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Ramos-Gonzalez N, Paul B, Majumdar S. IUPHAR themed review: Opioid efficacy, bias, and selectivity. Pharmacol Res 2023; 197:106961. [PMID: 37844653 DOI: 10.1016/j.phrs.2023.106961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023]
Abstract
Drugs acting at the opioid receptor family are clinically used to treat chronic and acute pain, though they represent the second line of treatment behind GABA analogs, antidepressants and SSRI's. Within the opioid family mu and kappa opioid receptor are commonly targeted. However, activation of the mu opioid receptor has side effects of constipation, tolerance, dependence, euphoria, and respiratory depression; activation of the kappa opioid receptor leads to dysphoria and sedation. The side effects of mu opioid receptor activation have led to mu receptor drugs being widely abused with great overdose risk. For these reasons, newer safer opioid analgesics are in high demand. For many years a focus within the opioid field was finding drugs that activated the G protein pathway at mu opioid receptor, without activating the β-arrestin pathway, known as biased agonism. Recent advances have shown that this may not be the way forward to develop safer analgesics at mu opioid receptor, though there is still some promise at the kappa opioid receptor. Here we discuss recent novel approaches to develop safer opioid drugs including efficacy vs bias and fine-tuning receptor activation by targeting sub-pockets in the orthosteric site, we explore recent works on the structural basis of bias, and we put forward the suggestion that Gα subtype selectivity may be an exciting new area of interest.
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Affiliation(s)
- Nokomis Ramos-Gonzalez
- Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, Saint Louis, MO, USA; Center for Clinical Pharmacology, University of Health Sciences & Pharmacy at St. Louis and Washington University School of Medicine, St. Louis, MO, USA
| | - Barnali Paul
- Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, Saint Louis, MO, USA; Center for Clinical Pharmacology, University of Health Sciences & Pharmacy at St. Louis and Washington University School of Medicine, St. Louis, MO, USA
| | - Susruta Majumdar
- Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine, Saint Louis, MO, USA; Center for Clinical Pharmacology, University of Health Sciences & Pharmacy at St. Louis and Washington University School of Medicine, St. Louis, MO, USA.
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Paul B, Sribhashyam S, Majumdar S. Opioid signaling and design of analgesics. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 195:153-176. [PMID: 36707153 PMCID: PMC10325139 DOI: 10.1016/bs.pmbts.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Clinical treatment of acute to severe pain relies on the use of opioids. While their potency is significant, there are considerable side effects that can negatively affect patients. Their rise in usage has correlated with the current opioid epidemic in the United States, which has led to more than 70,000 deaths per year (Volkow and Blanco, 2021). Opioid-related drug development aims to make target compounds that show strong potency but with diminished side effects. Research into pharmaceuticals that could act as potential alternatives to current pains medications has relied on mechanistic insights of opioid receptors, a class of G-protein coupled receptors (GPCRs), and biased agonism, a common phenomenon among pharmaceutical compounds where downstream effects can be altered at the same receptor via different agonists. Opioids function typically by binding to an active site on the extracellular portion of opioid receptors. Once activated, the opioid receptor initiates a G-protein signaling pathway and/or the β-arrestin2 pathway. The proposed concept for the development of safe analgesics around mu and kappa opioid receptor subtypes has focused on not recruiting β-arrestin2 (biased agonism) and/or having low efficacy at the receptor (partial agonism). By altering chemical motifs on a common scaffold, chemists can take advantage of biased agonism as well as create compounds with low intrinsic efficacy for the desired treatments. This review will focus on ligands with bias profile, signaling aspects of the receptor and probe into the structural basis of receptor that leads to bias and/or partial agonism.
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Affiliation(s)
- Barnali Paul
- Center for Clinical Pharmacology, University of Health Sciences & Pharmacy at St Louis and Washington University School of Medicine, St Louis, MO, United States
| | - Sashrik Sribhashyam
- Center for Clinical Pharmacology, University of Health Sciences & Pharmacy at St Louis and Washington University School of Medicine, St Louis, MO, United States
| | - Susruta Majumdar
- Center for Clinical Pharmacology, University of Health Sciences & Pharmacy at St Louis and Washington University School of Medicine, St Louis, MO, United States.
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Chakraborty S, DiBerto JF, Faouzi A, Bernhard SM, Gutridge AM, Ramsey S, Zhou Y, Provasi D, Nuthikattu N, Jilakara R, Nelson MNF, Asher WB, Eans SO, Wilson LL, Chintala SM, Filizola M, van Rijn RM, Margolis EB, Roth BL, McLaughlin JP, Che T, Sames D, Javitch JA, Majumdar S. A Novel Mitragynine Analog with Low-Efficacy Mu Opioid Receptor Agonism Displays Antinociception with Attenuated Adverse Effects. J Med Chem 2021; 64:13873-13892. [PMID: 34505767 PMCID: PMC8530377 DOI: 10.1021/acs.jmedchem.1c01273] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Mitragynine and 7-hydroxymitragynine (7OH) are the major alkaloids mediating the biological actions of the psychoactive plant kratom. To investigate the structure-activity relationships of mitragynine/7OH templates, we diversified the aromatic ring of the indole at the C9, C10, and C12 positions and investigated their G-protein and arrestin signaling mediated by mu opioid receptors (MOR). Three synthesized lead C9 analogs replacing the 9-OCH3 group with phenyl (4), methyl (5), or 3'-furanyl [6 (SC13)] substituents demonstrated partial agonism with a lower efficacy than DAMGO or morphine in heterologous G-protein assays and synaptic physiology. In assays limiting MOR reserve, the G-protein efficacy of all three was comparable to buprenorphine. 6 (SC13) showed MOR-dependent analgesia with potency similar to morphine without respiratory depression, hyperlocomotion, constipation, or place conditioning in mice. These results suggest the possibility of activating MOR minimally (G-protein Emax ≈ 10%) in cell lines while yet attaining maximal antinociception in vivo with reduced opioid liabilities.
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MESH Headings
- Analgesics, Opioid/adverse effects
- Analgesics, Opioid/chemical synthesis
- Analgesics, Opioid/metabolism
- Analgesics, Opioid/pharmacology
- Animals
- Male
- Mice, Inbred C57BL
- Molecular Docking Simulation
- Molecular Dynamics Simulation
- Molecular Structure
- Rats, Sprague-Dawley
- Receptors, Opioid, mu/agonists
- Receptors, Opioid, mu/metabolism
- Secologanin Tryptamine Alkaloids/adverse effects
- Secologanin Tryptamine Alkaloids/chemical synthesis
- Secologanin Tryptamine Alkaloids/metabolism
- Secologanin Tryptamine Alkaloids/pharmacology
- Structure-Activity Relationship
- Mice
- Rats
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Affiliation(s)
- Soumen Chakraborty
- Center for Clinical Pharmacology, University of Health Sciences
& Pharmacy at St. Louis and Washington University School of Medicine,
St. Louis, Missouri 63110, United States; Department of Anesthesiology,
Washington University School of Medicine, St. Louis, Missouri 63110, United
States
| | - Jeffrey F. DiBerto
- Department of Pharmacology, University of North Carolina at Chapel
Hill School of Medicine, Chapel Hill, North Carolina 27599, United
States
| | - Abdelfattah Faouzi
- Center for Clinical Pharmacology, University of Health Sciences
& Pharmacy at St. Louis and Washington University School of Medicine,
St. Louis, Missouri 63110, United States; Department of Anesthesiology,
Washington University School of Medicine, St. Louis, Missouri 63110, United
States
| | - Sarah M. Bernhard
- Center for Clinical Pharmacology, University of Health Sciences
& Pharmacy at St. Louis and Washington University School of Medicine,
St. Louis, Missouri 63110, United States; Department of Anesthesiology,
Washington University School of Medicine, St. Louis, Missouri 63110, United
States
| | - Anna M. Gutridge
- Department of Medicinal Chemistry and Molecular Pharmacology,
College of Pharmacy, Purdue University, West Lafayette, Indiana 47907,
United States
| | - Steven Ramsey
- Department of Pharmacological Sciences, Icahn School of Medicine at
Mount Sinai, New York, New York 10029, United States
| | - Yuchen Zhou
- Department of Pharmacological Sciences, Icahn School of Medicine at
Mount Sinai, New York, New York 10029, United States
| | - Davide Provasi
- Department of Pharmacological Sciences, Icahn School of Medicine at
Mount Sinai, New York, New York 10029, United States
| | - Nitin Nuthikattu
- Center for Clinical Pharmacology, University of Health Sciences
& Pharmacy at St. Louis and Washington University School of Medicine,
St. Louis, Missouri 63110, United States; Department of Anesthesiology,
Washington University School of Medicine, St. Louis, Missouri 63110, United
States
| | - Rahul Jilakara
- Center for Clinical Pharmacology, University of Health Sciences
& Pharmacy at St. Louis and Washington University School of Medicine,
St. Louis, Missouri 63110, United States; Department of Anesthesiology,
Washington University School of Medicine, St. Louis, Missouri 63110, United
States
| | - Melissa N. F. Nelson
- Departments of Psychiatry and Molecular Pharmacology and
Therapeutics, Columbia University Vagelos College of Physicians and
Surgeons, and Division of Molecular Therapeutics, New York State Psychiatric
Institute, New York, New York 10032, United States
| | - Wesley B. Asher
- Departments of Psychiatry and Molecular Pharmacology and
Therapeutics, Columbia University Vagelos College of Physicians and
Surgeons, and Division of Molecular Therapeutics, New York State Psychiatric
Institute, New York, New York 10032, United States
| | - Shainnel O. Eans
- Department of Pharmacodynamics, University of Florida,
Gainesville, Florida 032610, United States
| | - Lisa L. Wilson
- Department of Pharmacodynamics, University of Florida,
Gainesville, Florida 032610, United States
| | - Satyanarayana M. Chintala
- Department of Anesthesiology, Washington University School of
Medicine, St. Louis, Missouri 63110, United States
| | - Marta Filizola
- Department of Pharmacological Sciences, Icahn School of Medicine
at Mount Sinai, New York, New York 10029, United States
| | - Richard M. van Rijn
- Department of Medicinal Chemistry and Molecular Pharmacology,
College of Pharmacy, Purdue University, West Lafayette, Indiana 47907,
United States
| | - Elyssa B. Margolis
- Department of Neurology, UCSF Weill Institute for Neurosciences,
University of California San Francisco, San Francisco, California 94158,
United States
| | - Bryan L. Roth
- Department of Pharmacology, University of North Carolina at Chapel
Hill School of Medicine, Chapel Hill, North Carolina 27599, United
States
| | - Jay P. McLaughlin
- Department of Pharmacodynamics, University of Florida,
Gainesville, Florida 032610, United States
| | - Tao Che
- Center for Clinical Pharmacology, University of Health Sciences
& Pharmacy at St. Louis and Washington University School of Medicine,
St. Louis, Missouri 63110, United States; Department of Anesthesiology,
Washington University School of Medicine, St. Louis, Missouri 63110, United
States; Department of Pharmacology, University of North Carolina at Chapel
Hill School of Medicine, Chapel Hill, North Carolina 27599, United
States
| | - Dalibor Sames
- Department of Chemistry, Columbia University, New York 10027,
United States
| | - Jonathan A. Javitch
- Departments of Psychiatry and Molecular Pharmacology and
Therapeutics, Columbia University Vagelos College of Physicians and
Surgeons, and Division of Molecular Therapeutics, New York State Psychiatric
Institute, New York, New York 10032, United States
| | - Susruta Majumdar
- Center for Clinical Pharmacology, University of Health Sciences
& Pharmacy at St. Louis and Washington University School of Medicine,
St. Louis, Missouri 63110, United States; Department of Anesthesiology,
Washington University School of Medicine, St. Louis, Missouri 63110, United
States
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