靶向 NGF 而非 VEGFR1 或 BDNF 信号可减轻小鼠子宫内膜异位症相关疼痛。

Tiago H Zaninelli, Victor Fattori, Olivia K Heintz, Kristeena R Wright, Philip R Bennallack, Danielle Sim, Hussain Bukhari, Kathryn L Terry, Allison F Vitonis, Stacey A Missmer, Avacir C Andrello, Raymond M Anchan, Stephen K Godin, Dara Bree, Waldiceu A Verri, Michael S Rogers
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引用次数: 0

摘要

简介子宫内膜异位症是一种慢性炎症性疾病,约有 10% 的妇女患有此病。相当一部分患者对目前的疗法疗效有限或无效。邻近子宫内膜异位症病灶的组织经常表现出神经元和血管密度增加,这表明疾病病理涉及神经营养活动和血管生成:我们旨在评估关键的酪氨酸激酶受体偶联神经营养分子对小鼠子宫内膜异位症相关疼痛的潜在作用:方法:从接受手术的子宫内膜异位症患者体内收集腹腔液,并通过酶联免疫吸附试验(ELISA)量化NGF和VEGFR1调节因子(VEGFA、VEGFB、PLGF和sVEGFR1)的水平。VEGFR1 调节因子的浓度被用来计算 VEGFR1 占有率。我们在子宫内膜异位症相关疼痛的小鼠模型中使用了基因耗竭、中和抗体和药理学方法来特异性阻断神经营养配体(NGF 或 BDNF)或受体(VEGFR1、TRKs)。子宫内膜异位症相关疼痛通过 von Frey 灯丝、自发腹痛相关行为量化和热不适进行测量。疾病参数通过病灶大小和患病率进行评估。为了评估潜在的毒性,我们测量了恩替瑞尼剂量和疗程对体重、肝肾功能和骨结构(通过显微 CT)的影响:我们发现,entrectinib(泛Trk抑制剂)或抗NGF治疗可减少诱发疼痛、自发疼痛和热不适。相反,尽管计算的受体占有率显示血管内皮生长因子受体1激动剂水平足以支持信号传导,但通过抗体或他莫昔芬诱导的基因敲除阻断血管内皮生长因子受体1并不能减轻小鼠的疼痛或病变大小。用抗 BDNF 抗体靶向 BDNF-TrkB 也证明无效。值得注意的是,将给药时间改为每周一次可消除恩替替尼诱导的骨质流失,但对疼痛的疗效并没有降低:结论:这表明NGF-TrkA信号,而非BDNF-TrkB或VEGF-VEGFR1信号介导了子宫内膜异位症相关疼痛。此外,entrectinib 还能阻断子宫内膜异位症相关疼痛并缩小病灶范围。我们的研究结果还表明,entrectinib 类分子是治疗子宫内膜异位症的理想候选药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Targeting NGF but not VEGFR1 or BDNF signaling reduces endometriosis-associated pain in mice.

Introduction: Endometriosis is a chronic inflammatory disease that affects ∼10 % of women. A significant fraction of patients experience limited or no efficacy with current therapies. Tissue adjacent to endometriosis lesions often exhibits increased neurite and vascular density, suggesting that disease pathology involves neurotrophic activity and angiogenesis.

Objectives: We aim to evaluate the potential for key tyrosine-kinase-receptor-coupled neurotrophic molecules to contribute to endometriosis-associated pain in mice.

Methods: Peritoneal fluid was collected from endometriosis patients undergoing surgery and the levels of NGF and VEGFR1 regulators (VEGFA, VEGFB, PLGF, and sVEGFR1) were quantified by ELISA. VEGFR1 regulator concentrations were used to calculate VEGFR1 occupancy. We used genetic depletion, neutralizing antibodies, and pharmacological approaches to specifically block neurotrophic ligands (NGF or BDNF) or receptors (VEGFR1, TRKs) in a murine model of endometriosis-associated pain. Endometriosis-associated pain was measured using von Frey filaments, quantification of spontaneous abdominal pain-related behavior, and thermal discomfort. Disease parameters were evaluated by lesion size and prevalence. To evaluate potential toxicity, we measured the effect of entrectinib dose and schedule on body weight, liver and kidney function, and bone structure (via micro-CT).

Results: We found that entrectinib (pan-Trk inhibitor) or anti-NGF treatments reduced evoked pain, spontaneous pain, and thermal discomfort. In contrast, even though calculated receptor occupancy revealed that VEGFR1 agonist levels are sufficient to support signaling, blocking VEGFR1 via antibody or tamoxifen-induced knockout did not reduce pain or lesion size in mice. Targeting BDNF-TrkB with an anti-BDNF antibody also proved ineffective. Notably, changing dosing schedule to once weekly eliminated entrectinib-induced bone-loss without decreasing efficacy against pain.

Conclusions: This suggests NGF-TrkA signaling, but not BDNF-TrkB or VEGF-VEGFR1, mediates endometriosis-associated pain. Moreover, entrectinib blocks endometriosis-associated pain and reduces lesion sizes. Our results also indicated that entrectinib-like molecules are promising candidates for endometriosis treatment.

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