Liposomal DAGLβ Inhibitor Shows Substantial Antinociceptive Potency Mediated by AMPK in a Neuropathic Pain Mouse Models

Diacylglycerol lipase-beta (DAGL{beta}), a biosynthetic enzyme for the endocannabinoid 2-arachidonoylglycerol (2-AG), is highly expressed in macrophages and serves as a potential contributor to inflammatory and hypernociceptive responses. Moreover, the DAGL{beta} inhibitor KT109 produces antinociceptive effects in various rodent pain models, and its liposome formulation dramatically increases its antinociceptive potency in a lipopolysaccharide mouse model of inflammatory pain compared to free KT109. Here, we further optimized the liposomal KT109 formulation through adjustment of lipid composition and improved processing, achieving 100-fold higher drug encapsulation efficiency than the previous formulation, uniform size distribution, and excellent storage stability. Further, the second generation liposomal KT109 showed remarkable potency (ED50 [95% CL] = 0.226 [0.113-0.454] mg/kg) in a mouse model of paclitaxel-induced neuropathic pain, compared to free KT109 (ED50 [95% CL] = 31 [21-46] mg/kg). Liposomal KT109 (0.4 mg/kg) fully reversed paclitaxel-induced mechanical hypersensitivity for up to 24 hours, and its antinociceptive effects were sustained following a week of daily injections, with no detectable tolerance. In addition, the adenosine monophosphate-activated protein kinase (AMPK) inhibitor, dorsomorphin, prevented the antinociceptive effects of KT109, which is consistent with previous work demonstrating AMPK activation mediates the antinociceptive phenotype of DAGL{beta} knockout mice.