Potential to treat diabetic neuropathic pain without hyperthermia using TRPV1 antagonism

Diabetes is one of the leading causes of chronic neuropathic pain, leading to a reduced quality of life and posing a huge economic burden to the health system and society. The NHS spends billions of pounds each year on diabetes treatments, the majority of which is spent on managing complications, such as neuropathic pain.

Working with researchers at Transpharmation Ltd, we have established the potential for the safe use of a TRPV1 antagonist drug to treat neuropathic pain in the type 1 diabetic population. The clinical development of blocking this ‘capsaicin chilli pepper’ TRPV1 receptor to treat pain was halted due to undesired hyperthermic side effects seen in healthy volunteers. However, our findings have shown these hyperthermic side effects are absent in a type 1 diabetes model in rats.

The next step will be to demonstrate this concept in a type 2 model of diabetes, opening up the potential for the safe use of a TRPV1 antagonist in the wider diabetic population.

With clinical studies in mind, through an industry-academic collaboration, we propose to investigate TRPV1 antagonism in patients with type 1 diabetes, type 2 diabetes and lean and obese volunteers with a view of designing a simple bioassay capable of predicting thermic effects in humans.

Publication: Streptozocin-diabetic rats show reduced hyperthermic effects but maintained anti-allodynia responses to the TRPV1 antagonist ABT-102. Presented at IASP World Congress on Pain, Boston, US, 2018.