Evidence map›Paper›PMID 28394696›Full record

ArticleMolecular pain2017

Pharmacology, pharmacokinetics, and metabolism of the DNA-decoy AYX1 for the prevention of acute and chronic post-surgical pain.

Julien Mamet, Scott Harris, Michael Klukinov, David C Yeomans, Renee R Donahue, Brad K Taylor, Kelly Eddinger, Tony Yaksh, Donald C Manning

Open access · goldAbstract read
In one paragraph

Article in Molecular pain, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Julien Mamet1 Adynxx, Inc., CA, USA.
Scott Harris1 Adynxx, Inc., CA, USA.
Michael Klukinov2 Department of Anesthesia, Stanford University, CA, USA.
David C Yeomans2 Department of Anesthesia, Stanford University, CA, USA.
Renee R Donahue3 Department of Physiology, University of Kentucky, KY, USA.
Brad K Taylor3 Department of Physiology, University of Kentucky, KY, USA.
Kelly Eddinger4 Department of Anesthesiology and Pharmacology, University of California, San Diego, CA, USA.
Tony Yaksh4 Department of Anesthesiology and Pharmacology, University of California, San Diego, CA, USA.
Donald C Manning1 Adynxx, Inc., CA, USA.
Stanford University · USUniversity of California, San Diego · USUniversity of Kentucky · US

Funding

Long-term activation of spinal opioid analgesia after inflammationR01DA037621 · NIDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI TAYLOR, BRADLEY K. · 2015 to 2019
$3.4M
NIDA NIH HHS R01 DA037621
6 · The paper itself

Abstract

Background AYX1 is an unmodified DNA-decoy designed to reduce acute post-surgical pain and its chronification with a single intrathecal dose at the time of surgery. AYX1 inhibits the transcription factor early growth response protein 1, which is transiently induced at the time of injury and triggers gene regulation in the dorsal root ganglia and spinal cord that leads to long-term sensitization and pain. This work characterizes the AYX1 dose-response profile in rats and the link to AYX1 pharmacokinetics and metabolism in the cerebrospinal fluid, dorsal root ganglia, and spinal cord. Results The effects of ascending dose-levels of AYX1 on mechanical hypersensitivity were measured in the spared nerve injury model of chronic pain and in a plantar incision model of acute post-surgical pain. AYX1 dose-response profile shows that efficacy rapidly increases from a minimum effective dose of ∼ 0.5 mg to a peak maximum effective dose of ∼ 1 mg. With further dose escalation, the efficacy paradoxically appears to decrease by ∼ 30% and then returns to full efficacy at the maximum feasible dose of ∼ 4 mg. The reduction of efficacy is associated to doses triggering a near-saturation of AYX1 metabolism by nucleases in the cerebrospinal fluid and a paradoxical reduction of AYX1 exposure during the period of early growth response protein 1 induction. This effect is overcome at higher doses that compensate for the effect of metabolism. Discussion AYX1 is a competitive antagonist of early growth response protein 1, which is consistent with the overall increased efficacy observed as dose-levels initially escalate. Chemically, AYX1 is unprotected against degradation by nucleases. The sensitivity to nucleases is reflected in a paradoxical reduction of efficacy in the dose-response curve. Conclusions These findings point to the importance of the nuclease environment of the cerebrospinal fluid to the research and development of AYX1 and other intrathecal nucleotide-based therapeutics.

Indexed as

AnalgesicsDNAOligonucleotidesAcute PainAnimalsChronic PainDisease Models, AnimalDose-Response Relationship, DrugEarly Growth Response Protein 1Ganglia, SpinalPain MeasurementPostoperative PainRatsRats, Sprague-DawleySpinal CordAnalgesicsDNAEarly Growth Response Protein 1Egr1 protein, ratOligonucleotidescerebrospinal fluidChronic painearly growth response protein 1nucleasesoligonucleotide

Identifiers

PMID28394696
PMCPMC5407669
OpenAlexW2606904670

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.