Advancing precision pain medicines to the clinic

摘要 慢性疼痛是持续超过正常愈合时间的疼痛。1.5亿人 患有慢性疼痛，并且随着老年人口的增长， 糖尿病患病率上升，癌症存活率提高。慢性疼痛不仅 严重影响了许多患者的日常生活质量，也给社会经济带来了沉重的负担。 社会的负担。由于有效的治疗选择有限，慢性 尽管存在成瘾和副作用的风险，但通常用阿片类药物治疗疼痛。可惜 阿片类药物治疗慢性疼痛的处方在很大程度上助长了目前阿片类药物的流行。 因此，对于非成瘾性替代镇痛剂存在迫切且明确的未满足的需求， 慢性疼痛的治疗推动开发特定的和非成瘾性的替代品 止痛药引起了人们对一种特殊的钠通道NaV1.7的兴趣，NaV1.7被证明对 痛觉NaV1.7中的功能获得性突变与罕见疾病相关 以剧烈疼痛为特征，如原发性红斑性肢痛症和小纤维痛症患者 神经病变此外，NaV1.7表达水平已显示在各种疼痛中增加。 条件相反，NaV1.7的功能丧失导致无法感觉疼痛。因此，我们认为， 抑制NaV1.7可以是减轻疼痛和治疗慢性疼痛的有效方法。 痛苦为了实现这一点，我们设计了表观遗传调节剂来抑制NaV1.7的表达。 这些表观遗传调节剂不会对基因组进行永久性编辑， 抑制NaV1.7表达。通过在DNA水平上靶向NaV1.7，我们可以实现特异性和 NaV1.7的持久调节，具有比RNA和蛋白质更好的药代动力学前景， 目标定位方法。这种创新方法已被证明可以预防和逆转急性 和慢性疼痛的五个临床前疼痛模型。考虑到这种方法令人兴奋的新颖性， 除了其高水平的特异性和有效性外，该项目的目标是支持业务 开发活动，寻找强大的合作伙伴，将这种疗法带给数百万患者 需要非成瘾性、有效和持久的慢性疼痛治疗。

Abstract Chronic pain is pain that persists past the normal time of healing. 1.5 billion people worldwide suffer from chronic pain and this number continues to increase as the elderly population grows, the prevalence of diabetes rises, and cancer survival rates improve. Chronic pain not only severely impacts daily quality of life for many patients, it also places a heavy socioeconomic burden on society. Due to the limited number of efficacious treatment options available, chronic pain is often treated with opioids despite the risk of addiction and side effects. Unfortunately, the prescribing of opioids to treat chronic pain has largely fueled the current opioid epidemic. Therefore, there is an urgent and clear unmet need for non-addictive alternative analgesics for the treatment of chronic pain. The push to develop specific and non-addictive alternative painkillers has brought interest to a particular sodium channel, NaV1.7, shown to be important for pain sensing. Gain-of-function mutations in NaV1.7 are associated with rare disorder characterized by intense pain, such as in patients with primary erythromelalgia and small-fiber neuropathy. Additionally, NaV1.7 expression levels have been shown to increase in various pain conditions. Conversely, loss-of function of NaV1.7 results in the inability to feel pain. Therefore, inhibiting NaV1.7 can be an effective method of reducing pain and treating patients with chronic pain. To accomplish this, we designed epigenetic modulators to repress expression of NaV1.7. Rather than making permanent edits to the genome, these epigenetic modulators will transiently inhibit expression of NaV1.7. By targeting NaV1.7 at the DNA-level, we can achieve specific and long-lasting modulation of NaV1.7, with better pharmacokinetics prospects than RNA- and protein- targeting approaches. This innovative approach has been shown to prevent and reverse acute and chronic pain in five preclinical models of pain. Given the exciting novelty of this approach, in addition to its high level of specificity and efficacy, the goal of this project is to support the business development activities in finding a strong partner to bring this therapy to the millions of patients that need non-addictive, efficacious, and long-lasting treatments for chronic pain.