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Papers of the Week


Papers: 14 Nov 2020 - 20 Nov 2020


Pharmacology/Drug Development


2020 Nov 18


Br J Pharmacol

Fifteen years of Na 1.7 as an analgesic target: why has excellent in vitro pharmacology not translated into in vivo analgesic efficacy?

Abstract

In 2006, humans with a congenital insensitivity to pain (CIP) were found to lack functional Na 1.7 channels. In the 15 years since there has been a rush to develop selective Na 1.7 inhibitors with the goal of producing broadly effective analgesics without the problems of addiction and tolerance associated with opioids. Pharmacologically, this mission has been highly successful, leading to a number of highly potent and selective inhibitors of Na 1.7.However,there are very few examples where these inhibitors have yielded effective analgesia in preclinical pain models or human clinical trials. In this review we summarisethe role of Na 1.7 in nociception, its history as a therapeutic target, and the quest to develop potent inhibitors of this channel. Finally, we discuss possible reasons why the pain-free state seen in humans with CIP has been so elusive to recapitulate pharmacologically.