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Characterization of the Trigeminovascular Actions of Several Adenosine A2A Receptor Antagonists in an in Vivo Rat Model of Migraine Kristian A

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Characterization of the Trigeminovascular Actions of Several Adenosine A2A Receptor Antagonists in an in Vivo Rat Model of Migraine Kristian A Haanes et al. The Journal of Headache and Pain (2018) 19:41 The Journal of Headache https://doi.org/10.1186/s10194-018-0867-x and Pain RESEARCH ARTICLE Open Access Characterization of the trigeminovascular actions of several adenosine A2A receptor antagonists in an in vivo rat model of migraine Kristian A. Haanes1†, Alejandro Labastida-Ramírez1†, Kayi Y. Chan1, René de Vries1, Brian Shook2, Paul Jackson2, Jimmy Zhang2, Christopher M. Flores2, Alexander H. J. Danser1, Carlos M. Villalón3 and Antoinette MaassenVanDenBrink1* Abstract Background: Migraine is considered a neurovascular disorder, but its pathophysiological mechanisms are not yet fully understood. Adenosine has been shown to increase in plasma during migraine attacks and to induce vasodilation in several blood vessels; however, it remains unknown whether adenosine can interact with the trigeminovascular system. Moreover, caffeine, a non-selective adenosine receptor antagonist, is included in many over the counter anti-headache/migraine treatments. Methods: This study used the rat closed cranial window method to investigate in vivo the effects of the adenosine A2A receptor antagonists with varying selectivity over A1 receptors; JNJ-39928122, JNJ-40529749, JNJ-41942914, JNJ- 40064440 or JNJ-41501798 (0.3–10 mg/kg) on the vasodilation of the middle meningeal artery produced by either CGS21680 (an adenosine A2A receptor agonist) or endogenous CGRP (released by periarterial electrical stimulation). Results: Regarding the dural meningeal vasodilation produced neurogenically or pharmacologically, all JNJ antagonists: (i) did not affect neurogenic vasodilation but (ii) blocked the vasodilation produced by CGS21680, with a blocking potency directly related to their additional affinity for the adenosine A1 receptor. Conclusions: These results suggest that vascular adenosine A2A (and, to a certain extent, also A1) receptors mediate the CGS21680-induced meningeal vasodilation. These receptors do not appear to modulate prejunctionally the sensory release of CGRP. Prevention of meningeal arterial dilation might be predictive for anti-migraine drugs, and since none of these JNJ antagonists modified per se blood pressure, selective A2A receptor antagonism may offer a novel approach to antimigraine therapy which remains to be investigated in clinical trials. Keywords: Adenosine receptor, CGS21680, Dural vasodilation, Rat, vasodepressor response Background Migraine is a neurovascular disorder associated with ac- tivation of the trigeminovascular system and release of calcitonin gene-related peptide (CGRP) from trigeminal sensory perivascular nerves, which results in cranial * Correspondence: [email protected] vasodilation and stimulation of sensory nerve transmis- Kristian A. Haanes and Alejandro Labastida-Ramírez contributed equally to sion [1]. In line with these neurovascular mechanisms: (i) this work. †Equal contributors plasma levels of CGRP, which increase during migraine, 1Division of Vascular Medicine and Pharmacology, Department of Internal are normalized by triptans in parallel with amelioration of Medicine, Erasmus MC, Rotterdam, Dr Molewaterplein 50, 3015, GE, headache [2]; and (ii) CGRP receptor antagonists [1]and Rotterdam, The Netherlands Full list of author information is available at the end of the article antibodies against CGRP or its receptor [3]are © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Haanes et al. The Journal of Headache and Pain (2018) 19:41 Page 2 of 10 effective in migraine treatment. Although there seem to Within this framework, it has been shown ex vivo that be some full-responders, the average reduction in mi- adenosine and CGS21680, a stable A2A receptor agonist graine days compared to placebo is only in the excess of (with about 10–100-fold selectivity for A2A receptors 1 day per month when administering any CGRP anti- over A1 and A3 receptors and poor affinity for A2B body [4]. This limited efficacy resulting from inhibiting receptors [17]), dilate middle meningeal and cerebral CGRP effects suggests that the pathogenesis of migraine arteries respectively, a response blocked by A2A re- could involve additional mechanisms. ceptor antagonists [13, 18]. Interestingly, adenosine (released centrally and periph- The above findings, coupled to the demonstration that erally as a breakdown product of ATP) is another neuro- the trigeminal ganglion expresses A2A receptors [19]and modulator that seems to play a role in migraine the ability of this receptor to facilitate CGRP release in the pathophysiology [5]. Indeed: (i) adenosine plasma levels hippocampus [20], beg the questions of whether adeno- have been reported to be increased during migraine at- sine A2A receptors can induce meningeal vasodilation in tacks [6]; (ii) exogenous adenosine may trigger migraine vivo, and also whether they could be involved in neuro- attacks [7]; (iii) dipyridamole, an adenosine uptake inhibi- genic vasodilation either per se or as modulators of CGRP tor, may increase the frequency of migraine attacks [8]; release in the trigeminovascular system. and (iv) an adenosine gene haplotype has been associated Hence, this study used the rat closed cranial window with migraine with aura [9]. Accordingly, adenosine re- method, a model predictive of antimigraine action [21], ceptor antagonists may have potential therapeutic useful- to investigate the effects of five novel adenosine A2A re- ness in the treatment of migraine; while caffeine, a ceptor antagonists (Fig. 1) on the vasodilation of the non-selective adenosine receptor antagonist [5], is already middle meningeal artery produced by either CGS21680 or present in several over-the-counter anti-headache/mi- endogenous CGRP (released by periarterial electrical stimu- graine medications [10]. lation). These antagonists (JNJ-41942914, JNJ-39928122, The conjunction of structural, transductional and op- JNJ-40529749, JNJ-40064440 and JNJ-41501798) were de- erational criteria has shown that adenosine can activate veloped as described by Shook et al. [22]anddisplayavary- four subtypes of G-protein-coupled receptors [11, 12], ing degree of selectivity for A2A over A1 receptors (Table 1). namely adenosine: (i) A1 and A3 receptors (coupled to Gi proteins), which mediate vascular smooth muscle constric- Methods tion; and (ii) A2A and A2B receptors (coupled to Gs pro- Intravital microscopy experiments teins), which mediate direct and endothelium-dependent Animals vasodilation [13, 14]. Moreover, the A1 receptor can also Fifty seven normotensive male Sprague-Dawley rats (300– mediate endothelium-dependent vasodilation [15, 16]. 400 g), purchased from Harlan (Horst, The Netherlands), Fig. 1 Molecular structures of the JNJ antagonists from Janssen Research & Development Haanes et al. The Journal of Headache and Pain (2018) 19:41 Page 3 of 10 Table 1 Affinity constants indicated as IC50 in nM (and the bone overlying a segment of the dural meningeal artery was corresponding pIC50) for the compounds used in the present carefully drilled thin, applying cold saline (4 °C) until the ar- study tery was visible. Since skull drilling induces vasodilation, we Compound A2A A1 Fold selectivity allowed the animal to recover for 1 h before the experimen- Selectivity A2A vs. A1 tal protocol. The drilled area was covered with mineral oil CGS2168033 22 nM (7.6) 3100 nM (5.5) 141 to prevent drying and to facilitate visualization of the men- Caffeine28 8100 nM (5.1) 20,000 nM (4.7) 2.5 ingeal artery. The artery was captured with an intravital λ λ microscope (model MZ 16; LeicamicrosystemLtd.,Heer- JNJ-39928122a 7.9 nM (8.1) 55.1 nM (7.3) 7 a brugg, Switzerland) using a cyanbluefilteronacoldsource JNJ-40529749 4.9 nM (8.3) 89.1 nM (7.1) 18 of light. A zoom lens (80–450 × magnification) and a cam- a JNJ-41942914 8.3 nM (8.1) 1093 nM (6.0) 132 erawasusedtodisplayimageswiththebloodvesseldiam- JNJ-40064440a 8.2 nM (8.1) 1240 nM (5.9) 151 eter (30–40 μm at baseline) being continuously monitored JNJ-41501798a 11.5 nM (7.9) 7997 nM (5.1) 695 and measured with a video dimension analyser (Living Sys- The JNJ antagonists were developed by Johnson & Johnson Pharmaceutical tems Instrumentation Inc., Burlington, VT, U.S.A.). In rats Research & Development, L.L.C where periarterial electrical stimulation was used to evoke Hutchison et al. 1989 [33]; Fredholm et al. 1999 [28]; a, Paul Jackson (Janssen λ dural vasodilation, a bipolar stimulating electrode (NE Research & Development, personal communication); , Indicates Ki values 200X, Clark Electromedical, Edenbridge, Kent, U.K.) was were maintained at a 12/12-h light-dark cycle (with light placed on the surface of the cranial window approximately beginning at 7 a.m.) and housed at a constant temperature within 200 μm from the vessel of interest. The cranial win- (22 ± 2°C) and humidity (50%), with food and water ad dow surface was stimulated at 5 Hz, 1 ms for 10 s (Stimula- libitum. Only male rats were used to avoid crosstalk be- tor model S88, Grass Instruments, West Warwick, RI, tween CGRP and hormonal fluctuations during the female U.S.A.). For neurogenic dural vasodilation, we initially oestrus cycle [23]. The animals
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