Orally Active Peptide Vector Allows Using Cannabis to Fight Pain While Avoiding Side Effects

The activation of cannabinoid CB1 receptors (CB1R) by Delta(9)-tetrahydrocannabinol (THC), the main component of Cannabis sativa, induces analgesia. CB1R activation, however, also causes cognitive impairment via the serotonin 5HT(2A) receptor (5HT(2A)R), a component of a CB1R-5HT(2A)R heteromer, posing a serious drawback for cannabinoid therapeutic use. We have shown that peptides reproducing CB1R transmembrane (TM) helices 5 and 6, fused to a cell-penetrating sequence (CPP), can alter the structure of the CB1R-5HT(2A)R heteromer and avert THC cognitive impairment while preserving analgesia. Here, we report the optimization of these prototypes into drug-like leads by (i) shortening the TM5, TM6, and CPP sequences, without losing the ability to disturb the CB1R-5HT(2A)R heteromer, and (ii) extensive sequence remodeling to achieve protease resistance and blood-brain barrier penetration. Our efforts have culminated in the identification of an ideal candidate for cannabis-based pain management, an orally active 16-residue peptide preserving THC-induced analgesia.

Automated summary

Optimizing peptides reproducing CB1R transmembrane helices 5 and 6 has led to the identification of an ideal candidate for cannabis-based pain management, preserving THC-induced analgesia while avoiding cognitive impairment.