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Fingolimod reduces neuropathic pain behaviors in a mouse model of multiple sclerosis by a sphingosine-1 phosphate receptor 1-dependent inhibition of central sensitization in the dorsal horn.

Abstract
Multiple sclerosis (MS) is an autoimmune-inflammatory neurodegenerative disease that is often accompanied by a debilitating neuropathic pain. Disease-modifying agents slow down the progression of multiple sclerosis and prevent relapses, yet it remains unclear if they yield analgesia. We explored the analgesic potential of fingolimod (FTY720), an agonist and/or functional antagonist at the sphingosine-1-phosphate receptor 1 (S1PR1), because it reduces hyperalgesia in models of peripheral inflammatory and neuropathic pain. We used a myelin oligodendrocyte glycoprotein 35 to 55 (MOG35-55) mouse model of experimental autoimmune encephalomyelitis, modified to avoid frank paralysis, and thus, allow for assessment of withdrawal behaviors to somatosensory stimuli. Daily intraperitoneal fingolimod reduced behavioral signs of central neuropathic pain (mechanical and cold hypersensitivity) in a dose-dependent and reversible manner. Both autoimmune encephalomyelitis and fingolimod changed hyperalgesia before modifying motor function, suggesting that pain-related effects and clinical neurological deficits were modulated independently. Fingolimod also reduced cellular markers of central sensitization of neurons in the dorsal horn of the spinal cord: glutamate-evoked Ca signaling and stimulus-evoked phospho-extracellular signal-related kinase ERK (pERK) expression, as well as upregulation of astrocytes (GFAP) and macrophage/microglia (Iba1) immunoreactivity. The antihyperalgesic effects of fingolimod were prevented or reversed by the S1PR1 antagonist W146 (1 mg/kg daily, i.p.) and could be mimicked by either repeated or single injection of the S1PR1-selective agonist SEW2871. Fingolimod did not change spinal membrane S1PR1 content, arguing against a functional antagonist mechanism. We conclude that fingolimod behaves as an S1PR1 agonist to reduce pain in multiple sclerosis by reversing central sensitization of spinal nociceptive neurons.
AuthorsSuzanne Doolen, Tommaso Iannitti, Renee R Donahue, Benjamin C Shaw, Carolyn M Grachen, Bradley K Taylor
JournalPain (Pain) Vol. 159 Issue 2 Pg. 224-238 (02 2018) ISSN: 1872-6623 [Electronic] United States
PMID29140922 (Publication Type: Journal Article)
Chemical References
  • 3-amino-4-(3-hexylphenylamino)-4-oxobutylphosphonic acid
  • Anilides
  • Immunosuppressive Agents
  • Myelin-Oligodendrocyte Glycoprotein
  • Organophosphonates
  • Oxadiazoles
  • Peptide Fragments
  • Receptors, Lysosphingolipid
  • S1pr1 protein, mouse
  • SEW2871
  • Sphingosine-1-Phosphate Receptors
  • Thiophenes
  • myelin oligodendrocyte glycoprotein (35-55)
  • PERK kinase
  • eIF-2 Kinase
  • Fingolimod Hydrochloride
Topics
  • Anilides (pharmacology)
  • Animals
  • Central Nervous System Sensitization (drug effects)
  • Disease Models, Animal
  • Female
  • Fingolimod Hydrochloride (therapeutic use)
  • Immunosuppressive Agents (therapeutic use)
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Motor Activity (drug effects)
  • Multiple Sclerosis (chemically induced, complications, drug therapy)
  • Myelin-Oligodendrocyte Glycoprotein (toxicity)
  • Neuralgia (drug therapy, etiology, pathology)
  • Organophosphonates (pharmacology)
  • Oxadiazoles (pharmacology)
  • Pain Threshold (drug effects)
  • Peptide Fragments (toxicity)
  • Receptors, Lysosphingolipid (metabolism)
  • Sphingosine-1-Phosphate Receptors
  • Spinal Cord (metabolism, pathology)
  • Spinal Nerve Roots (drug effects, metabolism)
  • Subcellular Fractions (drug effects, metabolism)
  • Thiophenes (pharmacology)
  • eIF-2 Kinase (metabolism)

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