Targeting AMPK for the Alleviation of Pathological Pain

Exp Suppl. 2016:107:257-285. doi: 10.1007/978-3-319-43589-3_11.

Abstract

Chronic pain is a major clinical problem that is poorly treated with available therapeutics. Adenosine monophosphate-activated protein kinase (AMPK) has recently emerged as a novel target for the treatment of pain with the exciting potential for disease modification. AMPK activators inhibit signaling pathways that are known to promote changes in the function and phenotype of peripheral nociceptive neurons and promote chronic pain. AMPK activators also reduce the excitability of these cells suggesting that AMPK activators may be efficacious for the treatment of chronic pain disorders, like neuropathic pain, where changes in the excitability of nociceptors is thought to be an underlying cause. In agreement with this, AMPK activators have now been shown to alleviate pain in a broad variety of preclinical pain models indicating that this mechanism might be engaged for the treatment of many types of pain in the clinic. A key feature of the effect of AMPK activators in these models is that they can lead to a long-lasting reversal of pain hypersensitivity even long after treatment cessation, indicative of disease modification. Here, we review the evidence supporting AMPK as a novel pain target pointing out opportunities for further discovery that are likely to have an impact on drug discovery efforts centered around potent and specific allosteric activators of AMPK for chronic pain treatment.

Keywords: AMPK; Cancer pain;; MAPK; Neuropathic pain; Postsurgical pain; mTOR.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • AMP-Activated Protein Kinases / genetics*
  • AMP-Activated Protein Kinases / metabolism
  • Analgesics / therapeutic use*
  • Chronic Pain / drug therapy*
  • Chronic Pain / enzymology
  • Chronic Pain / genetics
  • Chronic Pain / pathology
  • Diabetic Neuropathies / drug therapy*
  • Diabetic Neuropathies / enzymology
  • Diabetic Neuropathies / genetics
  • Diabetic Neuropathies / pathology
  • Enzyme Activation / drug effects
  • Gene Expression Regulation
  • Humans
  • Inflammation
  • Ion Channels / genetics
  • Ion Channels / metabolism
  • Molecular Targeted Therapy
  • Morphine / therapeutic use
  • Neoplasms / drug therapy*
  • Neoplasms / enzymology
  • Neoplasms / genetics
  • Neoplasms / pathology
  • Neuralgia / drug therapy*
  • Neuralgia / enzymology
  • Neuralgia / genetics
  • Neuralgia / pathology
  • Nociceptors / drug effects
  • Nociceptors / enzymology
  • Nociceptors / pathology
  • Protein Subunits / genetics
  • Protein Subunits / metabolism
  • Signal Transduction

Substances

  • Analgesics
  • Ion Channels
  • Protein Subunits
  • Morphine
  • AMP-Activated Protein Kinases