Protease-activated receptor-2 in endosomes signals persistent pain of irritable bowel syndrome.

Nestor Jimenez-Vargas, Luke Pattison, Peishen Zhao, Tina Marie Lieu, Rocco Latorre, Dane Jensen, Joel Castro, Luigi Aurelio, Giang Le, Bernard Flynn, Carem Herenbrink, Holly R. Yeatman, Laura Edgington-Mitchell, Christopher Porter, Michelle Halls, Meritxell Canals, Nicholas Veldhuis, Daniel Poole, Peter McLean, Gareth HicksNicole Scheff, Elyssa Chen, Aditi Bhattacharya, Brian Schmidt, Stuart Brierley, Stephen Vanner, Nigel Bunnett

Research output: Contribution to journalArticlepeer-review

90 Citations (Scopus)


Once activated at the surface of cells, G protein-coupled receptors (GPCRs) redistribute to endosomes, where they can continue to signal. Whether GPCRs in endosomes generate signals that contribute to human disease is unknown. We evaluated endosomal signaling of protease-activated receptor-2 (PAR2), which has been proposed to mediate pain in patients with irritable bowel syndrome (IBS). Trypsin, elastase, and cathepsin S, which are activated in the colonic mucosa of patients with IBS and in experimental animals with colitis, caused persistent PAR2-dependent hyperexcitability of nociceptors, sensitization of colonic afferent neurons to mechanical stimuli, and somatic mechanical allodynia. Inhibitors of clathrin- and dynamin-dependent endocytosis and of mitogen-activated protein kinase kinase-1 prevented trypsin-induced hyperexcitability, sensitization, and allodynia. However, they did not affect elastase- or cathepsin S-induced hyperexcitability, sensitization, or allodynia. Trypsin stimulated endocytosis of PAR2, which signaled from endosomes to activate extracellular signal-regulated kinase. Elastase and cathepsin S did not stimulate endocytosis of PAR2, which signaled from the plasma membrane to activate adenylyl cyclase. Biopsies of colonic mucosa from IBS patients released proteases that induced persistent PAR2-dependent hyperexcitability of nociceptors, and PAR2 association with β-arrestins, which mediate endocytosis. Conjugation to cholestanol promoted delivery and retention of antagonists in endosomes containing PAR2. A cholestanol-conjugated PAR2 antagonist prevented persistent trypsin- and IBS protease-induced hyperexcitability of nociceptors. The results reveal that PAR2 signaling from endosomes underlies the persistent hyperexcitability of nociceptors that mediates chronic pain of IBS. Endosomally targeted PAR2 antagonists are potential therapies for IBS pain. GPCRs in endosomes transmit signals that contribute to human diseases.

Original languageEnglish
Pages (from-to)E7438-E7447
Number of pages9
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number31
Publication statusPublished - 31 Jul 2018


  • Endosomes
  • Pain
  • Proteases
  • Receptors


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