/deficiencia , Interleucina-1/genética , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Noqueados , Dolor/etiología , Dolor Postoperatorio/fisiopatología , Distribución Aleatoria , Prueba de Desempeño de Rotación con Aceleración Constante , Neuropatía Ciática/complicaciones
20.
J Pharmacol Exp Ther ; 314(1): 410-21, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15837818

RESUMEN

The vanilloid receptor 1 (VR1, TRPV1), which is a member of the transient receptor potential (TRP) superfamily, is highly localized on peripheral and central processes of nociceptive afferent fibers. Activation of TRPV1 contributes to the pronociceptive effects of capsaicin, protons, heat, and various endogenous lipid agonists such as anandamide and N-arachidonoyl-dopamine. A-425619 [1-isoquinolin-5-yl-3-(4-trifluoromethyl-benzyl)urea] is a novel potent and selective antagonist at both human and rat TRPV1 receptors. In vivo, A-425619 dose dependently reduced capsaicin-induced mechanical hyperalgesia (ED50 = 45 micromol/kg p.o.). A-425619 was also effective in models of inflammatory pain and postoperative pain. A-425619 potently reduced complete Freund's adjuvant-induced chronic inflammatory pain after oral administration (ED50 = 40 micromol/kg p.o.) and was also effective after either i.t. administration or local injection into the inflamed paw. Furthermore, A-425619 maintained efficacy in the postoperative pain model after twice daily dosing p.o. for 5 days. A-425619 also showed partial efficacy in models of neuropathic pain. A-425619 did not alter motor performance at the highest dose tested (300 micromol/kg p.o.). Taken together, the present data indicate that A-425619, a potent and selective antagonist of TRPV1 receptors, effectively relieves acute and chronic inflammatory pain and postoperative pain.


Asunto(s)
Analgésicos , Inflamación/complicaciones , Isoquinolinas/farmacología , Dolor/tratamiento farmacológico , Receptores de Droga/antagonistas & inhibidores , Urea/análogos & derivados , Enfermedad Aguda , Animales , Capsaicina , Carragenina , Enfermedad Crónica , Relación Dosis-Respuesta a Droga , Edema/inducido químicamente , Edema/complicaciones , Formaldehído , Adyuvante de Freund , Calor , Hiperalgesia/inducido químicamente , Hiperalgesia/tratamiento farmacológico , Ligadura , Masculino , Actividad Motora/efectos de los fármacos , Osteoartritis/complicaciones , Dolor/etiología , Dimensión del Dolor/efectos de los fármacos , Dolor Postoperatorio/tratamiento farmacológico , Equilibrio Postural/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Nervio Ciático/patología , Nervios Espinales/patología , Urea/farmacología
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