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µ-阿片受体的药理学和遗传学操作揭示了抑制蛋白 3 的结合限制了镇痛耐受,并且不会加重小鼠的呼吸抑制。

Pharmacological and genetic manipulations at the µ-opioid receptor reveal arrestin-3 engagement limits analgesic tolerance and does not exacerbate respiratory depression in mice.

机构信息

Center for Neuroscience, University of California-Davis, Davis, CA, USA.

Department of Physiology and Membrane Biology, UC Davis School of Medicine, Davis, CA, USA.

出版信息

Neuropsychopharmacology. 2021 Dec;46(13):2241-2249. doi: 10.1038/s41386-021-01054-x. Epub 2021 Jul 13.

Abstract

Opioid drugs are widely used analgesics that activate the G protein-coupled µ-opioid receptor, whose endogenous neuropeptide agonists, endorphins and enkephalins, are potent pain relievers. The therapeutic utility of opioid drugs is hindered by development of tolerance to the analgesic effects, requiring dose escalation for persistent pain control and leading to overdose and fatal respiratory distress. The prevailing hypothesis is that the intended analgesic effects of opioid drugs are mediated by µ-opioid receptor signaling to G protein, while the side-effects of respiratory depression and analgesic tolerance are caused by engagement of the receptor with the arrestin-3 protein. Consequently, opioid drug development has focused exclusively on identifying agonists devoid of arrestin-3 engagement. Here, we challenge the prevailing hypothesis with a panel of six clinically relevant opioid drugs and mice of three distinct genotypes with varying abilities to promote morphine-mediated arrestin-3 engagement. With this genetic and pharmacological approach, we demonstrate that arrestin-3 recruitment does not impact respiratory depression, and effective arrestin-3 engagement reduces, rather than exacerbates, the development of analgesic tolerance. These studies suggest that future development of safer opioids should focus on identifying opioid ligands that recruit both G protein and arrestin-3, thereby mimicking the signaling profile of most endogenous µ-opioid receptor agonists.

摘要

阿片类药物是广泛使用的镇痛药,能激活 G 蛋白偶联μ阿片受体,其内源性神经肽激动剂内啡肽和脑啡肽是有效的止痛药。阿片类药物的治疗效用受到对镇痛作用的耐受性的限制,需要增加剂量以控制持续性疼痛,从而导致过量和致命的呼吸窘迫。目前的假设是,阿片类药物的预期镇痛作用是通过 μ阿片受体信号转导到 G 蛋白来介导的,而呼吸抑制和镇痛耐受的副作用是由受体与 arrestin-3 蛋白的结合引起的。因此,阿片类药物的开发完全集中在确定不与 arrestin-3 结合的激动剂上。在这里,我们用一组六种临床相关的阿片类药物和三种不同基因型的小鼠来挑战这一普遍假说,这些小鼠在促进吗啡介导的 arrestin-3 结合方面的能力各不相同。通过这种遗传和药理学方法,我们证明 arrestin-3 的募集并不影响呼吸抑制,而有效的 arrestin-3 结合减少而不是加剧了镇痛耐受的发展。这些研究表明,未来更安全的阿片类药物的开发应该集中在识别既能募集 G 蛋白又能募集 arrestin-3 的阿片类配体,从而模拟大多数内源性 μ阿片受体激动剂的信号转导特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/875e/8581001/ddabdb67ecfc/41386_2021_1054_Fig1_HTML.jpg

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