Modulation of Glycine-Mediated Spinal Neurotransmission for the Treatment of Chronic Pain

J Med Chem. 2018 Apr 12;61(7):2652-2679. doi: 10.1021/acs.jmedchem.7b00956. Epub 2017 Sep 22.

Abstract

Chronic pain constitutes a significant and expanding worldwide health crisis. Currently available analgesics poorly serve individuals suffering from chronic pain, and new therapeutic agents that are more effective, safer, and devoid of abuse liabilities are desperately needed. Among the myriad of cellular and molecular processes contributing to chronic pain, spinal disinhibition of pain signaling to higher cortical centers plays a critical role. Accumulating evidence shows that glycinergic inhibitory neurotransmission in the spinal cord dorsal horn gates nociceptive signaling, is essential in maintaining physiological pain sensitivity, and is diminished in pathological pain states. Thus, it is hypothesized that agents capable of enhancing glycinergic tone within the dorsal horn could obtund nociceptor signaling to the brain and serve as analgesics for persistent pain. This Perspective highlights the potential that pharmacotherapies capable of increasing inhibitory spinal glycinergic neurotransmission hold in providing new and transformative analgesic therapies for the treatment of chronic pain.

Publication types

  • Review

MeSH terms

  • Analgesics / pharmacology
  • Analgesics / therapeutic use
  • Animals
  • Chronic Pain / drug therapy*
  • Glycine / physiology*
  • Humans
  • Nociceptors / drug effects
  • Receptors, Glycine / drug effects
  • Spinal Cord / drug effects*
  • Spinal Cord / physiopathology
  • Synaptic Transmission / drug effects*

Substances

  • Analgesics
  • Receptors, Glycine
  • Glycine