# Therapeutic potential and the critical site of action of non-addicting glibenclamide in neuropathic pain

> **NIH VA I01** · BALTIMORE VA MEDICAL CENTER · 2022 · —

## Abstract

BACKGROUND: Almost half of Veterans experience chronic pain, which is disproportionately greater than the
25 million Americans in the civilian population who suffer from significant chronic pain. Chronic pain is a common
sequela of military- and terror-related injuries. The majority of battlefield wounds involve injuries to exposed
limbs, resulting in high rates of neuropathic pain caused by damage to a peripheral nerve. Opioid use disorder
and the ongoing “opioid epidemic” are driven in part by the legitimate use of opioids prescribed for neuropathic
pain. Post-deployment, 15% of military Veterans use opioids, compared to 4% of the general population, and in
Veterans, there is a direct correlation between the use of opioids and suicide. Targeting alternative non-opioid
pathways for pain control using non-addicting drugs is a major goal of neuropathic pain research. After peripheral
nerve injury (PNI), cytokines and chemokines are upregulated centrally, including in dorsal horn astrocytes,
where they contribute mechanistically to the pathogenesis of neuropathic pain. Reactive astrocytes in the dorsal
horn exhibit a chronically activated, pro-inflammatory secretory (CAPS) phenotype characterized by the
secretion of numerous factors, including interleukin-6 (IL-6), chemokine C-C motif ligand 2 (CCL2) and
chemokine C-X-C motif ligand 1 (CXCL1), each of which individually has been shown to contribute to neuropathic
pain behaviors. The post-PNI astrocytic CAPS phenotype contributes to both inflammation and neuronal
hyperactivation via neuronal chemokine receptors, leading to neuropathic pain. Our pilot data demonstrate the
novel findings that, in the murine sciatic nerve cuff model of neuropathic pain, inhibiting sulfonylurea receptor 1
(SUR1) with low-dose glibenclamide administered daily over several weeks, with treatment beginning during the
chronic phase at day21 after PNI, causes marked reductions in: (i) mechanical allodynia, thermal hyperalgesia
and place escape/avoidance; (ii) dorsal horn astrocyte expression of IL-6, CCL2 and CXCL1.
DESCRIPTION: This project has the clinically relevant aim of establishing the therapeutic potential, durability,
and critical site of action of glibenclamide treatment in neuropathic pain behaviors induced by PNI. Four separate
experiments are planned in males and females using the murine sciatic nerve cuff model, with treatments applied
only during the chronic phase, 3 weeks after PNI. In these experiments, we will examine: (a) the ability of various
doses of systemic and intrathecal glibenclamide to effectively reverse neuropathic pain behaviors (mechanical
allodynia, thermal hyperalgesia, place escape/avoidance, anxiety and depression-like behaviors), and related
motor dysfunction; (b) the ability of systemic glibenclamide to gradually extinguish neuroinflammation in the
DRG/dorsal horn, for correlation with the observed gradual extinction of allodynia; (c) the durability of
glibenclamide treatment after treatm...

## Key facts

- **NIH application ID:** 10359075
- **Project number:** 5I01RX003060-03
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** J. Marc Simard
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10359075

## Citation

> US National Institutes of Health, RePORTER application 10359075, Therapeutic potential and the critical site of action of non-addicting glibenclamide in neuropathic pain (5I01RX003060-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10359075. Licensed CC0.

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