Mounting evidences suggests that cancers such as melanoma produce programmed death protein-1 ligand 1 (PD-L1) to suppress T cell activation and immunity via interaction with PD-1 (receptor of PD-L1). Emerging immune therapies such as anti-PD1 and anti-PD-L1 treatments have shown great success in treating cancers, such as melanoma and head and neck cancers. However, the unique role of PD-L1/PD-1 in pain regulation is unknown. Our work in progress has demonstrated the presence of anatomical and functional PD-1 in primary sensory neurons and identified PD-L1 as a novel pain inhibitor, produced not only by cancer cells but also by normal neural tissues. We hypothesize that PD-L1 masks cancer pain and inhibits baseline pain and neuropathic pain via silencing PD-1 expressing nociceptive neurons. We also hypothesize that PD-L1 can inhibit somatic and trigeminal neuropathic pain via suppressing microglial and T-cell activation in the spinal cord and brain stem. Of interest recent studies have shown that microglia and T cells in the spinal cord contribute to neuropathic pain in a sex-dependent manner. Consistently, our pilot study shows that intrathecal inhibition of caspase-6 and p38 signaling inhibits nerve injury-induced mechanical allodynia in male but not female mice. We further hypothesize that PD-L1 inhibits microglial and T-cell activation in a sex-dependent manner. The overall goal of this application is to investigate how the PD-L1/PD-1 pathway can mask cancer pain and also suppress neuropathic pain via regulating the function of neurons, microglia, and T-cells. We will use mouse melanoma and neuropathic pain models of both sexes to test our hypotheses by accomplishing the following 3 specific aims:
Aim 1. Test the hypothesis that the PD-L1/PD-1 pathway can mask skin cancer pain, suppress somatic and trigeminal neuropathic pain, and inhibit baseline pain;
Aim 2. Test the hypothesis that activation of the PD- L1/PD-1 pathway can suppress neuronal excitability in mouse and human DRG/TG neurons and inhibit synaptic plasticity in mouse spinal cord neurons;
Aim 3. Test the hypothesis that the PD-L1/PD-1 pathway can inhibit pain via suppressing microglial and T-cell activation in a sex-dependent manner. This project will identify PD-L1 as a novel endogenous pain inhibitor and provide new insights into neuron-glia, neuron-immune, and neuron- cancer interactions. Manipulation of PD-L1/PD-1 signaling may lead to the development of novel analgesics.

Public Health Relevance

Emerging immune therapies such as anti-PD-L1 (programmed death-ligand 1) and anti-PD-1 treatments have shown great efficacy in treating cancers; however, the unique role of PD-L1 and PD-1 in pain regulation is unknown. The overall goal of this application is to investigate how the PD-L1/PD-1 pathway can mask cancer pain in a melanoma model and also suppress neuropathic pain in somatic and trigeminal regions via neuron-glia, neuron-cancer, and neuron-immune interactions, and furthermore, to define the sex-dependent effects by testing both sexes. This project will identify PD-L1 as a novel endogenous pain inhibitor and provide new insights into neuron-glia, neuron-immune, and neuron-cancer interactions.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
5R01DE017794-15
Application #
10020184
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Vallejo, Yolanda F
Project Start
2006-07-01
Project End
2022-03-31
Budget Start
2020-05-01
Budget End
2021-04-30
Support Year
15
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Duke University
Department
Anesthesiology
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
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