α9-Containing
nicotinic acetylcholine receptors (nAChRs)
are key targets for the treatment of neuropathic pain. α-Conotoxin
RgIA4 is a peptide antagonist of human α9α10 nAChRs with
high selectivity. However, structural rearrangement reveals a potential
liability for clinical applications. We herein report our designer
RgIA analogues stabilized by methylene thioacetal as nonopioid analgesic
agents. We demonstrate that replacing disulfide loop I [CysI–CysIII] with methylene thioacetal in the RgIA
skeleton results in activity loss, whereas substitution of loop II
[CysII–CysIV] can be accommodated. The
lead molecule, RgIA-5524, exhibits highly selective inhibition of
α9α10 nAChRs with an IC50 of 0.9 nM and much
reduced degradation in human serum. In vivo studies
showed that RgIA-5524 relieves chemotherapy-induced neuropathic pain
in wild type but not α9 knockout mouse models, demonstrating
that α9-containing nAChRs are necessary for the therapeutic
effects. This work highlights the application of methylene thioacetal
as a disulfide surrogate in conotoxin-based, disulfide-rich peptide
drugs.