浏览全部资源
扫码关注微信
1.德州学院药学院,山东 德州 253023
2.新型药用辅料与缓控释制剂山东省工程研究中心,山东 德州 253023
3.德州学院健康医学院,山东 德州 253023
4.兰州大学生命科学学院动物学与生物医学系,兰州 730000
5.甘肃省新药临床前研究重点实验室,兰州 730000
Published:15 September 2024,
Received:29 December 2023,
Revised:14 August 2024,
移动端阅览
贺春波,王丹,杨淑佳等.新型阿片类镇痛药的研发进展 Δ[J].中国药房,2024,35(17):2176-2180.
HE Chunbo,WANG Dan,YANG Shujia,et al.Research progress of novel opioid analgesics[J].ZHONGGUO YAOFANG,2024,35(17):2176-2180.
贺春波,王丹,杨淑佳等.新型阿片类镇痛药的研发进展 Δ[J].中国药房,2024,35(17):2176-2180. DOI: 10.6039/j.issn.1001-0408.2024.17.21.
HE Chunbo,WANG Dan,YANG Shujia,et al.Research progress of novel opioid analgesics[J].ZHONGGUO YAOFANG,2024,35(17):2176-2180. DOI: 10.6039/j.issn.1001-0408.2024.17.21.
阿片类镇痛药是目前已知疗效最好的镇痛药,然而其便秘、耐受和成瘾等毒副作用严重限制了其临床应用。随着对阿片受体信号转导机制的深入认知和药物设计技术的不断进步,研究者们近年来尝试了许多有前景、不同于传统的改造吗啡骨架结构的全新方法,致力于开发低毒高效的阿片类镇痛药。本文聚焦于目前比较主流的偏向性激动、“一药多靶”和外周激动3种新型研发策略,介绍了各个策略实现镇痛活性与不良反应相对分离的基本原理,并结合相应代表性药物的最新研究进展进行简要综述。其中,近期获批上市的新型阿片类镇痛药奥赛利定和泰吉利定都是偏向性μ阿片受体激动剂,Cebranopadol是典型的“一药多靶”镇痛药,NFEPP是外周阿片受体激动剂的代表性药物。上述几种研发策略相辅相成,为阿片类镇痛新药的研发提供了借鉴与参考。
Opioid analgesics are currently known as the best analgesics. However, toxicity and side effects such as constipation, tolerance and addiction severely limit their clinical application. With the in-depth understanding of the signal transduction mechanism of opioid receptors and the continuous advancement of drug design technology, researchers have managed to develop many promising new methods to get low-toxic and more efficient opioid analgesics, which are different from the traditional morphine skeleton structure modifications. This article focuses on three new research strategies of G-protein biased activation, “one drug-multiple targets” and peripheral activation. The basic principles of relative separation of analgesic activity and adverse drug reaction by each strategy are introduced, and the latest research progress of representative drugs is briefly reviewed. Among them, the recently approved novel opioid analgesics oliceridine and tegileridine are G-protein biased μ-opioid receptor agonists, Cebranopadol is a typical “one drug-multiple targets” analgesic, and NFEPP is a representative drug of peripheral opioid receptor agonists. The above several strategies complement each other and provide reference for the development of new opioid analgesic drugs.
阿片类镇痛药偏向性激动剂一药多靶外周激动剂新药研发
biased agonistone drug-multiple targetsperipheral agonistnew drug development
樊碧发. 中国疼痛医学发展报告:2020[M]. 北京:清华大学出版社,2020:2-3.
FAN B F. China pain medical development report:2020 [M]. Beijing:Tsinghua University Press,2020:2-3.
SHANTHANNA H,LADHA K S,KEHLET H,et al. Perioperative opioid administration[J]. Anesthesiology,2021,134(4):645-659.
PAICE J A,BOHLKE K,BARTON D,et al. Use of opioids for adults with pain from cancer or cancer treatment:ASCO guideline[J]. J Clin Oncol,2023,41(4):914-930.
DOWELL D,RAGAN K R,JONES C M,et al. CDC clinical practice guideline for prescribing opioids for pain:United States,2022[J]. MMWR Recomm Rep,2022,71(3):1-95.
LAU J,MAZZOTTA P,FAZELZAD R,et al. Assessment tools for problematic opioid use in palliative care:a sco- ping review[J]. Palliat Med,2021,35(7):1295-1322.
BATEMAN J T,SAUNDERS S E,LEVITT E S. Understanding and countering opioid-induced respiratory depression[J]. Br J Pharmacol,2023,180(7):813-828.
DAVIES A,LEACH C,BUTLER C,et al. Opioid-induced constipation in patients with cancer:a “real-world”, multicentre,observational study of diagnostic criteria and clinical features[J]. Pain,2021,162(1):309-318.
HERLINGER K,LINGFORD-HUGHES A. Opioid use disorder and the brain:a clinical perspective[J]. Addiction,2022,117(2):495-505.
HE Y,SU Q,ZHAO L Y,et al. Historical perspectives and recent advances in small molecule ligands of selective/biased/multi-targeted μ/δ/κ opioid receptor:2019-2022[J]. Bioorg Chem,2023,141:106869.
VARGA B R,STREICHER J M,MAJUMDAR S. Strategies towards safer opioid analgesics:a review of old and upcoming targets[J]. Br J Pharmacol,2023,180(7):975-993.
CHE T,DWIVEDI-AGNIHOTRI H,SHUKLA A K,et al. Biased ligands at opioid receptors:current status and future directions[J]. Sci Signal,2021,14(677):eaav0320.
SOYKA M. Novel long-acting buprenorphine medications for opioid dependence:current update[J]. Pharmacopsychiatry,2021,54(1):18-22.
INFANTINO R,MATTIA C,LOCARINI P,et al. Buprenorphine:far beyond the “ceiling”[J]. Biomolecules,2021,11(6):816.
MCPHERSON J,RIVERO G,BAPTIST M,et al. μ- opioid receptors:correlation of agonist efficacy for signalling with ability to activate internalization[J]. Mol Pharmacol,2010,78(4):756-766.
AZZAM A A H,LAMBERT D G. Preclinical discovery and development of oliceridine (Olinvyk®) for the treatment of post-operative pain[J]. Expert Opin Drug Discov,2022,17(3):215-223.
DAKSLA N,WANG A,JIN Z S,et al. Oliceridine for the management of moderate to severe acute postoperative pain:a narrative review[J]. Drug Des Devel Ther,2023,17:875-886.
MANGLIK A,LIN H,ARYAL D K,et al. Structure-based discovery of opioid analgesics with reduced side effects[J]. Nature,2016,537(7619):185-190.
DING H P,KIGUCHI N,PERREY D A,et al. Antinociceptive,reinforcing,and pruritic effects of the G-protein signalling-biased mu opioid receptor agonist PZM21 in non-human primates[J]. Br J Anaesth,2020,125(4):596-604.
MA M J,LI X,TONG K,et al. Discovery of biased mu-opioid receptor agonists for the treatment of pain[J]. ChemMedChem,2020,15(1):155-161.
ZHUANG Y W,WANG Y,HE B Q,et al. Molecular reco- gnition of morphine and fentanyl by the human μ-opioid receptor[J]. Cell,2022,185(23):4361-4375.e19.
DHILLON S. Tegileridine:first approval[J]. Drugs,2024,84(6):717-720.
KABIR A,MUTH A. Polypharmacology:the science of multi-targeting molecules[J]. Pharmacol Res,2022,176:106055.
SMITH M T,KONG D H,KUO A,et al. Multitargeted opioid ligand discovery as a strategy to retain analgesia and reduce opioid-related adverse effects[J]. J Med Chem,2023,66(6):3746-3784.
陈泽权,肖国伟,敖健,等. 阿片受体激动-拮抗剂的镇痛作用及不良反应研究进展[J]. 中国药房,2023,34(18):2299-2304.
CHEN Z Q,XIAO G W,AO J,et al. Research progress on analgesic effect and adverse drug reactions of opioid receptor agonist-antagonists[J]. China Pharm,2023,34(18):2299-2304.
MADA S,GERAK L R,SOYER A,et al. Behavioral effects of benzylideneoxymorphone (BOM),a low efficacy µ opioid receptor agonist and a δ opioid receptor antagonist[J]. Psychopharmacology,2020,237(12):3591-3602.
DING H P,KIGUCHI N,DOBBINS M,et al. Nociceptin receptor-related agonists as safe and non-addictive analgesics[J]. Drugs,2023,83(9):771-793.
DING H P,TRAPELLA C,KIGUCHI N,et al. Functional profile of systemic and intrathecal cebranopadol in nonhuman Primates[J]. Anesthesiology,2021,135(3):482-493.
HE C B,WANG X L,ZHANG J,et al. MCRT,a multifunctional ligand of opioid and neuropeptide FF receptors,attenuates neuropathic pain in spared nerve injury model[J]. Basic Clin Pharmacol Toxicol,2021,128(6):731-740.
ZHANG M N,XU B,LI N,et al. Development of multifunctional and orally active cyclic peptide agonists of opioid/neuropeptide FF receptors that produce potent,long-lasting,and peripherally restricted antinociception with diminished side effects[J]. J Med Chem,2021,64(18):13394-13409.
XU B,ZHANG M N,SHI X R,et al. The multifunctional peptide DN-9 produced peripherally acting antinociception in inflammatory and neuropathic pain via μ- and κ- opioid receptors[J]. Br J Pharmacol,2020,177(1):93-109.
WANG Y H,CHAI J R,XU X J,et al. Pharmacological characterization of dezocine,a potent analgesic acting as a κ partial agonist and μ partial agonist[J]. Sci Rep,2018,8(1):14087.
SETH R,KUPPALLI S S,NADAV D,et al. Recent advances in peripheral opioid receptor therapeutics[J]. Curr Pain Headache Rep,2021,25(7):46.
JIMÉNEZ-VARGAS N N,YU Y,JENSEN D D,et al. Agonist that activates the µ-opioid receptor in acidified microenvironments inhibits colitis pain without side effects[J]. Gut,2022,71(4):695-704.
DEGRO C E,JIMÉNEZ-VARGAS N N,TSANG Q,et al. Evolving acidic microenvironments during colitis provide selective analgesic targets for a pH-sensitive opioid[J]. Pain,2023,164(11):2501-2515.
FENG J,LEPETRE-MOUELHI S,GAUTIER A,et al. A new painkiller nanomedicine to bypass the blood-brain barrier and the use of morphine[J]. Sci Adv,2019,5(2):eaau5148.
LEBON B,ZEPPETELLA G,HIGGINSON I J. Effectiveness of topical administration of opioids in palliative care:a systematic review[J]. J Pain Symptom Manage,2009,37(5):913-917.
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution