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Title:
USE OF CREATINE KINASE AND DERIVED PEPTIDES THEREOF TO RELIEF PAIN
Document Type and Number:
WIPO Patent Application WO/2016/142349
Kind Code:
A1
Abstract:
The present invention relates to the use of creatine kinase or fragments thereof which induce analgesia, and also to the use of pharmaceutical compositions comprising the same, to relief pain.

Inventors:
GOUMON YANNICK (FR)
MOUHEICHE JINANE (FR)
LAUX-BIEHLMANN ALEXIS (DE)
POISBEAU PIERRICK (FR)
KAMOUN NISRINE (FR)
Application Number:
PCT/EP2016/054816
Publication Date:
September 15, 2016
Filing Date:
March 07, 2016
Export Citation:
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Assignee:
CENTRE NAT DE LA RECH SCIENT - CNRS - (FR)
UNIV STRASBOURG (FR)
International Classes:
A61K38/45; A61K31/485; A61P25/04
Foreign References:
FR2971161A12012-08-10
US20070265221A12007-11-15
FR2971161A12012-08-10
Other References:
UNIVERSITÉ DE STRASBOURG ET AL: "Dr Présentée par", 1 January 2011 (2011-01-01), XP055191744, Retrieved from the Internet [retrieved on 20150528]
"LICENSING OPPORTUNITIES CNRS patent portfolio related to Central Nervous System Disorders", 1 January 2014 (2014-01-01), XP055191985, Retrieved from the Internet [retrieved on 20150528]
22 December 2014 (2014-12-22), XP055191994, Retrieved from the Internet [retrieved on 20150528]
MOSCONI; KRUGER, PAIN, vol. 64, no. 1, 1996, pages 37 - 57
BERTIN; VERGNE-SALLE: "Traitements medicamenteux de l'inflammation et des douleurs inflammatoires", 2007, UPSA PAIN INSTITUTE - A EDITORIAL PARIS, pages: 113 - 132
GUTSTEIN; AKIL ET AL.: "The Pharmacological Basis of Therapeutics", 2006, MCGRAW-HILL, article "Opioid analgesics"
BANNISTER; DICKENSON: "Curr. Opin. Support Palliat", CARE, vol. 4, 2010, pages 1 - 5
YENNURAJALINGAM ET AL., SUPPORT CANCER THER., vol. 1, 2004, pages 97 - 110
MIZOGUCHI ET AL., INT. REV. NEUROBIOL., vol. 85, 2009, pages 249 - 260
Attorney, Agent or Firm:
NOVAGRAAF TECHNOLOGIES (2 rue Sarah BernhardtCS, 92665 Asnières-sur-Seine Cedex, FR)
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Claims:
CLAIMS

1 . Peptide comprising between 5 and 75 amino acids of the amino acid sequence of creatine kinase and having an analgesic activity, for use as a drug.

2. Peptide for use according to claim 1 , wherein the drug is an analgesic. 3. Peptide for use according to either one of claim 1 or 2, wherein the drug is administered centrally, subcutaneously, transcutaneously, systemically, orally or via the respiratory route.

4. Peptide comprising between 5 and 75 amino acids of the amino acid sequence of creatine kinase and having an analgesic activity, for a use in the prevention or treatment of pain.

5. Peptide for use according to any one of claims 1 to 4, said peptide comprising between 5 and 75 amino acids of SEQ ID NO: 1 .

6. Peptide for use according to claim 5, said peptide comprising the sequence SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4 and/or SEQ ID NO: 5. 7. Pharmaceutical composition for a use in the prevention or treatment of pain, said composition comprising at least a peptide as defined in any one of claim 1 to 6 and a pharmaceutically acceptable vehicle. 8. Pharmaceutical composition for use according to claim 7, said composition comprising the peptide comprising the sequence SEQ ID NO: 3.

9. Pharmaceutical composition for use according to either one of claim 7 or 8, said composition further comprising one or more analgesic compound.

10. Pharmaceutical composition for use according to claim 9, wherein the analgesic compound is morphine.

1 1 . Peptide comprising between 5 and 75 amino acids, preferably between 25 and 75 amino acids, of the amino acid sequence of creatine kinase, and having an analgesic activity.

12. Peptide according to claim 1 1 , said peptide of 25 to 75 amino acids comprising the sequence SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4 and/or SEQ ID NO: 5.

13. Nucleic acid sequence encoding a peptide as defined in claim 1 1 or 12.

Description:
USE OF CREATINE KINASE AND DERIVED PEPTIDES THEREOF TO

RELIEF PAIN

DESCRIPTION

Field of technology

The present invention relates to the use of creatine kinase or fragments thereof which induce analgesia, and also to the use of pharmaceutical compositions comprising the same. In particular two novel peptides consisting of the amino acid sequence 1 -75 and 184-258 derived from the amino acid sequence of creatine kinase exhibit an analgesic activity, thereby proposing them as an interesting substitute for morphine.

The present invention notably finds application in the prevention or treatment of pain.

In the following description, the references in brackets ([ ]) refer to the list of references presented at the end of the text.

Background

Creatine kinase (CK, EC 2.7.3.2), also called phosphocreatine kinase or creatine phosphokinase (CPK), is an enzyme expressed by various tissues including the brain and muscles, where it is present in cytoplasmic and mitochondrial form. There are several isoenzymes (present in the form of noncovalent dimers): CK-MM present in muscles, CK-MB found in the myocardial cells, and CK-BB which occurs in the brain. Mitochondrial CK

(mtCK) also occurs. This enzyme catalyzes the reversible conversion of creatine to phosphocreatine via the use of adenosine triphosphate (ATP, figure 1 ). This enzyme is essential for the production of ATP from stored phosphocreatine. Phosphocreatine, via ATP, thus constitutes a reservoir of energy that is rapidly usable for the muscles and other organs including the brain. CK (isoforms MM and MB; dimers) is released in the blood during tissue lesions causing cellular lysis (for example in a muscle disorder such as rhabdomyolysis, muscular effort, myocardial infarction, etc.). Assaying isoenzymes in the blood makes it possible to differentiate the origin of the cellular destruction. Thus, increase in blood CK-MB has been used in a blood test for diagnosing myocardial infarction.

In addition to its role in the metabolism of ATP, it has been recently shown that CK forms non covalent complexes of very high affinity with morphine [Patent Application FR 2 971 161 ] [6]. The functional consequences of this interaction are not yet clearly defined, however results show that the enzymatic activity of CK (production of ATP from phosphocreatine) is inhibited by morphine by almost 18% (figure 2).

Taking into account and treatment of pain are essential aspects of improving the quality of life of patients. Pain affects a considerable number of individuals, about 60 million in Europe each year, which represents an annual cost of 1 billion dollars in analgesic drugs for pain relief. The amount spent annually throughout the world on analgesic drugs was evaluated at approximately 42 billion dollars in 2010. Pain is divided up into two categories: acute pain and chronic pain. Acute pain corresponds to rapid and brief pain which is limited over time. Conversely, chronic pain is a persistent pain which can be linked, for example, to hyperalgesia, and which constitutes an enormous disease burden, affecting approximately 20% of adults and 50% of the elderly population.

The treatment of pain is based essentially on the prescription of antiinflammatory drugs, whether they are nonsteroidal (NSAIDs) or steroidal (corticoids), and of weak or strong opiates. NSAIDs form the therapeutic class most widely prescribed throughout the world, owing to their great efficacy both on inflammation and on pain itself. They are used in all types of inflammatory pain, whether acute or chronic [Bertin and Vergne-Salle, 2007] [1 ]. When NSAIDs and/or corticoids are not sufficient to relieve inflammatory pain, the prescribing physician combines a non-anti- inflammatory analgesic, for example paracetamol, weak opioids (codeine, tramadol), and, if the pain continues to be resistant to the treatment, strong opioids (morphine, oxycodone, fentanyl) [Gutstein & Akil, 2006] [2]. While NSAIDs are very effective, they nevertheless remain great purveyors of adverse side effects. Among the most standard adverse side effects, digestive effects are very frequent and limit the use of NSAIDs in many clinical situations. There are also renal, cutaneous, mucosal, allergic and respiratory, hematological, hepatic and, finally, neurosensory and psychological adverse side effects [Bertin and Vergne-Salle, 2007, mentioned above] [1 ]. In addition, NSAIDs are not effective in all types of pain. Opioids also play a major role in pain relief, but can cause hallucinatory phenomena, constipation and cardiorespiratory depression. Analgesics can also be a source of dependence (morphine, methadone, etc .). There are also cases of habituation or tolerance to analgesics, that is to say the dose necessary to obtain a constant effect must be increased. This habituation increases over time and therefore leads to the need to increase the doses and can lead to ineffectiveness of the medicament. Indeed, the dose necessary to relieve pain can reach the toxic dose. Finally, treatment with opioids can also be associated with adverse effects including hyperalgesia when the treatment is stopped (post-operative pain, for example) [Gutstein & Akil, 2006, mentioned above; Bannister & Dickenson, 2010] [2, 3].

Furthermore despite the diversity of the existing therapeutic arsenal, many types of pain remain relatively insensitive to the known analgesics, such as neuropathic pain following damage to the nervous system (50% of patients experience no relief), chronic visceral pain such as irritable bowel syndrome or chronic inflammatory bowel disease, fibromyalgia, pain associated with cancers and bone metastases, etc. [Yennurajalingam et al., 2004; Mizoguchi et al., 2009] [4, 5].

Research in the pharmaceutical industry on pain has over the past few years resulted only in a few limited developments. Mention may, for example, be made of triptans for migraine and certain novel medicaments of which the use still remains limited, such as the combination of tetrahydrocannabinol and cannabidiol for cancer-related and neuropathic pain. In fact, the progress made over the last two decades comes essentially from a better use and adjustments of the dosage of the available analgesics. None of the major families of these analgesics has a benefit/risk ratio which is optimal, because of a limited efficacy and/or considerable side effects.

In this context, the discovery of novel analgesics represents real progress.

Description of the invention

The inventors were the first to unexpectedly identify peptides of creatine kinase containing binding sites for morphine only. The first two peptides identified consist of amino acids 1 -75 and 184-258, sequences SEQ ID NOs: 2 and 3 respectively, of the full-length amino sequence of the mouse creatine kinase B (figure 3). Their functional properties were first evaluated through injections into the spinal cord of healthy mice C57B16/J in comparison to those of morphine, and showed an almost complete insensitivity of mice towards mechanical stimulation. Furthermore, using the "cuff neuropathic rat model and the calibrated clamp test, an intrathecal injection of the peptide of amino acids 184-258 reveals that the peptide reverses the neuropathic pain (ipsilateral paw) at the mechanical level for at least 6h. Two other peptides identified consist of amino acids 214-238 and 196-246, sequences SEQ ID NOs: 4 and 5 respectively, of the full-length amino sequence of the mouse creatine kinase B, and present analgesic activity.

These results allow to consider using these peptides derived from creatine kinase as a substitute for morphine or as adjuvant of current analgesic treatments.

A subject of the present invention is therefore a peptide comprising at least, or consisting of, or comprising a peptide consisting of, 5, 10, 15, 25, 35, 45, 55, 65 or 75 amino acids of the amino acid sequence of creatine kinase and having an analgesic activity, for use as an analgesic drug. For example, such peptides comprise a peptide consisting of 5 to 75, preferably 25 to 75 amino acids, of the amino acid sequence of creatine

CK-MM present in the muscles, the CK-MB found in the myocardial cells, the CK-BB that occurs in the brain and the mtCK (sarcomere and ubiquitous) which is present in the mitochondria of mammalian cells, as well as the monomers of CK (CK-B and CK-M).

Preferably said drug is an analgesic, for example intended for the prevention or treatment of pain.

"Pain" means, in the sense of the present invention, acute or chronic pain resulting for example from arthritis, neuropathy, cancer treatments induced pain, fibromyalgia or an old injury, etc...

Preferably said drug is administered parenterally, namely locoregionally or centrally (intraperitoneally, peridurally, intrathecally, intra- cerebroventricularly, intradermally, etc.) and systemically (intramuscularly, intravenously, subcutaneously, etc.), orally, locally (transcutaneously, etc.) or via the respiratory route (inhalation, instillation, etc.). Most preferentially, said medicament is administered intrathecally, peridurally, intracerebroventricularly, intraperitoneally or subcutaneously. In particular said drug is administered centrally, subcutaneously, transcutaneously, systemically, orally or via the respiratory route.

Preferably said peptide comprises or consists of at least about 5, 10,

15, 25, 35, 45, 55, 65 or 75 amino acids of SEQ ID NO: 1 , more preferably comprises 5 to 75, 25 to 75 amino acids of SEQ ID NO: 1 .

Preferably said peptide comprises or consists of the sequence SEQ

ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4 and/or SEQ ID NO: 5.Another subject of the present invention is also a peptide comprising at least, or consisting of, or comprising a peptide consisting of, 5, 10, 15, 25, 35, 45, 55, 65 or 75 amino acids of the amino acid sequence of creatine kinase and having an analgesic activity, for a use in the prevention or treatment of pain.

Preferably said peptide comprises or consists of an amino acid sequence of at least about 5, 10, 15, 25, 35, 45, 55, 65 or 75 amino acids of SEQ ID NO: 1 , more preferably comprises 5 to 75, 25 to 75 amino acids of SEQ ID NO: 1 .

Preferably said peptide comprises or consists of the sequence SEQ

ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4and/or SEQ ID NO: 5.

Another subject of the present invention is also a pharmaceutical composition for a use in the prevention or treatment of pain, said composition comprising a least a peptide as defined in the invention and a pharmaceutically acceptable vehicle. Said composition may further comprise one or more other analgesic compound(s).

"Analgesic compound" means, in the sense of the present invention, general opiate compounds, i.e., compounds that act on opioid receptors. They are generally used to treat severe and long-lasting pain. Preferably, these are morphine compounds, notably morphine or morphinomimetic compounds, i.e., compounds that are derived from morphine and/or that act on morphine receptors and/or that recruit one or more metabolic pathways common to morphine. As particular examples, mention may be made of the following compounds in particular: morphine, fentanyl, sufentanil, alfentanyl, heroin, oxycodone, hydromorphone, levorphanol, methadone, buprenorphine, butorphanol, meperidine, etc....

Preferably said pharmaceutical comprises the peptide comprising or consisting of the sequence SEQ ID NO 2, SEQ ID NO: 3, SEQ ID NO: 4 and/or 5, eventually in combination with morphine.

Another subject of the present invention is therefore a peptide comprising, or consisting of, or comprising a peptide consisting of, 5 to 75 amino acids, preferably 25 to 75 amino acids, of the full-length amino acid sequence of creatine kinase, and having an analgesic activity. Preferably said peptide of 25 to 75 amino acids comprises the sequence SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4 and/or SEQ ID NO: 5.

Another subject of the present invention is also a variant of a peptide of the present invention (by deletion, addition and/or substitution of amino acid(s)), said variant having at least 85%, preferably at least 90%, more preferably at least 95%, sequence identity with the full-length sequence SEQ ID NO: 2 or SEQ ID NO: 3, preferably SEQ ID NO: 2, and retaining an analgesic activity,

Another subject of the present invention is also a nucleic acid encoding the sequence SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4 and/or SEQ ID NO: 5 or a variant thereof as defined above; said nucleic acid corresponding to RNA or DNA, preferably to DNA.

Another subject of the present invention is also a vector or host cell comprising a nucleic acid of the present invention. Such (expression) vectors and host cells are well known in the art.

Other advantages may also occur to a skilled person upon reading the example below, illustrated by the attached figures, given for illustrative purposes.

Brief description of figures

The figure 1 represents the enzymatic reaction catalyzed by creatine kinase.

The figure 2 represents the inhibitory effect of morphine of the ATP formation by CK-M (ratio 3n/1 n).

The figure 3 represents ELISA tests showing affinity for morphine of (A) peptide P1 (amino acids 1 -75 of mouse CK-B) for morphine, and (B) peptide P4 (amino acids 184-258 of mouse CK-B).

The figure 4 represent effect of saline solution (SAL-right), morphine (MOR-right), peptides P1 (P1 (20nmoles)-right) and P4

(P4(10nmoles)-right) on mechanical nociceptive thresholds of mice using von Frey filaments. n=6 for each group, statistical analysis: two-ways ANOVA, Holm-Sidak ** p<0.01 , **** p<0.0001 .

The figure 5 represents effect of morphine (l Onmoles) on analgesic activity of (A) peptide P1 (20nmoles) and (B) peptide P4 (l Onmoles).

The figure 6 represents effect of intrathecal (IT) injection of peptide P4 (l Onmoles) on mechanical threshold of rats using the calibrated forceps test (A), and mechanical thresholds of the ipsilateral (= neuropathic paw) (B) or of the contralateral (= non neuropathic paw) (C) of cuffed rats before and after injection of the peptide P4.

The figure 7 represents effect of intraperitoneal injection of peptide P4 (C) vs saline solution (A) and morphine (B) on mechanical thresholds of neuropathic mice using von Frey filaments. Comparison to baseline (BL), Tukey multiple comparison posthoc, # #= p<0.01 , ###= p<0.001 , n=10 for each groups.

The figure 8 represents effect of intrathecal (IT) injection of peptide AI-25 (l O nmoles) on mechanical nociceptive threshold of mice using calibrated forceps test (A), and mechanical thresholds of the ipsilateral paw (8), or of the contralateral paw (C) of cuffed mice before and after injection of the peptide AI-25.

The figure 9 represents the effect of intrathecal (IT) injection of peptide KN-50 (33 nmoles) on mechanical nociceptive threshold of the ipsilateral or contralateral paw of cuffed mice, before and after injection of the peptide KN-50, in comparison of saline solution (control).

EXAMPLES

EXAMPLE 1 : IDENTIFICATION OF PEPTIDES FROM CREATINE KINASE CONTAINING BINDING SITES FOR MORPHINE ONLY

In order to characterize the fragment of CK that can bind morphine/morphine metabolites, six overlapping mouse CK-B-derived peptides (73 to 96 residues) have been synthesized (Proteogenix, Schiltigheim, France) : CK-B1 -75, CK-B65-140, CK-B127-199, CK-B184- 258, CK-B248-343, CK-B286-381 .

Determination of the affinity and specificity for alkaloids was done on a 96-well plate (NUNC, Roskilde, Denmark) coated 90min at 37°C with 10ΟμΙ of a 10pg/nnl of the corresponding peptide solution in carbonate- bicarbonate buffer (CA buffer, 15mM Na 2 CO 3 , 35mM NaHCO 3 , pH9.6). After three washes with 0.1 M NaCI/Pi-0.05% Tween 20 buffer (PT; 10min), wells were incubated for 30min with 200μΙ of bovine serum albumin (BSA) diluted in NaCI/Pi buffer (5%, w/v) in order to saturate non specific sites. After saturation, wells were incubated for 1 h at 37°C with 10ΟμΙ of NaCI/Pi- BSA (3%, w/v) containing from 300μΜ to 0.1 μΜ of the following potential CK-ligands : morphine (Sigma-Aldrich), M6G (Sigma-Aldrich), M3G (Sigma-Aldrich), codeine (Sigma-Aldrich). Then, the plate was washed three times with PT buffer, and 100μΙ of the primary antibody (6D6, 1 : 2,000, v/v; Aviva Systems Biology, ref. AMM00043) were added in each well. After three more washes with PT buffer, 100μΙ of the secondary antibody (HRP-conjugated donkey anti-mouse IgG, P.A.R.I.S.; dilution 1 :2,000) were added and left in the wells for 30min at room temperature

(RT). After two washes with PT buffer followed by two washes with a pH 7.5 phosphate-citrate-0.05% Tween 20 buffer (CT buffer, 10min), revelation was performed with 200μΙ of a fresh solution of ortho-phenylene diamine (Sigma Aldrich) at 1 .5mg/ml in CT buffer containing 0.075% hydrogen peroxide. After 20min of incubation at RT, optical density was determined at 410nm with a Multiskan EX plate reader (Thermo Life Sciences, Cergy Pontoise, France). Two peptides containing binding sites for morphine only were identified: peptide P1 consisting of amino acids 1 -75 (SEQ ID NO: 2) from the mouse CK-B sequence SEQ ID NO: 1 , and peptide P4 consisting of amino acids 184-258 (SEQ ID NO: 3) of the mouse CK-B sequence SEQ ID NO: 1 .

The results are shown in figure 3.

Peptides P1 and P4 showed an affinity for morphine but not for metabolites thereof (M3G and M6G) and codeine, thereby indicating that peptides P1 and P4 only contain binding sites for morphine.

EXAMPLE 2: EFFECT OF INTRATHECAL INJECTIONS OF MORPHINE, PEPTIDES P1 AND P4 ON MECHANICAL NOCICEPTIVE THRESHOLDS OF HEALTHY MICE

Experiments were performed on adult male C57BI/6Jmice (6 weeks old, Charles River, L'Arbresle, France). Animals were housed in groups of 3, under standard conditions (room temperature: 22°C; 12/12-hour light- dark cycle) with ad libitum access to food and water. All experiments were conducted according to the recommendations of the European Committee Council Direction of September 22, 2010 (2010/63/EU).

The functional properties of peptides P1 (20nmoles) and P4

(l Onmoles) were evaluated through injections in the spinal cord of 4 groups of 6 mice C57B16/J (intrathecal injection, volume of 5μΙ). The aim was to study the consequences of these injections on nociceptive thresholds in comparison of low concentrations of morphine (MOR, l Onmoles) and saline solution (SAL, control), using the von Frey filaments test. Mice were previously placed under gaseous anesthesia with isoflurane (volatile anesthetic agent) with a minimum alveolar concentration (MAC) of 1 .34%. A 27-gauge needle connected to a syringe was inserted between the vertebrae L5 and L6, in the subarachnoid space. Isoflurane induced a general anesthesia with respiratory depression in mice. The mechanical threshold for hind paw withdrawal was determined using Von Frey hairs. Mice were placed in clear plexiglass boxes on an elevated mesh screen. Von Frey filaments (Bioseb, Chaville, France) were applied to the plantar surface of each hind paw in a series of ascending forces (0.4 g - 15 g). Filaments were tested 5 times per paw, and the mechanical threshold was defined as 3 or more withdrawals out of the 5 trials. Lithium chloride and naloxone (Sigma-Aldrich, St. Louis, U.S.A.) were diluted in NaCI 0.9% (w/v).

When using the von Frey filaments test, naive mice showed basic mechanical nociceptive thresholds around 6g for both hind legs (= pretest).

The results regarding right hind paw are shown in figure 4.

Compared to the pre-test before injection, injection of saline solution 0.9% did not affect the nociceptive thresholds (control). Unlike the observed threshold for the control, injections of morphine (l Onmoles), peptides P1 (20nmoles) and P4 (l Onmoles) induced a significant analgesia (two-ways ANOVA for repeated measures, interaction time against treatment for right leg, F(44,220)=6.243, p<0.0001 ). At a low dose of l Onmoles and 4 hours after injection, morphine induced a significant analgesia on right leg (multiple comparison test of Holm-Sidak, p<0.01 ). Analgesia was even stronger for peptides P1 and P4 (Holm-Sidak, p<0.0001 ). For both peptides, the values of von Frey were close or equal to cut-off, namely a value allowing to conclude to an almost complete insensitivity of mice towards mechanical stimulation.

Furthermore, when injections were carried out in presence of morphine (figure 5), it was significant to note occlusion of analgesic activity of peptide P1 (20nmoles) by l Onmoles of morphine while this property was not observed for peptide P4 injected at l Onmoles. EXAMPLE 3: EFFECT OF INTRATHECAL INJECTIONS OF PEPTIDES

P1 AND P4 ON MECHANICAL NOCICEPTIVE THRESHOLDS OF NEUROPATHIC RATS MODEL Experiments were performed on adult male Wistar at (6 weeks old, Charles River, L'Arbresle, France). Animals were housed in groups of 3, under standard conditions (room temperature: 22°C; 12/12-hour light-dark cycle) with ad libitum access to food and water. All experiments were conducted according to the recommendations of the European Committee Council Direction of September 22, 2010 (2010/63/EU). Procedures were positively evaluated by the regional ethical committee, and experiments were conducted with an official authorization for animal experimentation from the French Department of Agriculture (license 67-1 16 to P.P.).

All surgeries were done under aseptic conditions and ketamine/xylazine anaesthesia (ketamine: 17mg/ml, xylazine: 2.5mg/ml, i.p., 4ml/kg, i.p.; Centravet, Taden, France). The right sciatic nerve was cuffed with a section of polyethylene tubing (cuff group) as previously described [Mosconi et Kruger, Pain, 64(1 ): 37-57, 1996] [7]. Sham- operated mice underwent the same surgical procedure as cuffed animals without implantation of the cuff (sham group).

The functional property of peptide P4 (l Onmoles) was evaluated through injections in the spinal cord of 1 groups of 3 rats (intrathecal injection, volume of 5 μΙ). The aim was to study the consequences of these injections on mechanic nociceptive threshold of cuffed animals in comparison of the sham group (control), using the calibrated forceps test. Rats were previously placed under gaseous anesthesia with isoflurane (volatile anesthetic agent) with a minimum alveolar concentration (MAC) of 1 .34%. A 27-gauge needle connected to a syringe was inserted between the vertebrae L5 and L6, in the subarachnoid space.

The mechanical response was evaluated using digital calibrated forceps (Bioseb, Chaville, France) according to company's recommendations, before and 1 to 6 hours after intrathecal injections.

The results at T + h are shown in figure 6.

The intrathecal injection of l Onmoles of the peptide 4 revealed that the peptide reversed the neuropathic pain (ipsilateral paw) at the mechanical level. However peptide 4 did not affect both the non cuffed contralateral paw mechanical threshold and the sham group. This analgesia lasted for at least 6h.

EXAMPLE 4: EFFECT OF INTRAPERITONEAL INJECTIONS OF MORPHINE, PEPTIDES P1 AND P4 ON MECHANICAL NOCICEPTIVE THRESHOLDS OF NEUROPATHIC MICE

Experiments were performed on adult male C57BI/6J mice (6 weeks old, Charles River, L'Arbresle, France). Animals were housed in groups of 5, under standard conditions (room temperature: 22°C; 12/12-hour light- dark cycle) with ad libitum access to food and water. All experiments were conducted according to the recommendations of the European Committee Council Direction of September 22, 2010 (2010/63/EU).

All surgeries were done under aseptic conditions and ketamine/xylazine anaesthesia (ketamine: 17mg/ml, xylazine: 2.5mg/ml, i.p., 4ml/kg, i.p.; Centravet, Taden, France). The right sciatic nerve was cuffed with a section of polyethylene tubing (cuff group) as previously described [Mosconi et Kruger, Pain, 64(1 ): 37-57, 1996] [7].

The functional properties of peptide P4 (l Onmoles), NaCI 0.9% and morphine (l Onmoles) were evaluated through intraperitoneal injection to C57B16/J neuropathic mice (l Onmole in a volume of 300μΙ). The aim was to study the consequences of P4 injections on nociceptive thresholds in comparison of low concentrations of morphine (MOR, l Onmoles) and NaCI solution (control). The mechanical threshold for hind paw withdrawal was determined using Von Frey hairs. Mice were placed in clear plexiglass boxes on an elevated mesh screen. Von Frey filaments (Bioseb, Chaville,

France) were applied to the plantar surface of each hind paw in a series of ascending forces (0.4 g - 15 g). Filaments were tested 5 times per paw, and the mechanical threshold was defined as 3 or more withdrawals out of the 5 trials.

The results are shown in figure 7.

When using the von Frey filaments test, NaCI injected mice showed basic mechanical nociceptive thresholds around 6g for contralateral hind legs (BL= pre-test), whereas the ipsilateral paw always show a nociceptive thresholds around 1 -2g (Fig. 7A). No effect was observed for Sham animals.

Morphine (l Onmoles) injections to mice do not modify basic mechanical nociceptive thresholds of the contralateral hind legs (BL= pretest), whereas a significant analgesic effect is observed at 3h for the ipsilateral paw (comparison to baseline (BL), Tukey multiple comparison posthoc, # #= p<0.01 ) (Fig. 7B). No significant effect was observed for the Sham group.

P4 (l Onmoles) injections to mice do not modify basic mechanical nociceptive thresholds of the contralateral hind legs (BL= pre-test), whereas a significant analgesic effect is observed at 3h and 4h post injection for the ipsilateral paw (comparison to baseline (BL), Tukey multiple comparison posthoc, # #= p<0.01 , ###= p<0.001 ) (Fig. 7C). No significant effect was observed for Sham animals.

EXAMPLE 5: EFFECT OF INTRATHECAL INJECTIONS OF A PEPTIDE AI-25 ON MECHANICAL NOCICEPTIVE THRESHOLDS OF NEUROPATHIC MICE

A peptide derived from the peptide P4 has been synthesized

(Proteogenix, Schiltigheim, France) : AI-25 corresponding to amino acids 214-238 (SEQ ID NO: 4) of the full-length amino sequence of the mouse creatine kinase B.

Experiments and surgeries were performed as previously described. The functional property of peptide AI-25 (10 nmoles) was evaluated through injections in the spinal cord of 8 mice C57B16/J (intrathecal injection, volume 5 μΙ). The aim was to study the consequences of these injections on mechanical nociceptive threshold of cuffed mice using the calibrated forceps test.

The mechanical threshold for hind paw withdrawal was determined using Von Frey filaments as previously described.

The results are shown in figure 8. The intrathecal injection of 10 nmoles of the peptide AI-25 revealed that the peptide reversed the neuropathic pain (ipsilateral paw) at the mechanical level. However the peptide AI-25 did not significantly affect the non cuffed contralateral paw mechanical threshold.

EXAMPLE 6: EFFECT OF INTRATHECAL INJECTIONS OF A PEPTIDE KN-50 ON MECHANICAL NOCICEPTIVE THRESHOLDS OF NEUROPATHIC MICE

A peptide derived from the peptide P4 has been synthesized (Proteogenix, Schiltigheim, France) : KN-50 corresponding to amino acids 196-246 (SEQ ID NO: 5) of the full-length amino sequence of the mouse creatine kinase B.

Experiments and surgeries were performed as previously described. The functional property of peptide KN-50 (33 nmoles) and NaCI 0.9% was evaluated through injections in the spinal cord of 8 mice C57B16/J (intrathecal injection, volume 5 μΙ). The aim was to study the consequences of these injections on mechanical nociceptive threshold of cuffed mice, in comparison of saline solution.

The mechanical threshold for hind paw withdrawal was determined using Von Frey filaments as previously described.

The results are shown in figure 9.

The intrathecal injection of 33 nmoles of the peptide KN-50 revealed that the peptide reversed the neuropathic pain (ipsilateral paw) at the mechanical level. However the KN-50 did not affect the non cuffed contralateral paw mechanical threshold.

List of references

Bertin and Vergne-Salle, "Traitements medicamenteux de inflammation et des douleurs inflannnnatoires" ["Drug treatments for inflammation and inflammatory pain"] UPSA Pain Institute - A

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