P2X Receptors Research Articles

P2X7R-primed keratinocytes are susceptible to apoptosis via GPCR-Gβγ-pERK signal pathways

BackgroundCell death constitutes a pivotal biological phenomenon essential for the preservation of homeostasis within living organisms. In the context of maintaining a functional skin barrier, keratinocytes exert positively and negatively control cell death signals. However, in patients with severe drug eruptions, anomalous overexpression of the formyl peptide receptor 1 (FPR1) in keratinocytes elicits a distinctive mode of cell death known as necroptosis, thereby suffering a loss of the skin barrier. The precise molecular mechanisms connecting FPR1 activation to this cell death remain unclear. ObjectiveWe have investigated the intracellular signal transduction cascade governing FPR1-mediated cell death in cultured keratinocytes. MethodsWe used HaCaT cells as a model keratinocyte. The expression of FPR1 was detected with qPCR. The presence of cell death events was monitored through live-cell fluorescent staining and LDH release assays. Furthermore, the phosphorylation of ERK was assessed via Western blot analysis. Intracellular signal pathways were investigated using specific inhibitors. ResultsLigand stimulation of an endogenous ion channel, purinergic receptor P2X7 (P2X7R), increased the FPR1 expression level. This upregulated FPR1 demonstrated functional competence in the phosphorylation of downstream MAP kinase and the initiation of cell death. Notably, this cell death was ameliorated upon the administration of inhibitors targeting Gβγ, ERK, and caspases. ConclusionThe induction and stimulation of FPR1 initiated apoptosis in keratinocytes via the Gβγ-pERK signaling pathway. Our findings postulate that the downstream components of FPR1 represent an alternative therapeutic target for preventing unintended keratinocyte cell death.

Evaluation of various polysaccharide-based stationary phases for enantioseparation of chloro-containing derivatives in normal phase liquid chromatography.

Six polysaccharide-based chiral stationary phases were screened to separate the enantiomers of six chloro-containing derivatives and one derivative bearing electron donating mesomeric substituents, chosen for comparison. These compounds are expected to be P2X7 receptor antagonists with potential anti-inflammatory activity. The study was carried out with four different mobile phases composed of n-heptane and ethanol or isopropanol. Thus, a total of 168 experiments were implemented to find the best conditions aimed at scaling-up the separation of these anti-inflammatory compounds. Chiralpak AD-H separated half of them, i.e., 1, 2, and 6; Chiralpak AS separated also three out of the six compounds, i.e., 1, 2, and 3; Lux Cellulose-5 separated 2, 4, and 6; Lux Cellulose-2 separated 1, 2, and 4; Chiralcel OD-H separated compounds 2 and 5; and finally Chiralcel OJ separated only 3, thus having the lowest rate of success. Additionally, the influence of (i) the stationary and mobile phases and (ii) the chemical structure of the analytes on retention and resolution was investigated.

Revealing the Novel Role of Purinergic Receptor P2X4 in Phagocytic Uptake After Ischemic Stroke.

Purinergic receptor P2X4 (P2X4R), highly expressed on microglia and macrophages, is activated by ATP released from damaged cells and linked to poststroke inflammation. Previous studies showed that short-term P2X4R inhibition reduces inflammation and promotes long term recovery, but the mechanism underlying P2X4R and inflammation remains unclear. We hypothesized that P2X4R absence or pharmacological blockade can enhance macrophage phagocytic function by alleviating excessive inflammation after stroke. We divided P2X4R knockout and littermate control mice into 2 groups either naive or mice subjected to ischemic stroke surgery. Additionally, the regular WT mice subjected to ischemic stroke were treated with 5-(3-Bromophenyl)-1,3-dihydro-2H-Benzofuro[3,2-e]-1,4-diazepin-2-one BD (a P2X4R inhibitor) or vehicle. We isolated phagocytic cells from mice in each group and assayed phagocytic activity by quantifying uptake of fluorescent beads and bioparticles using flow cytometry or confocal microscopy and by measuring protein expression related to phagocytosis. Short-term inhibition of P2X4R with with 5-(3-Bromophenyl)-1,3-dihydro-2H-Benzofuro[3,2-e]-1,4-diazepin-2-one treatment upregulated ANXA1 (annexinA1). P2X4R absence prevented ATP-induced decline in phagocytic uptake in macrophages. Microglia or macrophages derived from P2X4R knockout mice showed significantly increased phagocytic activity compared with microglia/macrophages taken from littermate control mice. Cell surface expression of CD36, a scavenger receptor protein, increased after stroke, and was higher in P2X4R knockout mice. This study suggests that blockade or absence of P2X4R increases phagocytic uptake of damaged tissue following ischemic stroke. Taken together with previous reports detailing how P2X4R inhibition is protective following stroke, our results demonstrate P2X4R may mediate long-term resolution after ischemic stroke by enhancing phagocytic clearance.

Structural insights into the human P2X1 receptor and ligand interactions.

The P2X1 receptor is a trimeric ligand-gated ion channel that plays an important role in urogenital and immune functions, offering the potential for new drug treatments. However, progress in this area has been hindered by limited structural information and a lack of well-characterised tool compounds. In this study, we employ cryogenic electron microscopy (cryo-EM) to elucidate the structures of the P2X1 receptor in an ATP-bound desensitised state and an NF449-bound closed state. NF449, a potent P2X1 receptor antagonist, engages the receptor distinctively, while ATP, the endogenous ligand, binds in a manner consistent with other P2X receptors. To explore the molecular basis of receptor inhibition, activation, and ligand interactions, key residues involved in ligand and metal ion binding were mutated. Radioligand binding assays with [3H]-α,β-methylene ATP and intracellular calcium ion influx assays were used to evaluate the effects of these mutations. These experiments validate key ligand-receptor interactions and identify conserved and non-conserved residues critical for ligand binding or receptor modulation. This research expands our understanding of the P2X1 receptor structure at a molecular level and opens new avenues for in silico drug design targeting the P2X1 receptor.

Pharmacology of P2X Receptors and Their Possible Therapeutic Potential in Obesity and Diabetes

The role of P2X ionotropic receptors in the behavior of purinergic signaling on pathophysiological processes has been widely studied. In recent years, the important participation of P2X receptors in physiological and pathological processes, such as energy metabolism, characteristic inflammatory responses of the immune system, and nociceptive activity in response to pain stimuli, has been noted. Here, we explore the molecular characteristics of the P2X receptors and the use of the different agonist and antagonist agents recently described, focusing on their potential as new therapeutic targets in the treatment of diseases with emphasis on obesity, diabetes, and some of the complications derived from these pathologies.

Discovery of a Potent, Orally Active, and Long-Lasting P2X7 Receptor Antagonist as a Preclinical Candidate for Delaying the Progression of Chronic Kidney Disease.

Chronic kidney disease (CKD) is a condition characterized by functional deterioration with sustained inflammation and progressive fibrosis of the kidneys affecting over 800 million people worldwide. The P2X7 receptor (P2X7R) plays a key role in CKD progression. Our previous P2X7R antagonists demonstrated good efficacy for treating kidney injury but were limited by low oral exposure and short half-life, restricting their application. This study reports the optimization of P2X7R antagonists for better oral pharmacokinetics. The candidate compound 13a with the respective IC50 of 34.86 and 25.28 nM against human and murine P2X7R, administered orally at 10 mg/kg in mice, exhibits a remarkably long half-life of 161.64 h, with a high exposure of 1,163,980.55 μg·h/L. Oral administration of 13a (0.3 or 1.0 mg/kg, twice weekly) significantly reduced renal injury and fibrosis in unilateral ureteral obstruction and adenine diet-induced mice models, highlighting its potential for delaying the progression of CKD.

ProDiVis: a method to normalize fluorescence signal localization in 3D specimens.

A common problem in confocal microscopy is the decrease in intensity of excitation light and emission signal from fluorophores as they travel through 3D specimens, resulting in decreased signal detected as a function of depth. Here, we report a visualization program compatible with widely used fluorophores in cell biology to facilitate image interpretation of differential protein disposition in 3D specimens. Glioblastoma cell clusters were fluorescently labeled for mitochondrial complex I (COXI), P2X7 receptor (P2X7R), β-Actin, Ki-67, and DAPI. Each cell cluster was imaged using a laser scanning confocal microscope. We observed up to ∼70% loss in fluorescence signal across the depth in Z-stacks. This progressive underrepresentation of fluorescence intensity as the focal plane deepens hinders an accurate representation of signal location within a 3D structure. To address these challenges, we developed ProDiVis: a program that adjusts apparent fluorescent signals by normalizing one fluorescent signal to a reference signal at each focal plane. ProDiVis serves as a free and accessible, unbiased visualization tool to use in conjunction with fluorescence microscopy images and imaging software.

The P2X7R is a crucial target for Angiotensin II-induced myocardial ferroptosis and remodeling

AbstractOngoing cardiac remodeling can lead to negative outcomes, such as cardiac failure and diminished myocardial function, although the remodeling process initially protects the heart as a compensatory mechanism[1] . Importantly, ferroptosis appears to be a critical process in the development of cardiac disease. In a recent publication in Redox Biology, (Zhong et al. [2] showed that reactive oxygen species (ROS) generation and cardiac ferroptosis may be the mechanisms underlying angiotensin II (Ang II)-induced cardiac remodeling, as well as that ferroptosis is required for heart impairment and cardiac dysfunction induced by Ang II. Moreover, this study provides evidence that Ang II increases the expression of P2X7 receptors (P2X7R) in cardiac tissues and that both silencing and pharmacological inhibition of P2X7R significantly inhibited Ang II-induced ferroptosis and hypertrophy. Also, this work confirmed that P2X7R deficiency mitigated the Ang II-induced deterioration of cardiac injury in mice fed an iron-rich diet. Most interestingly, this study revealed that Ang II directly interacts with the P2X7R to activate and induce nucleocytoplasmic shuttling of human antigen R (HuR), which in turn controls the stability of the mRNA of heme oxygenase 1 (HO-1) and GPX4 and subsequent ROS production, which translated to induction of myocardial ferroptosis and remodeling.

Exploring P2X receptor activity: A journey from cellular impact to electrophysiological profiling

The development of in vitro pharmacological assays relies on creating genetically modified cell lines that overexpress the target protein of interest. However, the choice of the host cell line can significantly impact the experimental outcomes. This study explores the functional characterization of P2X7 and P2X4 receptor modulators through cellular assays and advanced electrophysiological techniques. The influence of different host cell lines (HEK-293, HEK-293FT, and 1321N1) on the activity of reference agonists and antagonists targeting human and murine P2X4 and P2X7 receptors was systematically investigated, highlighting the significant impact of the host cell on experimental results. The 1321N1 cell line was identified as the preferred host cell line when investigating the human P2X4 receptor due to more consistent agonist activities, antagonist potencies, and a more stable assay signal window. Furthermore, a patch-clamp protocol that allows for the repetitive recording of ATP-mediated inward currents from isolated human CD4+ T-cells was established, revealing that both P2X7 and P2X4 receptors are crucial for immune cell regulation, positioning them as promising therapeutic targets for managing inflammatory disorders.

Abstract C041: Emerging role of P2X receptors as Golgi pH regulators in pancreatic cancer

Abstract Cancer cells reprogram their metabolism to meet their elevated energy demands, favoring energy production via glycolysis even with functional mitochondria. Upregulated glycolysis results in rapid production of lactate and protons in the cytoplasm. This would normally reduce the intracellular pH (pHi); however, cancer cells employ mechanisms such as ion transporters that remove excess protons from the cytoplasm to maintain an alkaline pHi, allowing for cell growth, evasion of cell death and cell proliferation. Our previous studies have shown that in pancreatic ductal adenocarcinoma (PDAC), the Golgi apparatus is among the intracellular compartments that can uptake excess protons, giving PDAC cells a cell fitness advantage. The underlying mechanisms that drive Golgi acidification in PDAC are incompletely understood. Here, we set out to comprehensively identify novel modulators that can affect this process. By using a fluorescent-protein-based ratiometric pH biosensor targeted to the Golgi membrane, we screened thousands of chemical compounds for an impairment in Golgi acidification, which would lead to pHi dysregulation and cell death. One of our hits from the screen was an inhibitor of the P2X family of receptors (P2XRs). P2XRs consist of seven subtypes (P2X1-7) and are ATP-gated ion channels that mediate the passage of non-selective cations through the plasma membrane and intracellular compartments. P2XRs have also been shown to regulate the pHi. We are elucidating the mechanism by which P2XRs may regulate pHi via the Golgi in PDAC. Our preliminary results show that concomitant with the alkalinization of the Golgi, P2XR inhibition leads to a pronounced decrease of pHi and results in cell death in PDAC while normal untransformed pancreas cells are unaffected. These data suggest that P2XRs play a role in pHi regulation and cell fitness maintenance through a function in the Golgi. Targeting this metabolic reprograming dependency may serve as a novel therapeutic tool for PDAC. Citation Format: Cheska Marie Galapate, Koen Galenkamp, Charles Fisher, Susanne Heynen-Genel, Cosimo Commisso. Emerging role of P2X receptors as Golgi pH regulators in pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr C041.

Retraction Note: Anti-inflammatory Effects of Novel P2X4 Receptor Antagonists, NC-2600 and NP-1815-PX, in a Murine Model of Colitis.

Retraction Note: Anti-inflammatory Effects of Novel P2X4 Receptor Antagonists, NC-2600 and NP-1815-PX, in a Murine Model of Colitis.

Moxibustion pre-treatment attenuates seizure severity during status epilepticus and counteracts the proconvulsant function of the purinergic P2X7 receptor.

Moxibustion, traditional Chinese medicine treatment, involves the warming of specific acupuncture points of the body using ignited herbal materials. Evidence suggests beneficial effects of moxibustion in several brain diseases including epilepsy, however, whether moxibustion pretreatment impacts on seizures and what are the underlying mechanisms remains to be established. Evidence has suggested the purinergic ATP-gated P2X7 receptor (P2X7R) to be involved in the actions of moxibustion. Moreover, P2X7R signalling is now well established to contribute to long-lasting brain hyperexcitability underlying epilepsy development. Whether P2X7R signalling is involved in the seizure-reducing actions of moxibustion has not been investigated to date. For our studies we used C57BL/6 male mice that received moxibustion pre-treatments at the acupoints Zusanli (ST36) and Dazhui (GV14) once daily for either 7, 14, or 21days. This was followed by an intraperitoneal injection of kainic acid (KA, 30mg/kg) to induce status epilepticus. Behavioral changes during KA-induced status epilepticus were analyzed according to the Racine scale. Changes in electrographic seizures were analyzed via cortical implanted electroencephalogram (EEG) electrodes. While no effect on seizure severity was observed following 7days of moxibustion pre-treatment, moxibustion pre-treatment at both ST36 and GV14 for 14 or 21days significantly reduced KA-induced behavior seizures at a similar rate. Cortical EEG recordings showed that 14days of moxibustion pre-treatments also reduced electrographic seizures, confirming the anticonvulsant actions of moxibustion pre-treatment. To determine whether moxibustion impacts the pro-convulsant actions of P2X7R signaling, mice were treated with the P2X7R agonist BzATP or P2X7R antagonist A438079. While treatment with the P2X7R agonist BzATP exacerbated seizure severity, treatment with the P2X7R antagonist reduced seizure severity. We further found that moxibustion pre-treatment attenuated epileptic seizures by counteracting the effects ofBzATP. These results suggest that moxibustion pre-treatment at the acupoints ST36 and GV14 for 14days has anti-epileptic effects, which may counteract the proconvulsant functions of the P2X7R.

Role and Therapeutic Potential of P2X7 Receptor in Lung Cancer Progression.

Lung cancer is the second malignant tumor in the world and is the most prevalent malignant tumor of the respiratory system. In lung cancer, the P2X7 receptor (P2X7R) is an important purinergic receptor. P2X7R is a class of ionotropic adenosine triphosphate (ATP)-gated receptors, which exists in many kinds of immune tissues and cells and is involved in tumorigenesis and progression. P2X7R is closely related to lung cancer and is expressed at higher levels in lung cancer than in normal lung tissue. P2X7R plays a critical regulatory function in lung cancer invasion and migration through multiple mechanisms of action and affects the proliferation and apoptosis of cancer cells in the lung. Antagonists of P2X7R can block its function, which in turn has a significant inhibitory effect on lung cancer cell development and progression. This paper details a comprehensive overview of the structure and function of P2X7R. It focuses on the impact and treatment potential of P2X7R in lung cancer invasion, migration, proliferation, and apoptosis, providing new ideas and a new basis for clinical lung cancer treatment and prognosis.

P2X7 receptors from the perspective of NLRP3 inflammasome pathway in depression: Potential role of cannabidiol

Many patients with depressive disorder do not respond to conventional antidepressant treatment. There is an ongoing interest in investigating potential mechanisms of treatment resistance in depression to provide alternative treatment options involving inflammatory mechanisms. Increasing evidence implicates the NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome as a critical factor in neuroinflammation. ATP-induced P2X7 receptor (P2X7R) activation is a major trigger for inflammation, activating the canonical NLRP3 inflammatory cascade. Psychosocial stress, the primary environmental risk factor for depression, is associated with changes in ATP-mediated P2X7R signaling. Depression and stress response can be alleviated by Cannabidiol (CBD). CBD has an anti-inflammatory activity related to the regulation of NLRP3 inflammasome activation. However, CBD's effects on the inflammasome pathway are poorly understood in central nervous system (CNS) cells, including microglia, astrocytes, and neurons. This review will emphasize some findings for neuroinflammation and NLRP3 inflammasome pathway involvement in depression, particularly addressing the ATP-induced P2X7R activation. Moreover, we will underline evidence for the effect of CBD on depression and address its potential impacts on neuroinflammation through the NLRP3 inflammasome cascade.

Finely ordered intracellular domain harbors an allosteric site to modulate physiopathological function of P2X3 receptors

P2X receptors, a subfamily of ligand-gated ion channels activated by extracellular ATP, are implicated in various physiopathological processes, including inflammation, pain perception, and immune and respiratory regulations. Structural determinations using crystallography and cryo-EM have revealed that the extracellular three-dimensional architectures of different P2X subtypes across various species are remarkably identical, greatly advancing our understanding of P2X activation mechanisms. However, structural studies yield paradoxical architectures of the intracellular domain (ICD) of different subtypes (e.g., P2X3 and P2X7) at the apo state, and the role of the ICD in P2X functional regulation remains unclear. Here, we propose that the P2X3 receptor’s ICD has an apo state conformation similar to the open state but with a less tense architecture, containing allosteric sites that influence P2X3’s physiological and pathological roles. Using covalent occupancy, engineered disulfide bonds and voltage-clamp fluorometry, we suggested that the ICD can undergo coordinated motions with the transmembrane domain of P2X3, thereby facilitating channel activation. Additionally, we identified a novel P2X3 enhancer, PSFL77, and uncovered its potential allosteric site located in the 1α3β domain of the ICD. PSFL77 modulated pain perception in P2rx3+/+, but not in P2rx3−/−, mice, indicating that the 1α3β, a “tunable” region implicated in the regulation of P2X3 functions. Thus, when P2X3 is in its apo state, its ICD architecture is fairly ordered rather than an unstructured outward folding, enabling allosteric modulation of the signaling of P2X3 receptors.

THE effect of P2X7 receptor activation on functional responses of human left internal mammary artery.

The Purinoreceptor 7 (P2X7R) has become a promising drug target in many cardiovascular diseases, including coronary artery disease, since prolonged activation of P2X7R could promote vascular dysfunction, atherosclerosis, and thrombosis. Thus, we aimed to study the effects of P2X7R activation on vascular relaxation responses of the human left internal mammary artery (LIMA). Sections of redundant human LIMA were cut into 3-mm wide rings,, suspended in 20-mL organ baths containing physiologic salt solution, and attached to an isometric force transducer connected to a computer-based data acquisition system. Long-term (60min) incubation with specific P2X7R agonist Bz-ATP caused significant reductions in relaxation responses of LIMA to ATP and acetylcholine, which were reversed by selective P2X7R antagonists Brilliant Blue G or AZ11645373, whereas there were no changes in relaxation responses to endothelium-independent vasodilators isoprenaline, cAMP analog 8-Br-cAMP, and nitric oxide donor sodium nitroprusside. The impairment in relaxant responses of LIMA to endothelium-dependent vasodilators following activation of P2X7R for the long-term may contribute to postoperative LIMA vasospasm and hypertension. Modulation of P2X7R activity with selective agents may represent a new potential therapeutic approach in patients undergoing coronary artery bypass grafting surgery.

Astrocytic P2X7 receptor in retrosplenial cortex drives electroacupuncture analgesia.

P2X7 receptor (P2X7R) has been found to contribute to the peripheral mechanism of acupuncture analgesia (AA). However, whether it plays an important role in central mechanism remains unknown. In this study, we aimed to reveal the role of astrocytic P2X7R in retrosplenial cortex (RSC) in AA and provide new evidence for underlying the central mechanism of AA. We applied the chemogenetic receptors hM3Dq to stimulate or hM4Di to inhibit astrocytes ligand clozapine-N-oxide (CNO) following injection of adeno-associated virus (AAV) into the bilateral RSC, or pharmacologically intervened in the activity of the purinergic receptor P2X7R. Current data indicated that chemogenetic inhibition of astrocytes or injection of P2X7R agonist Bz-ATP in the bilateral RSC significantly reverses the analgesic effect of electroacupuncture (EA) in formalin tests while the bilateral injection of the P2X7R antagonist A438079 alleviated formalin-induced nociceptive behavior. Additionally, chemogenetic suppression of astrocytic P2X7R by injection of AAV in the bilateral RSC decreased hind paw flinches induced by formalin in the mice. These findings indicate the participation of both astrocytes and P2X7R in the RSC in EA analgesic. Moreover, P2X7R on astrocytes in the RSC appears to play a critical role in the ability of EA to attenuate formalin-induced pain responses in mice.

Abstract MP36: Excessive ATP Promotes Hypertension Via Stimulating T cells

While CD8+ T cells (CD8Ts) have recently emerged as key players in hypertension, the precise mechanisms underlying their involvement remain incompletely understood. We reported previously that CD8T-activation is critical in initiating their direct interaction with renal tubules. Here, we discovered that CD8T activation in hypertension occurs in an antigen-independent manner. In this study, we delve into the contribution of the P2X7 receptor to CD8T activation and its subsequent promotion of hypertension. To investigate whether CD8T activation in hypertension necessitates T cell receptor (TCR) stimulation, we employed Rag2/OT1 mice, which exclusively harbor transgenic OT1 CD8Ts, recognizing only ovalbumin peptides but no other antigens. These mice, without any exposure to ovalbumin, were induced hypertension through the DOCA + salt (DOCA) model. Blood pressure was monitored using biotelemetry, and CD8T activation was confirmed using flow cytometry. In our in-vitro studies, CD8Ts were obtained from WT or P2X7-KO mice and stimulated with ATP. The endpoints include calcium influx and cytokine production as indicators of activation. Moreover, we measured the activation profiles of CD8Ts obtained from WT or P2X7-KO mice subjected to sham or DOCA treatment using RT-PCR and flow cytometry. Additionally, we conducted an adoptive transfer experiment, transferring naive WT CD8Ts to P2X7-KO mice undergoing DOCA treatment. We found that CD8Ts from Rag2/OT1 mice become activated in response to the DOCA pressor, leading to increased IFNγ production and contributing to salt-sensitive hypertension, even in the absence of TCR-mediated antigen stimulation. Furthermore, ATP elicited calcium influx in CD8Ts via P2X7, thereby upregulated IFNγ production. In addition, CD8Ts pre-treated with ATP exhibited a higher ability to stimulate sodium retention in co-cultured renal tubule epithelial cells compared to those co-cultured with naive CD8Ts. Notably, DOCA-treated P2X7 KO CD8Ts were unable to induce an increase in blood pressure in our adoptive transfer model. However, transferring sham WT CD8Ts to DOCA-treated P2X7 KO mice successfully restored hypertension to WT levels. Our findings reveal a novel mechanism by which ATP/P2X7 signaling leads to activation of CD8Ts as the culprit to the pathogenesis of hypertension. As such, the CD8T P2X7 receptor presents itself as a promising target for improving blood pressure management.

Randomized, controlled, proof-of-concept trial of gefapixant for endometriosis-related pain

ObjectiveTo evaluate the P2X3 receptor antagonist, gefapixant, for treating moderate-to-severe endometriosis-related pain. DesignRandomized, double-blind, Phase 2, proof-of-concept trial. ParticipantsPremenopausal women age 18-49y with moderate-to-severe endometriosis-related pain who were not using hormonal treatment. InterventionsGefapixant 45mg twice-daily or placebo over two menstrual cycles. Main outcome measuresParticipants rated peak pelvic pain severity daily on a 0 (no pain) - 10 (extremely severe pain) scale. The primary endpoint was change-from-baseline in average daily peak pelvic pain severity during Treatment Cycle 2. ResultsAll 187 participants randomized (gefapixant N=94, placebo N=93) took ≥1 dose of investigational treatment and all but 6 in each treatment group completed the trial. The model-based least squares mean reduction-from-baseline in average daily peak pelvic pain severity during Treatment Cycle 2 was -2.2 for gefapixant and -1.7 for placebo (difference = -0.5 [95% confidence interval: -1.01, 0.03], P=0.066). In secondary analyses, the difference between gefapixant and placebo in peak pelvic pain severity reduction-from-baseline on menstrual days was -0.6 [95% confidence interval: -1.18, -0.06], and -0.5 [95% confidence interval: -1.04, 0.03] on non-menstrual days. Taste-related adverse events were reported in 31.9% of participants for gefapixant versus 4.3% for placebo. Pharmacokinetic assessments at Month 1 and Month 2 clinic visits indicated that of the 94 participants in the gefapixant group, 39 had detectable levels of gefapixant in the blood for both assessments while 38 had no detectable levels for ≥1 assessment. ConclusionGefapixant 45mg twice-daily was not shown to be superior to placebo in reducing endometriosis-related pain, although the results directionally favored gefapixant. This trial result should be considered inconclusive given possible issues with treatment compliance. (Clinical trial registration: NCT03654326)

Elastic Properties of the Cell Surface and Metabolic Profile of an Embryonic Primary Mixed Culture of Hippocampal Neurons under Conditions of P2X3 Receptor Blockade

Elastic Properties of the Cell Surface and Metabolic Profile of an Embryonic Primary Mixed Culture of Hippocampal Neurons under Conditions of P2X3 Receptor Blockade