Eliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers

Abstract ATP-dependent P2X3 receptors play a crucial role in the sensitization of nerve fibers and pathological pain pathways. They are also involved in pathways triggering cough and may contribute to the pathophysiology of endometriosis and overactive bladder. However, despite the strong therapeuti...

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Autores principales: Adam J. Davenport, Ioana Neagoe, Nico Bräuer, Markus Koch, Andrea Rotgeri, Jens Nagel, Alexis Laux-Biehlmann, Frederic Machet, Anne-Marie Coelho, Susan Boyce, Nikisha Carty, Mark J. Gemkow, Stephen D. Hess, Thomas M. Zollner, Oliver M. Fischer
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Publicado: Nature Portfolio 2021
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spelling oai:doaj.org-article:db0e029d06d746b6aa334c9d4e1c736d2021-12-02T19:16:14ZEliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers10.1038/s41598-021-99177-02045-2322https://doaj.org/article/db0e029d06d746b6aa334c9d4e1c736d2021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99177-0https://doaj.org/toc/2045-2322Abstract ATP-dependent P2X3 receptors play a crucial role in the sensitization of nerve fibers and pathological pain pathways. They are also involved in pathways triggering cough and may contribute to the pathophysiology of endometriosis and overactive bladder. However, despite the strong therapeutic rationale for targeting P2X3 receptors, preliminary antagonists have been hampered by off-target effects, including severe taste disturbances associated with blocking the P2X2/3 receptor heterotrimer. Here we present a P2X3 receptor antagonist, eliapixant (BAY 1817080), which is both highly potent and selective for P2X3 over other P2X subtypes in vitro, including P2X2/3. We show that eliapixant reduces inflammatory pain in relevant animal models. We also provide the first in vivo experimental evidence that P2X3 antagonism reduces neurogenic inflammation, a phenomenon hypothesised to contribute to several diseases, including endometriosis. To test whether eliapixant could help treat endometriosis, we confirmed P2X3 expression on nerve fibers innervating human endometriotic lesions. We then demonstrate that eliapixant reduces vaginal hyperalgesia in an animal model of endometriosis-associated dyspareunia, even beyond treatment cessation. Our findings indicate that P2X3 antagonism could alleviate pain, including non-menstrual pelvic pain, and modify the underlying disease pathophysiology in women with endometriosis. Eliapixant is currently under clinical development for the treatment of disorders associated with hypersensitive nerve fibers.Adam J. DavenportIoana NeagoeNico BräuerMarkus KochAndrea RotgeriJens NagelAlexis Laux-BiehlmannFrederic MachetAnne-Marie CoelhoSusan BoyceNikisha CartyMark J. GemkowStephen D. HessThomas M. ZollnerOliver M. FischerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Adam J. Davenport
Ioana Neagoe
Nico Bräuer
Markus Koch
Andrea Rotgeri
Jens Nagel
Alexis Laux-Biehlmann
Frederic Machet
Anne-Marie Coelho
Susan Boyce
Nikisha Carty
Mark J. Gemkow
Stephen D. Hess
Thomas M. Zollner
Oliver M. Fischer
Eliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers
description Abstract ATP-dependent P2X3 receptors play a crucial role in the sensitization of nerve fibers and pathological pain pathways. They are also involved in pathways triggering cough and may contribute to the pathophysiology of endometriosis and overactive bladder. However, despite the strong therapeutic rationale for targeting P2X3 receptors, preliminary antagonists have been hampered by off-target effects, including severe taste disturbances associated with blocking the P2X2/3 receptor heterotrimer. Here we present a P2X3 receptor antagonist, eliapixant (BAY 1817080), which is both highly potent and selective for P2X3 over other P2X subtypes in vitro, including P2X2/3. We show that eliapixant reduces inflammatory pain in relevant animal models. We also provide the first in vivo experimental evidence that P2X3 antagonism reduces neurogenic inflammation, a phenomenon hypothesised to contribute to several diseases, including endometriosis. To test whether eliapixant could help treat endometriosis, we confirmed P2X3 expression on nerve fibers innervating human endometriotic lesions. We then demonstrate that eliapixant reduces vaginal hyperalgesia in an animal model of endometriosis-associated dyspareunia, even beyond treatment cessation. Our findings indicate that P2X3 antagonism could alleviate pain, including non-menstrual pelvic pain, and modify the underlying disease pathophysiology in women with endometriosis. Eliapixant is currently under clinical development for the treatment of disorders associated with hypersensitive nerve fibers.
format article
author Adam J. Davenport
Ioana Neagoe
Nico Bräuer
Markus Koch
Andrea Rotgeri
Jens Nagel
Alexis Laux-Biehlmann
Frederic Machet
Anne-Marie Coelho
Susan Boyce
Nikisha Carty
Mark J. Gemkow
Stephen D. Hess
Thomas M. Zollner
Oliver M. Fischer
author_facet Adam J. Davenport
Ioana Neagoe
Nico Bräuer
Markus Koch
Andrea Rotgeri
Jens Nagel
Alexis Laux-Biehlmann
Frederic Machet
Anne-Marie Coelho
Susan Boyce
Nikisha Carty
Mark J. Gemkow
Stephen D. Hess
Thomas M. Zollner
Oliver M. Fischer
author_sort Adam J. Davenport
title Eliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers
title_short Eliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers
title_full Eliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers
title_fullStr Eliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers
title_full_unstemmed Eliapixant is a selective P2X3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers
title_sort eliapixant is a selective p2x3 receptor antagonist for the treatment of disorders associated with hypersensitive nerve fibers
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/db0e029d06d746b6aa334c9d4e1c736d
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