Enhanced anti-nociception by novel dual antagonists for 5HT2AR and mGluR5 in preclinical models of pain

Abstract Significant research has focused on developing anti-nociceptive pain treatments by targeting specific molecular candidates. The serotonin 2A receptor (5-HT2AR) and metabotropic glutamate receptor 5 (mGluR5) are recognized as key mediators in neuropathic pain. However, the combined effects of simultaneous inhibition of these targets remain unexplored. This current study investigated the therapeutic potential of concurrently antagonizing 5-HT2AR and mGluR5. Using spinal nerve ligation (SNL) and formalin-induced pain models in male Sprague-Dawley rats, we demonstrated that the simultaneous administration of both antagonists significantly enhanced anti-allodynic and anti-nociceptive effects, resulting in increased allodynia thresholds and reduced pain-related behaviors. This dual antagonism provided pain relief comparable to that of gabapentin and morphine. Furthermore, novel small molecules designed to simultaneously antagonize 5-HT2AR and mGluR5 exerted anti-nociceptive effects by suppressing excitatory postsynaptic responses and inhibiting the phosphorylation of ERK and AKT signaling molecules. Notably, the dual antagonist maintained anti-allodynic efficacy with repeated administration, unlike morphine, which exhibited clear tolerance development with daily use. Moreover, when administered intravenously, the dual antagonist demonstrated a low potential for abuse. These findings indicate that the simultaneous antagonism of 5-HT2AR and mGluR5 represents a promising pharmacological target for the management of chronic pain. This approach may offer enhanced analgesic outcomes while reducing the risk of undesirable side effects, such as tolerance and the potential for abuse.