WO2014008477A2 - Activation of trpv4 ion channel by physical stimuli and critical role for trpv4 in organ-specific inflammation and itch - Google Patents

Activation of trpv4 ion channel by physical stimuli and critical role for trpv4 in organ-specific inflammation and itch Download PDF

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WO2014008477A2
WO2014008477A2 PCT/US2013/049457 US2013049457W WO2014008477A2 WO 2014008477 A2 WO2014008477 A2 WO 2014008477A2 US 2013049457 W US2013049457 W US 2013049457W WO 2014008477 A2 WO2014008477 A2 WO 2014008477A2
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trpv4
uvb
skin
inhibitor
mice
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PCT/US2013/049457
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English (en)
French (fr)
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WO2014008477A3 (en
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Wolfgang Liedtke
Martin Steinhoff
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Duke University
Regents Of The University Of California
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Priority to US14/413,172 priority Critical patent/US9290489B2/en
Priority to EP13813477.0A priority patent/EP2869897A4/en
Publication of WO2014008477A2 publication Critical patent/WO2014008477A2/en
Publication of WO2014008477A3 publication Critical patent/WO2014008477A3/en
Priority to US15/018,595 priority patent/US9701675B2/en
Priority to US15/624,508 priority patent/US20180022740A1/en
Priority to US16/217,948 priority patent/US20190112301A1/en

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Definitions

  • This disclosure relates to methods and compositions for treating inflammation, pain, itch, cancer, autoimmune diseases, fibrotic diseases, skin pigmentation, and/or other dermatological disorders.
  • the skin is the largest organ in many vertebrates, including humans. It provides barrier protection against the potentially harmful external environment.
  • the skin also represents the site of first interaction of the ambient environment to immunologically competent and sentient structures of the organism. Cells endowed with sensory transduction capacity for warmth, cold, mechanical cues, pain, and itch are sensory neurons in the dorsal root and trigeminal ganglia with their peripheral axons directly interfacing with skin.
  • TRPV4 is a multimodally-activated non-selective cation channel permeable to calcium (i.e., Ca++).
  • Ca++ calcium
  • the TRPV4 ion channel is expressed robustly.
  • TRPV4 is also expressed in skin-innervating sensory neurons.
  • Trpv4-/- mice an epidermal phenotype of impaired barrier function between epidermis and dermis has been shown.
  • Trpv4 has been found critical for physiological withdrawal responses to noxious osmotic and mechanical, but not thermal cues, and has also been found relevant for inflammation or nerve-damage-induced sensitization of nociception.
  • TRPV4 is expressed in epidermal keratinocytes and skin-innervating sensory neurons
  • an in-vivo role of TRPV4 in pathological pain evoked by UVB exposure has not been demonstrated.
  • a direct role of TRPV4 in itch transmission has not been demonstrated as of yet.
  • the disclosure relates to methods of treating and/or preventing a dermatological disorder in a subject in need thereof.
  • the methods may include administering to the subject an effective amount of a TRPV4 inhibitor.
  • the dermatological disorder may be selected from inflammation, pain, itch, cancer, autoimmune diseases, fibrotic diseases, skin pigmentation, and/or other dermatological disorders.
  • the TRPV4 inhibitor may include a compound according to Formula I:
  • A, B, and C are independently selected from the group consisting of aromatic, heteroaromatic, cycloalkenyl, and heterocycloalkenyl groups; D is C 1 -C3 alkylene; E is a bond, or C 1 -C 2 alkylene; and R is selected from the group consisting of hydrogen, hydroxyl, amino, alkyl, alkenyl, heteroalkyl, aromatic ring, or heteroaromatic ring.
  • the TRPV4 inhibitor may include a compound selected from the following:
  • the disclosure relates to methods of reducing skin inflammation in a subject in need thereof.
  • the methods may include administering to the subject an effective amount of a TRPV4 inhibitor.
  • the skin inflammation may be related to UVB exposure.
  • the skin inflammation may be associated with a dermatological disorder selected from sunburn, rosacea, Xeroderma pigmentosum, non-melanoma skin cancer, and photoaging, or with a disorder selected from non-UV skin burn, disturbed wound healing, and pain of bone fractures.
  • the method may further include reducing pain in the subject.
  • the TRPV4 inhibitor may include a compound according to Formula I:
  • A, B, and C are independently selected from the group consisting of aromatic, heteroaromatic, cycloalkenyl, and heterocycloalkenyl groups; D is C 1 -C3 alkylene; E is a bond, or C 1 -C 2 alkylene; and R is selected from the group consisting of hydrogen, hydroxyl, amino, alkyl, alkenyl, heteroalkyl, aromatic ring, or heteroaromatic ring.
  • the TRPV4 inhibitor may include a compound selected from the following:
  • the disclosure relates to methods of pain management.
  • the methods may include administering to at least a portion of the skin of a subject in need thereof an effective amount of a TRPV4 inhibitor.
  • the pain may be associated with a dermatological disorder selected from sunburn, rosacea, Xeroderma pigmentosum, non-melanoma skin cancer, and photoaging, or with a disorder selected from non-UV skin burn, disturbed wound healing, and pain of bone fractures.
  • the method may further include reducing pain in the subject.
  • the TRPV4 inhibitor may include a compound according to Formula I:
  • A, B, and C are independently selected from the group consisting of aromatic, heteroaromatic, cycloalkenyl, and heterocycloalkenyl groups; D is C-
  • the TRPV4 inhibitor may include a compound selected from the following:
  • Another aspect of the disclosure provides methods of reducing itch in a subject in need thereof.
  • the methods may include administering to the subject an effective amount of a TRPV4 inhibitor.
  • compositions including a TRPV4 inhibitor compound in combination with a carrier, vehicle, or diluent that is suitable for topical application.
  • the disclosure relates to topical formulations including a TRPV4 inhibitor, wherein the TRPV4 inhibitor includes a compound according to the following formula:
  • A, B, and C are independently selected from the group consisting of aromatic, heteroaromatic, cycloalkenyl, and heterocycloalkenyl groups; D is C 1 -C3 alkylene; E is a bond, or C-
  • the TRPV4 inhibitor may include a compound selected from the following:
  • the disclosure relates to novel TRPV4 inhibitors.
  • the TRPV4 inhibitor may be a compound selected from the following:
  • the disclosure relates to a transgenic mouse whose genome includes deletions of the Trpv4 gene in keratinocytes of the epidermis, wherein said transgenic mouse is a knockout for the Trpv4 gene in keratinocytes of the epidermis following keratinocyte- specific activation and expression of a site-specific recombination enzyme.
  • a Keratin-14 promoter may drive expression of the site-specific recombination enzyme, wherein the site- specific recombination enzyme is fused to a mutated estrogen receptor, and wherein an anti- estrogen has increased affinity to the mutated estrogen receptor relative to wild-type estrogen such that addition of the anti-estrogen to the transgenic mouse drives the site-specific recombination enzyme to the nucleus and results in knockdown of expression of the Trpv4 gene.
  • the site-specific recombination enzyme may be CRE recombinase. Deletion of the Trpv4 gene may be specifically and conditionally induced in keratinocytes of the epidermis.
  • the keratinocyte-specific deletion of the Trpv4 gene may be induced by applying an anti-estrogen.
  • the anti-estrogen may include tamoxifen.
  • the transgenic mouse may exhibit reduced expression relative to a control of at least one of IL6, ET1 , caspasel , ⁇ _1 ⁇ , and CXCL5, or a combination thereof, in response to UVB exposure.
  • the disclosure relates to assays including a transgenic mouse as described herein.
  • the disclosure relates to methods for identifying a selective inhibitor of TRPV4.
  • the methods may include (a) contacting a mouse with a test compound; (b) determining a biological activity of TRPV4 after contacting with the test compound; and (c) determining a control level of biological activity of TRPV4 in the absence of the test compound; (d) comparing the biological activity of TRPV4 from step (b) with the biological activity of TRPV4 from a model of TRPV4 deletion, wherein the model of TRPV4 deletion includes the transgenic mouse as disclosed herein or a pan-null Trpv4-/- mouse; and (e) identifying the test compound as a selective inhibitor of TRPV4 when at least one of (i) the TRPV4 biological activity is lower in the presence of the test compound than the TRPV4 biological activity in the absence of the test compound; (ii) the TRPV4 biological activity in the presence of the test compound is about the same as, or lower than,
  • FIG. 1 Keratinocyte-specific and inducible Trpv4 null mouse and its UVB response.
  • A Gene-targeting of Trpv4 and genetic manipulation underlying generation of keratinocyte-specific and inducible Trpv4 knockout mice. Shown are sequential steps of mouse Trpv4 targeting, starting with flanking Trvp4 exon13 with loxP elements and insertion of a selection cassette, flanked by frt sites, in mouse embryonic stem cells. After generation of chimeric mice and stable transmission of the engineered mutation, the selection cassette was removed by breeding to FLPe mice.
  • mice were homozygosed and crossed with K14- CRE-ER tam mice, which then permitted keratinocyte-specific and inducible Trpv4 knockout/knockdown.
  • B DNA genotyping. Shown are PCR products of WT, heterozygote and homozygous Trpv4 toM x mice. Note that the PCR products needed to be digested with Pad, and that all mice were pre-screened to be CRE+ by another genotyping PCR.
  • C Co-labeling of mouse skin for keratin-1 and keratin-14 indicate the established pattern for vehicle-induced control mice (upper panel), and a similar pattern for specific TRPV4 knockdown in keratinocytes (lower panel).
  • FIG. 1 Size distribution of pERK-expressing L5 DRG neurons in oil-treated iKO mice, exposed to UVB.
  • Figure 2 UVB stimulation device and UVB keratinocyte control experiments.
  • A UV spectrum emitted by the LEDs, overlapped with the spectrum of quartz (red trace), which is almost fully permeable to UVB, and glass (blue trace), which has a very low UVB permeability.
  • B Focusing properties of the ball lens.
  • C Focal geometry of the combination of UV-LED and ball lens.
  • D Absence of thermal effects of the UV-LEDs; measurement of temperature in the focal point over time.
  • E TRPV3 activation experiment. Induction of a Ca++ transient by camphor, which can be blocked effectively by 10 ⁇ IPP, suggesting TRPV3- mediated signaling.
  • F TRPV4 selective activator GSK101-related findings.
  • TRPV4 is sufficient for the UVB-Ca++ response - HEK293T cell heterologous transfection. Directed expression of TRPV4 in HEK293T cells leads to a Ca++-transient in response to UVB radiation, which is greatly reduced in control-transfected cells. Preexposure to 20 ⁇ GSK205 virtually eliminates the Ca++-signal in TRPV4-transfected cells, and eliminates the moderate signal of control- transfected cells.
  • FIG. 3 Keratinocyte-specific ablation of Trpv4 leads to alterations in nocifensive behavior in response to UVB.
  • A Epidermal TRPV4 expression and its loss upon keratinocyte-specific ablation of Trpv4 in tarn-induced iKO mice,
  • FIG. 4 Structural and ultrastructural analyses showing that UVB-mediated skin tissue injury depends upon keratinocyte TRPV4, and Immuno-histochemical analysis demonstrates that UVB-mediated activation of keratinocytes and recruitment of macrophages and neutrophils depends upon keratinocyte TRPV4.
  • A 1 ⁇ toluidine-blue semi-thin sections. Micrographs show representative findings of skin in response to UVB, sampled 48 hours after UVB exposure. Note that upon UVB stimulation, oil- (TRPV+) but not tarn-treated (TRPV-) iKO mice exhibit separations at the epidermal-dermal boundary and robust signs of tissue injury; note granulocytes (Gr, neutrophil).
  • Basal (BL) and spinous (Sp) layers are magnified A' and C displaying a normal organization with no evidence of epidermal damage.
  • ( ⁇ , ⁇ ' ⁇ "), (D-D') and ( ⁇ - ⁇ ') show representative findings of skin in response to UVB, sampled 48h after UVB exposure.
  • (B) Disrupted epidermis in oil treated iKO mice. An area equivalent to the boxed area is magnified in ( ⁇ '), where granulocyte infiltration of epidermis is evident (Gr) and blistering with detachment of the epidermis from the dermis (double arrows).
  • FIG. 1 Histopathology in Trpv4-I- and control mice in response to UVB.
  • Trpv4 knockdown level of samples shown in Figure 4A-E This bar diagram shows relative level of knockdown of Trpv4 in comparison with WT, of UVB-exposed skin samples shown in Figure 4.
  • An adjacent sample of hindpaw skin was RNA-extracted at 48h post-exposure and subjected to Trpv4 qRT-PCR; pooled WT mRNA values from 10 mice were set as 100%.
  • Trpv4-I- and WT control mice show normal skin morphology with intact epidermis (Epi) in the absence of UVB stimulation. A' and B' show higher magnification of basal layer (BL) cells.
  • C-C Damaged epidermis with vacuolization (inset in C) and granulocyte (neutrophil) (granulocyte - Gr) infiltrate (C).
  • TRPV4. Custom-built UVB cell illumination apparatus. See also Figure 2.
  • Ca++ signaling is dependent upon UVB, and is strikingly reduced when quartz coverslips are replaced by glass ones, which prevent UVB permeation (see Figure 2A). Note that this particular Ca++ signal in WT 1 °MKs persisted after UVB, as is sometimes observed.
  • UVB-evoked Ca++ signaling is dependent on external [Ca++].
  • E UVB-evoked Ca++ signaling is not seen in Trpv4-I- 1 °MKs, revealing the importance of the TRPV4 ion channel.
  • UVB-evoked Ca++ signaling is strongly down-regulated in the presence of TRPV4-selective inhibitor, GSK205 (20 ⁇ ).
  • Panel (i) shows averaged Ca++ transients in 1 °MK in response to UVB, their augmentation by co-exposure to ET1 peptide, and their significant attenuation by either GSK205, which inhibits TRPV4, or ET-convertase inhibitor CGS35066, which blocks ET1 proteolytic processing.
  • Panel (ii) shows ET-augmented, UVB-induced Ca++ transients as in (i), but in this case, where they are attenuated by selective antagonism of ET(R)-A (BQ123) and ET(R)-B (BQ788).
  • Panel (iii) illustrates the complete elimination of the ET1 -augmented Ca++ transients when both subtypes of ET(R) are blocked.
  • Left-hand panel shows Ca++ transients (as per fura-2 ratiometric imaging) in response to the selective TRPV4 activator 4a-PDD.
  • a significant increase in the response can be observed by co-application of ET1 , and this is partially dependent on ET(R)-A and completely dependent on ET(R)-B.
  • (C) Upregulation of ET1 in mouse paw in response to UVB. Immunohistochemistry reveals a significantly stronger ET1 signal in UVB-exposed skin of oil-vehicle-treated (TRPV4+) rather than tamtreated iKO mice. Quantifications are for n 3 mice/group.
  • FIG. 8 Central role for KC TRPV4 in UVB-evoked Ca ++ signaling and nocifensive behavior - ET1 -related supplementary findings.
  • A Augmentation of GSK101- evoked Ca ++ signaling by ET1. Shown are averaged Ca ++ measurements (fura-2) in response to 5 nM GSK101. Note the increase in signal in response to co-exposure to ET1 .
  • B ET1 secretion by non-stimulated ⁇ depends on TRPV4 and PLC. Shown are relative ET1 concentrations (determined by ELISA, pg/mL; vehicle-treated and WT control normalized to 100) in supernatant of non-stimulated ⁇ .
  • B Quantifications of caspase-1 immunolabeling. Bar diagrams show densitometry, n ⁇ 3 animals/group. Comparisons: UVB exposed WT vs. Trpv4-I- and iKO + oil vs. iKO + tarn. ** p ⁇ 0.01 ANOVA.
  • C Western blotting for caspase-1 from 1 °MK ⁇ UVB-exposure.
  • caspase-1 levels in particular cleaved caspase-1 (lower band), are elevated in UVB- exposed WT cells, but there is a complete absence of both procaspase-1 and cleaved caspase- 1 in 1 °MK from Trpv4-I- mice.
  • D I L-1 ⁇ is induced upon UVB-exposure and is dependent on TRPV4. Anti-I L-1 ⁇ immunofluorescence, otherwise as in panel A.
  • E Quantifications of I L-1 ⁇ immunolabeling, n ⁇ 3 animals/group. Comparisons: UVB exposed WT vs. Trpv4-I- and iKO + oil vs. iKO + tarn, ** p ⁇ 0.01 ANOVA.
  • FIG. 10 Epidermal TRPV4, ET1 and IL-1 ⁇ are elevated in photodermatitis as compared to healthy human skin.
  • (B) Morphometric analysis for immunoreactive TRPV4, ET1 and ⁇ _-1 ⁇ . Findings reveal significantly increased immunolabeling for all three proteins in acute photodermatitis as compared to healthy human skin (n 3 subjects for normal, healthy skin, and 3 patients for acute UV photodermatitis).
  • Figure 11 Exemplars of human chronic photodermatitis.
  • Upper panel shows normal healthy human skin, as displayed in Figure 10A, for comparison.
  • Lower panel shows examples of chronic photodermatitis with elevated expression of TRPV4, in spinous and basal layers, ET1 (throughout) and I L-1 ⁇ (throughout).
  • ET1 throughout
  • I L-1 ⁇ throughout
  • Bar 50 ⁇ .
  • FIG. 12 External-topical application of a selective TRPV4 inhibitor attenuates UVB-evoked nocifensive behavior and inflammation.
  • A UVB-induced nocifensive behavior. Pain behavior is attenuated by topical application of GSK205.
  • FIG. 13 Topical application of a selective TRPV4 inhibitor attenuates UVB- evoked nocifensive behavior by suppressing upregulation of pro-algesic/algogenic mediators in murine keratinocytes - Findings for CXCL5 and IL6.
  • GSK205-treatment attenuates keratinocyte expression of CXCL5 in UVB-exposed footpad - micrographs and quantitation.
  • Figure 12B specific immunolabeling for CXCL5, which is selectively upregulated in footpad keratinocytes in response to UVB, note attenuation with GSK205 treatment.
  • FIG. 14 External-topical application of a selective TRPV4 inhibitor attenuates UVB-evoked nocifensive behavior and inflammation.
  • UVB-exposed skin with GSK205 improved the skin architecture in mice as compared to vehicle-treated mice after 24 hours
  • Representative skin sections of UVB-induced photodermatitis after GSK205 treatment showed markedly reduced inflammatory infiltrate, less spongiosis and dermal-epidermal blisters with remaining epidermal thickening
  • Vehicle-treated mice after UVB-induced photodermatitis were characterized by signs of severe acute photodermatitis such as spongiosis, epidermal hyperkeratosis, disrupted dermal-epidermal border (blister), and a marked inflammatory infiltrate with dilated blood vessels and dermal edema (arrows).
  • Topical treatment with a TRPV4-specific inhibitor attenuates upregulation of algogenic ET1/Edn1.
  • Edn1 mRNA was determined by qPCR after extraction of total RNA from paw-pad epidermis. In vehicletreated skin, note increase of Edn1 expression with early up-regulation at the 2 hour time-point, and sustained elevation up to the 24 hour time-point. This time-course resembles that seen in WT control mice, when comparing to Trpv4-/- ( Figure 15).
  • GSK205 does not function as sunscreen. Schematic illustrates the experimental set-up.
  • Figure 16 Skin UVB permeability testing.
  • A Experimental set-up for testing of skin permeability to UVB.
  • B Results from A. Note that intensity is 70% within 500 ⁇ radius to the center of the UV beam.
  • the disclosure relates to compositions and methods for treating and/or preventing a dermatological disorder.
  • the skin functions as an essential barrier between the external environment and the vertebrate organism. Keratinocytes in the skin absorb UV- light, leading to skin inflammation, pain, and itch after over-exposure, subsequently to skin pigmentation.
  • Keratinocytes in the skin absorb UV- light, leading to skin inflammation, pain, and itch after over-exposure, subsequently to skin pigmentation.
  • the inventors have identified that the skin, in particular its epidermal epithelia, is more substantially involved in sensory transduction. For this, the inventors used a mouse model of sunburn in order to induce a state of lowered sensory thresholds evoked by a limited, self-resolving inflammation in response to UV spectrum of light. UV-evoked lowering of sensory thresholds shares major hallmarks of pathological pain, which is another valuable feature of this model.
  • compositions and methods disclosed herein relate to the identification and characterization that epidermal keratinocytes function prominently to orchestrate UVB-mediated inflammation and sensitization of peripheral nerve endings in the skin, and in that respect, epidermal keratinocytes have a role similar to a co-sensory cell.
  • Keratinocytes abundantly express the cation channel protein TRPV4, and the inventors have determined that TRPV4, expressed in epidermal keratinocytes, plays a role in UV-induced inflammation and pain.
  • the channel exerts its role as a master regulator of UVB-evoked skin inflammation and nociception through Ca++ influx into keratinocytes.
  • TRPV4-mediated Ca++ influx re- programs the keratinocyte to function in a pro-inflammatory and pro-algesic (pro-pain) manner, via TRPV4-dependent secretion of endothelin-1 , which may lead to sensation of itch and skin pigmentation.
  • TRPV4 is activated contemporaneously with UVB exposure, which leads to activation of pro-algesic pathways via secreted factors previously demonstrated to have relevance in human pain.
  • mice with inducible Trpv4 deletions targeted to keratinocytes were induced for TRPV4 deletion, subsequently UVB- exposed, and found to be less sensitive to noxious thermal and mechanical stimulation than control mice.
  • Epidermal TRPV4 was identified as a protein involved in the orchestration of UVB-mediated skin inflammation.
  • UVB-evoked inflammasome activation and increased expression of pro-algesic/algogenic mediators such as ⁇ _1 - ⁇ , CXCL5, ET-1 , and IL- 6, were TRPV4-dependent.
  • ET-1 has been shown in humans to not only elicit painful sensations, but to also elicit itch, when injected into the skin.
  • ET-1 has been identified as a melanogen, that is, to increase skin pigmentation by signaling to melanocytes.
  • UVB caused a direct, TRPV4-dependent Ca ++ -response.
  • TRPV4-selective inhibitor reduced UVB-evoked epidermal inflammation and pain behavior. Additionally, it was found that epidermal expression of TRPV4, ET1 , and I L1 ⁇ were increased in acute human UV-photodermatitis.
  • photodermatitis is used in this application referring to skin inflammation in response to UV radiation/light. This tissue response can include pain, irritation, itch, influx of inflammatory and pain-enhancing cells and tissue injury.
  • the dermatological disorder may be associated with the TRPV4 pathway.
  • Dermatological disorders include, but are not limited to, photo-induced inflammation, pain in diseases involving skin pain, itch, cancer, autoimmune diseases, fibrotic diseases, other acneiform or inflammatory skin diseases, and pigmentation disorders.
  • dermatological disorders may include, but are not limited to, sunburn; photoallergic reaction; phototoxic reaction; phytophotodermatitis (Berloque dermatitis); acute and chronic actinic dermatitis; atopic dermatitis exacerbation; all subtypes of rosacea including trigeminal-pain associated rosacea; all lupus erythematosus subtypes (systemic, discoid, subacute); atopic dermatitis; actinic prurigo; prurigo nodularis; prurigo subacuta; prurigo pigmentosa; Lichen simplex (also called neurodermatitis); diabetic pruritus; uremic pruritus; pruritus induced by metabolic (liver) diseases; pruritus induced by malignancies like lymphoma; pruritus induced by polycythemia vera; pruritus induced by scabies; pruritus induced by bullous pemphigoi
  • the disclosure provides methods of reducing skin inflammation in a subject in need thereof.
  • the methods may comprise administering to the subject an effective amount of a TRPV4 inhibitor.
  • the skin inflammation may be related to UVB exposure.
  • Skin inflammation may be associated with conditions including, but not limited to, sunburn (acute photodermatitis), photoallergic reaction, phototoxic reaction, phytophotodermatitis (Berloque dermatitis), acute and chronic actinic dermatitis, atopic dermatitis exacerbation, and rosacea.
  • the disclosure provides methods of pain management.
  • the methods may comprise administering to at least a portion of the skin of a subject in need thereof an effective amount of a TRPV4 inhibitor.
  • the pain may be related to UVB exposure.
  • Pain may be chronic or acute. Pain may be associated with or result from conditions including, but not limited to, all subtypes of rosacea including trigeminal-pain associated rosacea, and all lupus erythematosus subtypes (systemic, discoid, subacute).
  • the disclosure provides methods of reducing itch in a subject in need thereof. ET-1 has been shown to elicit itch, and as shown in the Examples, increased expression of ET-1 was TRPV4-dependent. The methods may comprise administering to the subject an effective amount of a TRPV4 inhibitor.
  • Itch may be chronic or acute. Itch may be associated with or result from conditions including, but not limited to, rosacea, atopic dermatitis, actinic prurigo, prurigo nodularis, prurigo subacuta, prurigo pigmentosa, Lichen simplex (also called neurodermatitis), diabetic pruritus, and uremic pruritus. Itch or pruritus may be associated with or result from conditions including metabolic (liver) diseases, malignancies like lymphoma, polycythemia vera, scabies, bullous pemphigoid, urticaria (especially but not exclusively actinic urticaria), insect/arachnoid vector bite, and parasitosis.
  • metabolic liver
  • the disclosure provides methods of treating cancer in a subject in need thereof.
  • the methods may comprise administering to the subject an effective amount of a TRPV4 inhibitor.
  • the cancer and related conditions may include, but are not limited to, melanoma, non-melanoma skin cancer (BCC, SCC), actinic keratosis and other premalignant skin cancers, mycosis fungoides, Sezary syndrome, and Xeroderma pigmentosum.
  • BCC non-melanoma skin cancer
  • SCC actinic keratosis and other premalignant skin cancers
  • mycosis fungoides mycosis fungoides
  • Sezary syndrome and Xeroderma pigmentosum.
  • the disclosure provides methods of treating an autoimmune disease in a subject in need thereof.
  • the methods may comprise administering to the subject an effective amount of a TRPV4 inhibitor.
  • Autoimmune diseases may include, but are not limited to, all lupus erythematosus subtypes (systemic, discoid, subacute), dermatomyositis, erythema multiforme, and lichen planus.
  • the disclosure provides methods of treating a fibrotic disease in a subject in need thereof.
  • the methods may comprise administering to the subject an effective amount of a TRPV4 inhibitor.
  • Fibrotic diseases may include conditions induced by UV-exposure, such as, for example, Rhinophyma, chronic actinic dermatitis, actinic reticuloid, photoaging, and hyalinosis cutis et mucosae.
  • the disclosure provides methods of treating other acneiform or inflammatory skin disease in a subject in need thereof. The methods may comprise administering to the subject an effective amount of a TRPV4 inhibitor.
  • Acneiform or inflammatory skin diseases may include, but are not limited to, polymorph light eruption, Acne aestivalis, photo-induced Herpes simplex infection (Herpes labialis), morbus Darier, disseminated superficial actinic porokeratosis, Pityriasis rubra pilaris, and all porphyria subforms with implications on photo-induced skin changes such as, for example, erythropoetic porphyria, erythropoetic protoporphyria, and Porphyria variegate.
  • the disclosure provides methods of reducing skin pigmentation in a subject in need thereof.
  • the methods may comprise administering to the subject an effective amount of a TRPV4 inhibitor.
  • Skin inflammation, pain, itch, and/or pigmentation may also be associated with disorders including, but not limited to, Cockayne syndrome, non-UV skin burn less than 3 rd degree, disturbed wound healing, exposure and pathological response to poison ivy, and pain of bone fractures directly adjacent to the skin such as fractures of the tibia, digits, or skull.
  • the disclosure provides methods of preventing dermatological diseases or disorders such as irritation, pain, itch, pruritus, autoimmune diseases, skin cancer (including melanoma, for example, with topical treatment of TRPV4 inhibitor-based UV protection), autoimmune diseases, fibrotic disorders, pigmentation disorders, and others as described above.
  • the disclosure provides methods of preventing the development and/or exacerbation of Xeroderma pigmentosum, Cockayne syndrome, Bloom syndrome, Rothmund-Thomson syndrome, and Hartnup syndrome.
  • the disclosure provides methods of treating or preventing cosmetic conditions.
  • the disclosure provides methods of treating or preventing photoaging, wrinkles, photo-induced inflammation, pigmentation, and pigmentation disorders.
  • TRPV4 Inhibitor
  • TRPV4 is a Ca 2+ -permeable, nonselective cation channel
  • some embodiments provide for a TRPV4 inhibitor that can inhibit the biological function of TRPV4 (e.g., inhibit cation channel activity, inhibit Ca++ transport and/or availability).
  • Other embodiments provide for a TRPV4 inhibitor that may inhibit the expression of mRNA encoding TRPV4.
  • Some embodiments provide a TRPV4 inhibitor that may inhibit the translation of mRNA encoding TRPV4 to protein.
  • a TRPV4 inhibitor may indirectly or directly bind and inhibit the activity of TRPV4 (e.g., binding activity or enzymatic activity), reduce the expression of TRPV4, prevent expression of TRPV4, or inhibit the production of TRPV4 in a cell.
  • Inhibit or inhibiting relates to any measurable reduction or attenuation of amounts or activity, e.g., amounts or activity of TRPV4, such as those disclosed herein.
  • a TRPV4 inhibitor can increase the amount of, or the biological activity of a protein that can reduce the activity of TRPV4.
  • Agents capable of increasing the level of such a protein may include any agent capable of increasing protein or mRNA levels or increasing the expression of the protein.
  • a TRPV4 inhibitor may comprise the protein itself.
  • a TRPV4 inhibitor may include exogenously expressed and isolated protein capable of being delivered to the cells.
  • the protein may be delivered to cells by a variety of methods, including fusion to Tat or VP16 or via a delivery vehicle, such as a liposome, all of which allow delivery of protein-based agents across the cellular membrane.
  • a delivery vehicle such as a liposome
  • mRNA expression may be enhanced relative to control cells by contact with a TRPV4 inhibitor.
  • the agent capable of increasing the level of natively expressed protein may include a gene expression activator or de-repressor.
  • a TRPV4 inhibitor capable of decreasing the level of natively expressed protein may include a gene expression repressor.
  • An agent capable of increasing the level of protein may also include agents that bind to directly or indirectly and increase the effective level of protein, for example, by enhancing the binding or other activity of the protein.
  • the agent capable of decreasing the level of protein may also include agents that bind to directly or indirectly and decrease the effective level of protein, for example, by inhibiting or reducing the binding or other activity of the protein.
  • the amount or level of expression of a biomolecule (e.g., mRNA or protein) in a cell may be evaluated by any variety of techniques that are known in the art.
  • inhibit or inhibiting such as, for example, the level of protein expression (e.g., TRPV4)
  • the level of protein expression e.g., TRPV4
  • the expression level of a protein may be evaluated by immunofluorescence by visualizing cells stained with a fluorescently-labeled protein-specific antibody, Western blot analysis of protein expression, and RT-PCR of protein transcripts.
  • the expression level of TRPV4 may be compared to a control.
  • a control may include comparison to the level of expression in a control cell, such as a non-disease cell or other normal cell.
  • a control may include an average range of the level of expression from a population of normal cells.
  • a standard value developed by analyzing the results of a population of cells with known responses to therapies or agents may be used.
  • a TRPV4 inhibitor may comprise a variety of compounds and compositions and agents.
  • a TRPV4 inhibitor may comprise a compound.
  • a TRPV4 inhibitor may comprise a biological molecule, including nucleic acid molecules, such as a polynucleotide having RNAi activity against TRPV4 or a substrate thereof.
  • the nucleic acid molecules can include decoy RNAs, dsRNAs, miRNAs, siRNAs, nucleic acid aptamers, antisense nucleic acid molecules, and enzymatic nucleic acid molecules that comprise a sequence that is sufficient allow for binding to an encoding nucleic acid sequence and inhibit activity thereof (i.e., are complementary to such encoding nucleic acid sequences).
  • an RNAi molecule comprises a sequence that is complementary to at least a portion of a target sequence such that the RNAi can hybridize to the target sequence under physiological or artificially defined (e.g., reaction) conditions.
  • an RNAi molecule comprises a sequence that is complementary such that the molecule can hybridize to a target sequence under moderate or high stringency conditions, which are well known and can be determined by one of skill in the art.
  • an RNAi molecule has complete (100%) complementarity over its entire length to a target sequence.
  • a variety of RNAi molecules are known in the art, and can include chemical modifications, such as modifications to the sugar-phosphate backbone or nucleobase that are known in the art. The modifications may be selected by one of skill in the art to alter activity, binding, immune response, or other properties.
  • the RNAi can comprise an siRNA having a length from about 18 to about 24 nucleotides.
  • the inhibitory nucleic acid molecule can bind to a target nucleic acid sequence under stringent binding conditions.
  • stringent conditions or “stringent hybridization conditions” includes reference to conditions under which a polynucleotide will hybridize to its target sequence, to a detectably greater degree than other sequences (e.g., at least 2-fold over background).
  • An example of stringent conditions include those in which hybridization in 50% formamide, 1 M NaCI, 1 % SDS at 37°C, and a wash in 0.1x SSC at 60 to 65°C is performed.
  • Amino acid and polynucleotide identity, homology and/or similarity can be determined using the ClustalW algorithm, MEGALIGNTM (Lasergene, Wl).
  • MEGALIGNTM Lasergene, Wl.
  • an inhibitory nucleic acid molecule Given a target polynucleotide sequence, for example of TRPV4 or biological substrate thereof, an inhibitory nucleic acid molecule can be designed using motifs and targeted to a region that is anticipated to be effective for inhibitory activity, such as is known in the art.
  • a TRPV4 inhibitor comprises an antibody that can specifically bind to a protein such as TRPV4 or a fragment thereof.
  • Embodiments also provide for an antibody that inhibits TRPV4 through specific binding to a TRPV4 substrate molecule.
  • the antibodies can be produced by any method known in the art, such as by immunization with a full-length protein such as TRPV4, or fragments thereof.
  • the antibodies can be polyclonal or monoclonal, and/or may be recombinant antibodies.
  • antibodies that are human antibodies can be prepared, for example, by immunization of transgenic animals capable of producing a human antibody (see, for example, International Patent Application Publication No. WO 93/12227).
  • Monoclonal antibodies can be produced by a variety of techniques, including conventional monoclonal antibody methodology, e.g., the standard somatic cell hybridization technique of Kohler and Milstein, and other techniques, e.g., viral or oncogenic transformation of B-lymphocytes.
  • Animal systems for preparing hybridomas include mouse. Hybridoma production in the mouse is very well established, and immunization protocols and techniques for isolation of immunized splenocytes for fusion are well known in the art. Fusion partners (e.g., murine myeloma cells) and fusion procedures are also known.
  • Any suitable methods can be used to evaluate a candidate active agent for inhibitory activity toward TRPV4.
  • Such methods can include, for example, in vitro assays, in vitro cell- based assays, ex vivo assays, and in vivo methods.
  • the methods can evaluate binding activity, or an activity downstream of the enzyme of interest.
  • Ex vivo assays may involve treatment of cells with an agent of the invention, followed by detection of changes in transcription levels of certain genes, such as TRPV4 through collection of cellular RNA, conversion to cDNA, and quantification by quantitative real time polymerase chain reaction (RT-QPCR). Additionally, the cell viability or inflammation may be determined after treatment with an agent.
  • RT-QPCR quantitative real time polymerase chain reaction
  • the TRPV4 inhibitor is according to Formula I:
  • A, B, and C are independently selected from the group consisting of aromatic, heteroaromatic, cycloalkenyl, and heterocycloalkenyl groups;
  • D is C C 3 alkylene
  • E is a bond, or C ⁇ -C 2 alkylene
  • R is selected from the group consisting of hydrogen, hydroxyl, amino, alkyl, alkenyl, heteroalkyl, aromatic ring, or heteroaromatic ring.
  • B and C are independently a phenyl group.
  • A is phenyl or heteroaryl.
  • A is pyridnyl.
  • R is C1-C4 alkyl.
  • A is heteroaryl, B and C are phenyl, D is ethylene, E is methylene, and R is methyl.
  • R is ethyl.
  • the TRPV4 inhibitor comprises the following compound:
  • the TRPV4 inhibitor comprises the following compound:
  • the TRPV4 inhibitor comprises the following compound:
  • the disclosure provides a method of treating a subject wherein the method comprises administering an inhibitor of TRPV4 in a pharmaceutically acceptable composition.
  • compositions comprising a TRPV4 inhibitor.
  • administering refers to delivery of a compound or composition by any appropriate route to achieve the desired effect. Administration may include any convenient route of administration, whether systemically/peripherally or at the site of desired action, including but not limited to, oral (e.g. by ingestion); topical (including e.g. transdermal, intranasal, ocular, buccal, and sublingual); pulmonary; respiratory (e.g. by inhalation or insufflation therapy using, e.g. an aerosol, e.g.
  • vaginal parenteral, for example, by injection, including subcutaneous, intradermal, intramuscular, intravenous, intraarterial, intracardiac, intrathecal, intraspinal, intracapsular, subcapsular, intraorbital, intraperitoneal, intratracheal, subcuticular, intraarticular, subarachnoid, and intrasternal; by implant of a depot, for example, subcutaneously or intramuscularly.
  • administration may be topical.
  • “Co-administered” refers to simultaneous or sequential administration. A compound or composition may be administered before, concurrently with, or after administration of another compound or composition.
  • a dosage is selected that balances the effectiveness with the potential side effects, considering the severity of the disease, disorder, or condition (e.g., skin inflammation, pain, or itch).
  • “Pharmaceutically acceptable” means suitable for use in a human or other mammal.
  • pharmaceutically acceptable carriers and “pharmaceutically acceptable excipients” are used interchangeably and refer to substances that are useful for the preparation of a pharmaceutically acceptable composition.
  • pharmaceutically acceptable carriers are generally compatible with the other ingredients of the composition, not deleterious to the recipient, and/or neither biologically nor otherwise undesirable.
  • the composition may comprise the TRPV4 inhibitor in combination with a carrier, vehicle, or diluent.
  • a carrier vehicle, or diluent.
  • pharmaceutically acceptable carriers including, but not limited to, substances useful for topical, intrathecal, ocular, parenteral, intravenous, intraperitoneal intramuscular, sublingual, nasal, and oral administration. Administration may be systemic.
  • “Pharmaceutically acceptable carrier” also includes agents for preparation of aqueous dispersions and sterile powders for injection or dispersions. Examples of pharmaceutically acceptable carriers and excipients are discussed, e.g., in Remington Pharmaceutical Science, 16th Ed.
  • compositions for making dosage forms are described in the following references: Modern Pharmaceutics, Chapters 9 and 10, Banker & Rhodes, eds. (1979); Lieberman et al., Pharmaceutical Dosage Forms: Tablets (1981 ); and Ansel, Introduction to Pharmaceutical Dosage Forms, 2nd Ed., (1976).
  • the carrier, vehicle, or diluent may be suitable for topical application.
  • compositions are formulated for topical administration.
  • the composition may be combined with one or more carriers and used in the form of cosmetic formulations.
  • Formulations may include a foam, cream, gel, lotion, ointment, or solution.
  • a TRPV4 inhibitor may be suitably dissolved in the alcohol of skin disinfectant gel or in lotions, creams, or other formulations.
  • a TRPV4 inhibitor may be included in or added to a cosmetic formulation.
  • a TRPV4 inhibitor may be included in or added to sun protection topical formulations.
  • the composition may be combined with one or more carriers and used in the form of ingestible tablets, buccal tablets, troches, capsules, elixirs, suspensions, syrups, wafers, chewing gums, foods, and the like.
  • the percentage of the compositions and preparations may, of course, be varied and may conveniently be between about 0.1 to about 100% of the weight of a given unit dosage form.
  • the tablets, troches, pills, capsules, and the like may also contain the following: binders such as gum tragacanth, acacia, corn starch or gelatin; excipients such as dicalcium phosphate; a disintegrating agent such as corn starch, potato starch, alginic acid and the like; a lubricant such as magnesium stearate; and a sweetening agent such as sucrose, fructose, lactose or aspartame or a flavoring agent such as peppermint, oil of wintergreen, or cherry flavoring.
  • binders such as gum tragacanth, acacia, corn starch or gelatin
  • excipients such as dicalcium phosphate
  • a disintegrating agent such as corn starch, potato starch, alginic acid and the like
  • a lubricant such as magnesium stearate
  • a sweetening agent such as sucrose, fructose, lactose or aspartame or a flavoring
  • the unit dosage form When the unit dosage form is a capsule, it may contain, in addition to materials of the above type, a liquid carrier, such as a vegetable oil or a polyethylene glycol. Various other materials may be present as coatings or to otherwise modify the physical form of the solid unit dosage form. For instance, tablets, pills, or capsules may be coated with gelatin, wax, shellac or sugar and the like.
  • a liquid carrier such as a vegetable oil or a polyethylene glycol.
  • Various other materials may be present as coatings or to otherwise modify the physical form of the solid unit dosage form. For instance, tablets, pills, or capsules may be coated with gelatin, wax, shellac or sugar and the like.
  • Effective amount refers to a dosage of a compound or composition effective for eliciting a desired effect, commensurate with a reasonable benefit/risk ratio. This term as used herein may also refer to an amount effective at bringing about a desired in vivo effect in an animal, preferably, a human, such as reduction in skin inflammation, reduction in pain, or reduction in itch.
  • the amount of a TRPV4 inhibitor in such therapeutically useful compositions is such that an effective dosage level will be obtained.
  • the selected dosage level will depend upon a variety of factors including the activity of the particular compound employed, the route of administration, the time of administration, the rate of excretion or metabolism of the particular compound being employed, the duration of the treatment, other drugs, compounds and/or materials used in combination with the particular compound employed, the age, sex, weight, condition, general health and prior medical history of the patient being treated, and like factors well known in the medical arts.
  • the daily dose contains from about 0.1 mg to about 2000 mg of the active ingredient, or about 0.5 to about 60 mg of the active ingredient.
  • This dosage form permits the full daily dosage to be administered in one or two oral doses. More than once daily or twice daily administrations, e.g., 3, 4, 5, or 6 administrations per day, are also contemplated herein.
  • administering relates to providing an amount effective at bringing about a desired in vivo effect such as inhibition of TRPV4 in an animal, such as a human.
  • a "subject in need of treatment” refers to a subject having been diagnosed with a dermatological disease or disorder associated with skin inflammation, pain, itch, or a combination thereof.
  • a subject may be a mammalian subject.
  • a subject can include human and non-human animals.
  • non-human animals includes all vertebrates, e.g., non-mammals (such as chickens, amphibians, reptiles) and mammals, such as non-human primates, domesticated and/or agriculturally useful animals (such as sheep, dogs, cats, cows, pigs, etc.), and rodents (such as mice, rats, hamsters, guinea pigs, etc.).
  • non-mammals such as chickens, amphibians, reptiles
  • mammals such as non-human primates, domesticated and/or agriculturally useful animals (such as sheep, dogs, cats, cows, pigs, etc.), and rodents (such as mice, rats, hamsters, guinea pigs, etc.).
  • embodiments of the methods described herein relate to treatment of a cell or tissue, a cell or tissue from a subject, or a subject that may be a eukaryote, an animal, a vertebrate animal, a mammal, a rodent (e.g., a guinea pig, a hamster, a rat, a mouse), murine (e.g., a mouse), canine (e.g., a dog), feline (e.g., a cat), equine (e.g., a horse), a primate, simian (e.g., a monkey or ape), a monkey (e.g., marmoset, baboon), an ape (e.g., gorilla, chimpanzee, orangutan, gibbon), or a human.
  • a rodent e.g., a guinea pig, a hamster, a rat, a mouse
  • the disclosure provides a transgenic mouse whose genome comprises deletions of the Trpv4 gene in keratinocytes of the epidermis.
  • the transgenic mouse may be a knockout for the Trpv4 gene in keratinocytes of the epidermis following keratinocyte- specific activation and expression of a site-specific recombination enzyme.
  • Knockout of the Trpv4 gene may be carried out by any suitable means known in the art.
  • the transgenic mouse may be generated by Keratin-14 promoter expression of a site-specific recombination enzyme. Site-specific recombination enzymes may include CRE recombinase.
  • the site-specific recombination enzyme may be fused to a mutated estrogen receptor.
  • An anti- estrogen may have increased affinity to the mutated estrogen receptor relative to wild-type estrogen.
  • the anti-estrogen may comprise tamoxifen.
  • addition of the anti-estrogen to the transgenic mouse drives the site-specific recombination enzyme to the nucleus and results in knockdown of expression of the Trpv4 gene.
  • the keratinocyte- specific deletion of the Trpv4 gene may be induced by applying an anti-estrogen.
  • deletion of the Trpv4 gene can be specifically and conditionally induced in keratinocytes of the epidermis.
  • deletion of the Trpv4 gene may be achieved by expression of a constitutively active or inducible recombination enzyme in keratinocytes of the epidermis.
  • the transgenic mouse may exhibit reduced expression relative to a control of at least one of IL6, ET1 , caspasel , ⁇ _1 ⁇ , and CXCL5, or a combination thereof, in response to UVB exposure.
  • the disclosure provides methods for identifying a selective inhibitor of TRPV4.
  • the methods may include (a) contacting a mouse with a test compound; (b) determining a biological activity of TRPV4 after contacting with the test compound; and (c) determining a control level of biological activity of TRPV4 in the absence of the test compound; (d) comparing the biological activity of TRPV4 from step (b) with the biological activity of TRPV4 from a model of TRPV4 deletion, wherein the model of TRPV4 deletion includes the transgenic mouse as disclosed herein or a pan-null Trpv4-/- mouse; and (e) identifying the test compound as a selective inhibitor of TRPV4 when at least one of (i) the TRPV4 biological activity is lower in the presence of the test compound than the TRPV4 biological activity in the absence of the test compound; (ii) the TRPV4 biological activity in the presence of the test compound is about the same as, or lower than, the TRPV4
  • Trpv4 genomic locus was engineered so that loxP sites surrounded exon13 which encodes TM5-6. This mutation was propagated in mice which were crossed to K74-CRE- ERtam mice, so that ((7rp ⁇ 4lox/lox)X('Ki4-CRE-ERtam))-mice could be induced by tamoxifen administration via oral gavage for 5 consecutive days at 6 mg/day in 0.3 ml. cornoil, at age 2-4 months of age, plus a one-time booster two weeks after the last application. Male and female mice were induced equally.
  • Trpv4 targeting construct was electroporated into mouse ES cells (C57BL6 background), and orthotopic integration was verified by PCR and Southern blot.
  • the engineered mutation was introduced into the germline by mating of chimeric mice with C57BL6 WT mice.
  • the selection marker was deleted by FLPemediated excision of the frt-pGK-neo-frt cassette in FLPe deleter mice. Genotyping was accomplished by PCR and subsequent Pad digest ( Figure 1 B).
  • each animal received an intraplantar injection of 10 ⁇ _ PBS directly posteuthanasia.
  • the interstitial fluid was immediately collected and analyzed by ELISA (Biorad) for presence of IL-1 ⁇ .
  • ET1 injections After determining base-line withdrawal thresholds, each animal received an intraplantar injection of 10 ⁇ _ 100 nM ET-1 plus contralateral vehicle. Thresholds were again evaluated 1 hour after injection.
  • GSK205 topical treatment A viscous solution of 68%EtOH/5%glycerol plus 1 mM or 5 mM GSK205 (none for control) was applied to hindpaws by rubbing in 20 ⁇ _, applied at time- points 1 hour and again 10 min before UV exposure.
  • UV imaging of 1 °MK was conducted following routine procedures.
  • a customized device was built.
  • the system comprised a printed circuit board for electrical interconnects and mechanical support and an ultraviolet light-emitting diode (UV LED).
  • UV LED ultraviolet light-emitting diode
  • Customized provisions at the cellular end included a quartz coverslip as the bottom of the cell culture dish plus a thermal equilibration stage (HW-101 Dagan Corporation), fitted to an Olympus BX61 upright microscope.
  • the UV LED was a Ill-nitride-based type (UVTOP-295 BL; Sensor Electronic Technology).
  • the operating wavelength was 295 nm ( Figure 2A), with a full-width half-max of 12 nm.
  • the optical power was 500 mW.
  • the focal point was aimed at the plane of the upper surface of the quartz coverslip, which was used to minimize UV absorption along the optical path towards the cells ( Figure 2A-C).
  • the optical intensity at the focal point was estimated to be 150 mW/mm 2 .
  • Endothelinl Endothelinl ; BQ123 and BQ788 (ET(R) blockers for ET(R)-A and ET(R)-B; Sigma, St. Louis, MO), U73122 (PLC inhibitor; Tocris, Ellisville, MO), 4a-phorbol 12, 13 didecanoate (4a-PDD; TRPV4 activator; Tocris), GSK205 (TRPV4 inhibitor (Li et al., 201 1 ; Phan et al., 2009; Vincent and Duncton, 201 1 )), RN-1734 (TRPV4 inhibitor; Tocris), CGS35066 (endothelin-converting enzyme inhibitor, Tocris), isopentenyl pyrophosphate, IPP (TRPV3 inhibitor; Sigma); and Camphor (TRPV3 activator; Whole Foods).
  • Hindpaw mechanical withdrawal thresholds were determined by the automated von Frey hair method, using a 0.5 mm diameter stainless steel filament, part of an automated plantar touch stimulator (Ugo Basile, Modena, Italy). Relevant detail included pre-test acclimatization in a quiet room for 30 min, conducting the test at the same time of day and blinded observers. The stimulus was delivered to the hindpaw, automatically discontinued upon withdrawal, and its intensity recorded automatically. 6-8 trials per animal were conducted, with equal exposure of both hindpaws, leading to an average withdrawal threshold. Results are reported as ⁇ -threshold, which was calculated by subtracting post-treatment from pre-treatment measurements, expressed as % or relative to 1 .0. [00115] Hargreaves' test
  • Hindpaw thermal (hot) withdrawal thresholds were determined by the well- established Hargreaves' method, using an infra-red thermal stimulation device that delivers the stimulus from underneath the hindpaw combined with automatic shut-off upon withdrawal (Ugo Basile). Stimulation and measurements were conducted as described for von Frey hair testing. A cutoff of 20 sec was set to prevent tissue damage.
  • CD68 CD15 (neutrophil elastase) and CD3, mouse skin was prepared by 2% PFA perfusion. Footpad and DRG sections (both at 6-10 ⁇ ) were thaw-mounted, blocked with 5% normal goat serum (NGS; Jackson), then incubated overnight at 4°C with the following primary antibodies: rabbit anti-TRPV4 (1 :300; Abeam), mouse anti-keratin 14 (1 :300; Abeam against C-terminal peptide beyond residue 850); rabbit anti-keratin 14 (1 :1000; Fuchs-Lab), rabbit anti-phosph-ERK1/2 (1 :500; Cell signaling technologies), goat anti-IL-1 ⁇ (1 :800; Abeam), goat anti-IL-6 (1 :200; Santa Cruz Biotechnology Inc); rabbit anti-caspase-1 (1 :200; Biovision Research Products, CA); goat anti-mouse LIX/CXCL5 (1 :200; R&D Systems Inc), anti-CD68, anti-CD25 and anti-CD3 (
  • Immunodetection was accomplished with appropriate fluorescently-labeled secondary antibodies (AlexaFluor595, AlexaFluor488-conjugated antibodies at 1 :600; Invitrogen; for CD15 biotinylated secondary antibody from donkey, 1 :400 followed by rhodamine-streptavidine 1 :250), or with peroxidase-linked detection reagents (for CD68) for 2 hours at room-temperature. Sections were rinsed, mounted, and cover-slipped with fluoromount (Sigma).
  • Digital micrographs were obtained using a BX61 Olympus upright microscope, also with a Zeiss LSM510 confocal, both equipped with high-res CCD camera, and acquired with constant exposure settings, using ISEE or Zeiss Zen software. Morphometric analysis was conducted using ImageJ freeware (v1 .45) with tailored regions-of-interest that spared the nuclear compartment. ImageJ was also used for determination of DRG surface area.
  • Tissues were washed, dehydrated and then mounted in Permount (Fisher).
  • Permount Permount
  • DAB and HE staining in 3 randomly selected epidermal regions (3.5 x 1 .25 inches) of each image were separated using the IsoData thresholding method in the Color Threshold Plugin. Relative signal intensities were calculated from background-corrected measurements. Values are expressed as mean of averages determined from five sections per patient.
  • the epidermis was separated from the dermis by a 1 -hour dispase (BD Biosciences) treatment. Then the keratinocytes were dissociated from the epidermis using trypsin. Keratinocytes were plated on collagen coated dishes or glass or quartz coverslips and grown in keratinocyte serum free media (Gibco) supplemented with bovine pituitary extract and epidermal growth factor (EGF) (R&D Systems), 100 pmol cholera toxin (Calbiochem, San Diego, CA, USA) and 1 X antibiotics/antimycotics (Gibco), in an incubator at 5% C0 2 and 37°C.
  • keratinocyte serum free media Gibco
  • EGF epidermal growth factor
  • UVB-stimulation of cultured keratinocytes [00127] UVB-stimulation of cultured keratinocytes; calcium imaging
  • Ca++ imaging of mouse 1 °MK in response to chemical activation of TRPV4 was conducted after loading with 2 ⁇ fura2-AM, following a ratiometric Ca2+ imaging protocol with 340/380nm blue light for dual excitation. Ratios of emissions were acquired at 0.5 Hz. AR/R0 was determined as the fraction of the increase of a given ratio over baseline ratio, divided by baseline ratio. For stimulation of cells with UVB, where fura-2 was not suitable because of the proximity of stimulation with 340/380 nm and 295 nm, 2 ⁇ fluo4-AM was used instead. Ca++ imaging was carried out at 488 nm excitation, acquisition of emissions at 0.5 Hz, expressed as AF/F0.
  • UV LEDs were capped with a ball lens, a transparent optical window in the shape of a hemispherical lens (Figure 2B).
  • the LED output optical beam focused at 15-20 mm from the lens, with a spot diameter of approximately 1 .5-2.0 mm ( Figure 2C).
  • the electrical power supply for the UV LEDs was a surface mount component on the printed circuit board, which had a steady state 20 mA current output that was controlled by an external switch.
  • the thermal equilibration stage was set for physiological temperature.
  • the spot size of the UV input optical beam from a LED (UVTOP-295 UV) was estimated, as shown in Figure 16A, using the razor-edge optical spot occlusion method (results shown in Figure 16B).
  • the UV LED was powered with 20 mA of current, resulting in 500 ⁇ of optical power in a circular focal spot 1.5 mm in diameter, with 70% of the total flux in a 0.5 mm beam radius.
  • the UV optical power transmitted through the sample was detected by a Hamamatsu S127-66BR UV detector, and the output of the photodetector was measured using a Keithley 236 source measure unit.
  • the foot-pad epidermis of a mouse was measured for UV transmission by placing it on a quartz coverslip and exposure to the UV beam.
  • the GSK205 was administered to the foot-pad skin in an alcohol and glycerol solution as for the experiments shown in Figure 12A.
  • the vehicle-control group was treated with the alcohol and glycerol solution only.
  • Another control group consisted of a commercially-available SPF100 preparation sunscreen in form of a cream, which was applied similar to the vehicle-control.
  • the data for the GSK205 and sunscreen was normalized to this control data.
  • Trp ⁇ /4-knockdown resulted in no gross alterations in the skin/epidermis nor in the induction of the terminal differentiation-specific marker keratin-1 (K1 ), which is known to be governed by elevated Ca++ influx suprabasally ( Figure 3A and Figure 1C).
  • K1 terminal differentiation-specific marker keratin-1
  • Figure 3A and Figure 1C Closer analysis of Trp ⁇ /4-deficient skin revealed that expression of K14 was sustained suprabasally.
  • This keratin is normally down-regulated at the basal-to-suprabasal transition, concomitant with the rise in Ca++ signaling and induction of terminal differentiation.
  • Trpv4 ⁇ ox/+ heterozygous mice had virtually identical behavioral sensitization (similar to WT) in response to UVB, irrespective of CRE- induction with tamoxifen or vehicle (Figure 1 E). These findings exclude a functional role for CRE ER on its own and reiterate the specificity of our approach in targeting Trpv4 ablation to keratin ocytes. Also, Trpv4-/- skin was equally permeable to UVB as its WT counterpart.
  • IL-6 was a suitable candidate for the epidermal signal since it is an established marker of skin epidermal activation during UV dermatitis, and in addition, IL-6 is robustly algogenic. Indeed not only was IL-6 immunoreactivity observed in the UVB-exposed epidermis of control mice, but in addition, this robust IL-6 upregulation was virtually eliminated in conditionally targeted as well as pan-null Trpv4 knockout skin (Figure 4B and Figure 5D).
  • Both macrophages and neutrophils are known to contribute to the reduction of pain thresholds via their expression of a host of proalgesic/algogenic mediators such as TNFa, IL-6, IL-8, proteases and chemokines.
  • proalgesic/algogenic mediators such as TNFa, IL-6, IL-8, proteases and chemokines.
  • UVB-induced infiltration of both of these cell populations was markedly reduced in the skin of Tn/p4-conditional knockout mice ( Figure 4C-D).
  • Example 6 The UVB-lnduced Ca++ Response in Primary Mouse Keratinocytes to UVB is Critically Dependent on Extracellular Ca++ Influx through TRPV4
  • TRPV4 is sufficient for the UVB-evoked Ca++ influx.
  • Example 7 Elevated Endothelin-1 is a Critical Epidermal Effector of the UVB-TRPV4-Ca++ Response
  • UVB-TRPV4-Ca++ response depended on upon phospholipase-C (PLC), as it was virtually eliminated by the specific PLC inhibitor, U73122 ( Figure 6H).
  • PLC phospholipase-C
  • Figure 6H The reliance of TRPV4 activation upon PLC signaling suggested that PLC's respective lipid products, such as IP3, might be involved. It also hinted at possible involvement of G protein-coupled receptor signaling.
  • ET(R) endothelin receptors
  • ET1 endothelin-1
  • TRPV4 was also critical for the facilitatory effect of ET1 on nocifensive behavior, as judged by the finding that the withdrawal thresholds in response to von Frey hair stimulation were significantly lowered in control but not Trpv4-/- mice, both pan- and conditional null, in response to subepidermal ET1 injections (Figure 7D). This result suggested that ETVs pro-algesic/algogenic effect is fully dependent on TRPV4 in keratin ocytes.
  • caspase-1 cleavage activation was readily detected by Western blotting of lysates from WT 1 °MK exposed to UVB, caspase-1 expression was lacking in Trpv4-nu ⁇ counterparts, even without UVB ( Figure 9C).
  • Example 9 Clinical Relevance of Epidermally-derived TRPV4 in Transmitting Nociceptive Responses to UVB Exposure
  • TRPV4 was significantly increased in the epidermis of human patients with UV photodermatitis (Figure 10A and Figure 11 ). As compared to healthy skin controls, a robust increase was also seen for ET1 and I L-1 ⁇ immunostaining in acute photodermatitis ( Figure 10A-B). These findings suggest that TRPV4 is also likely to be involved in UVB- induced photodermatitis, one of the various responses of human skin to damaging UV radiation.

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US10329265B2 (en) 2014-08-22 2019-06-25 Duke University TRPA1 and TRPV4 inhibitors and methods of using the same for organ-specific inflammation and itch
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