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Contributions of different modes of TRPV1 activation to TRPV1 antagonist-induced hyperthermia
Andras Garami1, Yury P Shimansky, Eszter Pakai
1Systemic Inflammation Laboratory, Trauma Research, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
Abstract:
Transient receptor potential vanilloid-1 (TRPV1) antagonists are widely viewed as next-generation pain therapeutics. However, these compounds cause hyperthermia, a serious side effect. TRPV1 antagonists differentially block three modes of TRPV1 activation: by heat, protons, and chemical ligands (e.g., capsaicin). We asked what combination of potencies in these three modes of TRPV1 activation corresponds to the lowest potency of a TRPV1 antagonist to cause hyperthermia. We studied hyperthermic responses of rats, mice, and guinea pigs to eight TRPV1 antagonists with different pharmacological profiles and used mathematical modeling to find a relative contribution of the blockade of each activation mode to the development of hyperthermia. We found that the hyperthermic effect has the highest sensitivity to the extent of TRPV1 blockade in the proton mode (0.43 to 0.65) with no to moderate sensitivity in the capsaicin mode (-0.01 to 0.34) and no sensitivity in the heat mode (0.00 to 0.01). We conclude that hyperthermia-free TRPV1 antagonists do not block TRPV1 activation by protons, even if they are potent blockers of the heat mode, and that decreasing the potency to block the capsaicin mode may further decrease the potency to cause hyperthermia.
Insights
Transient receptor potential vanilloid-1 (TRPV1) antagonists can cause hyperthermia. Blocking proton activation of TRPV1 is key to preventing this side effect, not blocking heat activation.
Area of Science:
- Pharmacology
- Neuroscience
- Pain Research
Background:
- Transient receptor potential vanilloid-1 (TRPV1) antagonists are promising pain therapeutics.
- A significant side effect of TRPV1 antagonists is hyperthermia.
- TRPV1 antagonists exhibit differential blockade of heat, proton, and capsaicin activation modes.
Purpose of the Study:
- To determine the specific modes of TRPV1 activation blockade that minimize hyperthermia.
- To investigate the relationship between antagonist potency in different activation modes and hyperthermia.
Main Methods:
- Studied hyperthermic responses in rats, mice, and guinea pigs using eight TRPV1 antagonists.
- Employed mathematical modeling to quantify the contribution of each activation mode blockade to hyperthermia.
Main Results:
- Hyperthermia is most sensitive to blockade of proton activation (0.43–0.65).
- Sensitivity to capsaicin mode blockade is low to moderate (-0.01–0.34).
- Heat activation blockade shows minimal to no sensitivity (0.00–0.01).
Conclusions:
- Hyperthermia-free TRPV1 antagonists do not block proton activation, irrespective of heat activation blockade potency.
- Reducing potency against capsaicin activation may further mitigate hyperthermia risk.
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