AIMTo develop a non-invasive, safe and reproducible target-engagement biomarker for future TRPA1 antagonists in healthy volunteers.
METHODSDose finding (n = 11): 3%, 10%, and 30% cinnamaldehyde (CA) and placebo (= vehicle) was topically applied on the right forearm. One-way ANOVA with post-hoc Bonferroni was used to compare between doses. Reproducibility: 10% CA doses were topically applied during one visit on both arms (n = 10) or during two visits (n = 23) separated by a washout period of 7 days. CA-induced dermal blood flow (DBF) was assessed by laser Doppler imaging (LDI) at baseline and at 10, 20, 30, 40 and 50 min post-CA. Paired t-test was used to compare between arms or visits. Concordance correlation coefficient (CCC) was calculated to assess reproducibility. Data are expressed as percent change from baseline (mean ± 95% CI).
RESULTSAll three doses increased DBF compared to vehicle at all time-points, with the maximum response at 10-20 min post-CA. Dose response was found when comparing AUC 0-50min of 30% CA (51 364 ± 8475%*min) with 10% CA (32 239 ± 8034%*min, P = 0.03) and 3% CA (30 226 ± 11 958%*min, P = 0.015). 10% CA was chosen as an effective and safe dose. DBF response to 10% CA was found to be reproducible between arms (AUC 0-50min , CCC = 0.91) and visits (AUC 0-50min , CCC = 0.83). Based on sample size calculations, this model allows a change in CA-induced DBF of 30-50% to be detected between two independent groups of maximum 10-15 subjects with 80% power.
CONCLUSIONSEvaluation of CA-induced changes in DBF offers a safe, non-invasive and reproducible target-engagement biomarker in vivo in humans to evaluate TRPA1 antagonists.
British Journal of Clinical Pharmacology
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Cinnamaldehyde, the main component of cinnamon, activates the TRPA1 receptor and induces vasodilatation when applied on the human skin.• TRPA1, a non-selective cation channel, is expressed in small diameter nociceptors and involved in persistent to chronic painful states such as inflammation, neuropathic pain and migraine.• TRPA1 is an emerging target for treating these and other neurogenic inflammatory conditions.
WHAT THIS STUDY ADDS• Cinnamaldehyde 10% topical solution is tolerable and safe to use in healthy volunteers.• Cinnamaldehyde 10% applied on the human skin induces a robust increase in dermal blood flow which can be measured with laser Doppler imaging and is reproducible over time and between arms. • The cinnamaldehyde model can be used in future early clinical development studies with TRPA1 antagonists as a target engagement biomarker to guide dose selections for efficacy studies.
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