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Modulators of VR1: A novel approach to analgesia Chronic pain affects 40-70 million people per year in the US alone and represents a serious and multi-factorial clinical problem. Furthermore, establishing prolonged analgesia free of serious side effects is a particularly challenging area of medicine. The total economic cost of pain is US$100 billion and global sales of analgesics and anti-inflammatories have been estimated as US$18.7 billion worldwide. Analgesia is currently treated by NSAIDs or by opiates. The former is related to well-publicized and serious GI problems while the latter causes unwanted side central side effects. New analgesics are therefore urgently required (see our recent feature "Future Pain Drugs" for a full analysis of this field). Capsaicin and other similar molecules such as resiniferatoxin have been targeted as therapeutic approaches to analgesia, however this field took a major step forward in 1997 following the identification of the vanilloid receptor VR1 and more recently other member of this receptor family. Consequent advances in vanilloid pharmacology are now starting to produce therapeutic candidates and indeed the number of vanilloid ligands in pharmaceutical development has doubled over the past year. While the identification of receptor ligands offers one therapeutic approach, the identification of modulators of its channel activity represents an alternative strategy. Capsaicin responses in sensory neurons exhibit robust potentiation by cAMP-dependent protein kinase (PKA). Most recently Baylor researchers demonstrate that PKA reduces VR1 desensitization and directly phosphorylates VR1. In vitro phosphorylation, phosphopeptide mapping, and protein sequencing of VR1 cytoplasmic domains delineate several candidate PKA phosphorylation sites. Electrophysiological analysis of phosphorylation site mutants clearly pinpoints Ser116 as the residue responsible for PKA-dependent modulation of VR1. Given the significant roles of VR1 and PKA in inflammatory pain hypersensitivity, VR1 phosphorylation at Ser116 by PKA may represent an important molecular mechanism involved in the regulation of VR1 function after tissue injury. Furthermore the identification of molecules able to prevent this molecular interactions should offer significant therapeutic potential. Entry date October, 2002 Adapted from Bhave et al, Neuron 2002 Aug 15;35(4):721-31
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