Arrestin-biased allosteric modulator of neurotensin receptor 1 alleviates acute and chronic pain.

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作者:Guo Ran, Chen Ouyang, Zhou Yang, Bang Sangsu, Chandra Sharat, Li Yize, Chen Gang, Xie Rou-Gang, He Wei, Xu Jing, Zhou Richard, Song Shaoyong, Person Kelsey L, Moore Madelyn N, Alwin Abigail R, Spasojevic Ivan, Jackson Michael R, Olson Steven H, Caron Marc G, Slosky Lauren M, Wetsel William C, Barak Lawrence S, Ji Ru-Rong
G-protein-biased agonists have been shown to enhance opioid analgesia by circumventing β-arrestin-2 (βarr2) signaling. We previously reported that SBI-553, a neurotensin receptor 1 (NTSR1)-positive allosteric modulator biased toward βarr2 signaling, attenuates psychostimulant effects in mice. Here, we demonstrate that its analog, SBI-810, exhibits potent antinociceptive properties in rodent models of postoperative pain, inflammatory pain, and neuropathic pain via systemic and local administration. SBI-810's analgesic effects require NTSR1 and βarr2 but not NTSR2 or βarr1. Mechanistically, SBI-810 suppresses excitatory synaptic transmission, inhibits NMDA receptor and extracellular-regulated signal kinase (ERK) signaling in spinal cord nociceptive neurons, reduces Nav1.7 surface expression and action potential firing in primary sensory neurons, and dampens C-fiber responses. Behaviorally, it reduces opioid-induced conditioned place preference, alleviates constipation, and mitigates chronic opioid withdrawal symptoms. These findings highlight NTSR1-biased allosteric modulators as a promising, non-addictive therapeutic strategy for acute and chronic pain management, acting through both peripheral and central mechanisms.

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