PROJECT SUMMARY
Pain is a major global health problem, causing a significant economic and social burden. Most clinically used
opioid drugs are -opioid receptor (MOR) agonists with liabilities of tolerance, physical dependence and addiction
mediated by this receptor. Centrally acting kappa-opioid receptor (KOR) agonists also inhibit pain, but without
abuse potential and without the adverse side effects associated with MOR agonists. Antidepressants that target
neurotransmitters serotonin and norepinephrine relieve pain in patients with chronic neuropathic pain
syndromes. However, KOR agonists and antidepressants are not perfect. KOR agonists developed to date
exhibit undesirable dysphoria and aversion, while antidepressants have not been successful in all pain
conditions. Thereby, there is a large unmet need for innovative therapies for pain management. The overall goal
of the proposed research is to develop novel peptide analgesics, for use along the entire continuum of care, as
an alternative to the existing treatment options for acute and chronic pain.
Peptides have long been recognized for their roles in the normal function of the central nervous system (CNS),
making them particularly attractive candidates for the discovery and development of novel pain medications.
Conventional methods of drug administration such as oral or intravenous are inefficient in delivering peptides to
the brain. Both the blood-brain barrier (BBB) and blood-cerebrospinal fluid barrier (BCB) restrict the transport of
these therapeutic agents from blood into the CNS. Alternatively, intranasal (i.n.) delivery may be a route of
administration that would allow therapeutic peptides to bypass the BBB and BCB and directly enter the brain.
To address the need for novel therapeutics to treat acute and chronic pain syndromes, we designed new
cyclic peptide-based analgesics suitable for i.n. delivery that combine selective KOR agonist and antidepressant
pain reliving mechanisms. Combining KOR agonist activity with simultaneous delivery of norepinephrine and/or
serotonin may improve pain management when more than one physiological mechanism or system is implicated
and may potentially minimize side effects associated with the KOR activation. The proposed cyclic peptides
represent a new class of analgesics structurally distinct from the commonly prescribed pain medications. To
further validate our approach for the design of novel cyclic peptide-based analgesics we propose to: (a) further
improve the analgesic properties of the OL-based cyclic peptides and minimize or eliminate undesired side
effects by modifying amino acid sequences using rational synthetic approach based on our previous studies
(Aim 1), (b) assess metabolic stability and nose-to-brain transit of selected peptides in mice (Aim 2); (c) assess
the therapeutic potentials of selected peptides in well-established pain rodent models and identify lead OL-based
cyclic peptides (2 peptides) with improved analgesic activity and reduced or complete absence of abuse ability
and side effects for further development (Aim 3).