Neuropathic pain arises from nervous system injuries due to trauma, disease, or neurotoxin exposure afflicts
15-20 million people in the U.S is very difficult to treat.1-6 Currently available therapeutics include anticonvulsants,
antidepressants and opioids; these have limited efficacy and possess many side effects including high abuse
liability.4 Novel non opioid based targets are needed for therapeutic intervention. We believe that we have found
such target; the Gi/o protein-coupled receptor (GPCR) Gpr34. Our unbiased transcriptomic approach in a rat
model of traumatic nerve injury-induced neuropathic pain7 revealed that GPR34 increases in the dorsal horn of
the spinal cord ipsilateral to nerve injury. GPR34 is expressed in both humans and rodents and is highly
expressed in microglia.8-10 Its primary endogenous ligand is lysophosphatidylserine (LysoPS).11 Little is known
about the roles of LysoPS/GPR34 in pain. One study reported GPR34 deletion in the spinal cord reversed nerve
injury-induced neuropathic pain by suppressing pro-inflammatory responses of microglia.12 Chemical probes for
GPR34, especially antagonists, are limited with only on reported antagonists (Takeda).13 We synthesized this
compound (SLU-PP-2368) and found it antagonized LysoPS-induced β-arrestin recruitment and reversed
mechano- and cold allodynia in two rodent models7,14 with no observable side effects or engaging the
endogenous opioid system (preliminary data). This compound has poor physicochemical properties limiting its
clinical utility. Using the cryoEM structure of GPR34 bound with a synthetic agonist,15 we synthesized three
analogs (SLU-PP-2438, -2439 and -2440) with GPR34 antagonistic activity and improved solubility and stability.
Systemic and intrathecal administration of these antagonists reversed behavioral hypersensitivities in two
models of neuropathic pain7,14 (preliminary data). LysoPS (i.th.) in rodents recapitulated behavioral phenotypes
seen in the nerve-injury models and evoked dose- and time-dependent pertussis toxin-sensitive (Gαi/o-linked)
behavioral hypersensitivities that were blocked by GPR34 antagonists. Collectively, these data identify the spinal
cord as a potential site of GPR34 antagonist action that contributes to neuropathic pain. The mechanisms
engaged by LysoPS/GPR34 signaling that contribute to neuropathic pain are unknown, but studies implicate
mitogen-activated protein kinase (MAPK) signaling pathways.11,16,17 Our driving hypothesis is that GPR34 in the
spinal cord is a non-opioid based target for therapeutic intervention with GPR34 antagonists and the analgesic
actions of GPR34 antagonists result from attenuating MAPK in microglia. We also hypothesize that identifying
CNS-active GPR34 hits will allow future development of novel GPR34 antagonists with intellectual property
potential as drug candidates for neuropathic pain. Results from our studies are anticipated to develop a strong
biological rationale and establish a multidisciplinary team and infrastructure to develop CNS-penetrant selective
GPR34 antagonists that will be used for a therapeutics development plan to enable a future application for RFA-
NS-21-015, thereby directly addressing RFA-NS-21-029.