Preclinical assessment of utility of M6S for multimodal acute and chronic pain treatment in diabetic neuropathy

Life Sci. 2018 Jan 1:192:151-159. doi: 10.1016/j.lfs.2017.11.042. Epub 2017 Nov 28.

Abstract

Aims: Previous reports from our laboratory have established that morphine-6-O-sulfate (M6S) is a mixed μ/δ opioid receptor (OR) agonist and a potential improved alternative to morphine for treatment of chronic multimodal pain in non-diabetic rats. This study extends the antinociceptive effects of M6S and morphine in STZ-induced diabetic rats.

Materials and methods: Effects of morphine and M6S were studied across a range of pain modalities, using hot plate threshold (HPT), pinprick sensitivity threshold (PST) and paw pressure threshold (PPT) tests.

Key findings: Acutely, M6S was 3- to 5-fold more potent and 2- to 3-fold more efficacious than morphine in HPT and PST tests. No differences in analgesic drug potency/efficacy were detected in the PPT test. After 7-9days of chronic treatment, tolerance developed to the antinociceptive effects of morphine, but not to M6S, in all three pain tests. Furthermore, morphine-tolerant rats were not cross-tolerant to M6S. The selective δ-OR antagonist, naltrindole, blocked M6S-induced antinociception by 62±3% in the HPT test, 93±5% in the PST test, and 30±17% in the PPT test when examined acutely.

Significance: These studies provide additional confirmation for the mixed μ/δ activity of M6S and demonstrate potential improved clinical utility for dual μ/δ agonists relative to morphine in treatment of diabetic neuropathy across multiple pain domains.

Keywords: Antinociception; Morphine; Morphine-6-O-sulfate; Opioid receptors; Pain; Streptozotocin-induced diabetes.

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Animals
  • Chronic Pain / drug therapy*
  • Chronic Pain / etiology
  • Diabetes Mellitus, Experimental / complications
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / drug therapy*
  • Male
  • Morphine / therapeutic use
  • Morphine Derivatives / therapeutic use*
  • Pain / drug therapy*
  • Pain / etiology
  • Pain Management
  • Pain Measurement / drug effects
  • Pain Threshold / drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Receptors, Opioid, delta / drug effects

Substances

  • Analgesics, Opioid
  • Morphine Derivatives
  • Receptors, Opioid, delta
  • morphine-6-O-sulfate
  • Morphine