A novel inhibitor of active protein kinase G attenuates chronic inflammatory and osteoarthritic pain

Pain. 2017 May;158(5):822-832. doi: 10.1097/j.pain.0000000000000832.

Abstract

Activating PKG-1α induces a long-term hyperexcitability (LTH) in nociceptive neurons. Since the LTH correlates directly with chronic pain in many animal models, we tested the hypothesis that inhibiting PKG-1α would attenuate LTH-mediated pain. We first synthesized and characterized compound N46 (N-((3R,4R)-4-(4-(2-fluoro-3-methoxy-6-propoxybenzoyl)benzamido)pyrrolidin-3-yl)-1H-indazole-5-carboxamide). N46 inhibits PKG-1α with an IC50 of 7.5 nmol, was highly selective when tested against a panel of 274 kinases, and tissue distribution studies indicate that it does not enter the CNS. To evaluate its antinociceptive potential, we used 2 animal models in which the pain involves both activated PKG-1α and LTH. Injecting complete Freund's adjuvant (CFA) into the rat hind paw causes a thermal hyperalgesia that was significantly attenuated 24 hours after a single intravenous injection of N46. Next, we used a rat model of osteoarthritic knee joint pain and found that a single intra-articular injection of N46 alleviated the pain 14 days after the pain was established and the relief lasted for 7 days. Thermal hyperalgesia and osteoarthritic pain are also associated with the activation of the capsaicin-activated transient receptor protein vanilloid-1 (TRPV1) channel. We show that capsaicin activates PKG-1α in nerves and that a subcutaneous delivery of N46 attenuated the mechanical and thermal hypersensitivity elicited by exposure to capsaicin. Thus, PKG-1α appears to be downstream of the transient receptor protein vanilloid-1. Our studies provide proof of concept in animal models that a PKG-1α antagonist has a powerful antinociceptive effect on persistent, already existing inflammatory pain. They further suggest that N46 is a valid chemotype for the further development of such antagonists.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adenosine Triphosphate / metabolism
  • Adenosine Triphosphate / pharmacokinetics
  • Animals
  • Biphenyl Compounds / therapeutic use
  • Chronic Disease
  • Cyclic GMP / analogs & derivatives
  • Cyclic GMP / therapeutic use
  • Cyclic GMP-Dependent Protein Kinases / metabolism*
  • Disease Models, Animal
  • Double-Blind Method
  • Enzyme Inhibitors / therapeutic use
  • Freund's Adjuvant / toxicity
  • Gene Expression Regulation, Enzymologic / drug effects
  • Gene Expression Regulation, Enzymologic / physiology
  • Hyperalgesia / drug therapy
  • Hyperalgesia / etiology
  • Inflammation / chemically induced
  • Inflammation / complications*
  • Inflammation / drug therapy
  • Male
  • Models, Molecular
  • Osteoarthritis / complications*
  • Osteoarthritis / drug therapy
  • Osteoarthritis / enzymology*
  • Pain / drug therapy
  • Pain / enzymology*
  • Pain / etiology*
  • Pain Threshold / drug effects
  • Pain Threshold / physiology*
  • Pyridines / therapeutic use
  • Rats
  • Rats, Sprague-Dawley
  • Thionucleotides / therapeutic use
  • Time Factors

Substances

  • (N-((4,6-dimethyl-2-oxo-1,2-dihydropyridin-3-yl)methyl)-5-(ethyl9tetrahydro-2H-pyran-4-yl)amino)-4-methyl-4'-(morpholinomethyl)-91,1'-biphenyl0-3-carboxamide
  • 8-(4-chlorophenylthio)guanosine 3',5'-cyclic monophosphorothioate
  • Biphenyl Compounds
  • Enzyme Inhibitors
  • Pyridines
  • Thionucleotides
  • Adenosine Triphosphate
  • Freund's Adjuvant
  • Cyclic GMP-Dependent Protein Kinases
  • Cyclic GMP