Opioid tendency to generate analgesic tolerance has been previously linked to biased internalization. Here, we assessed an alternative possibility; whether tolerance of delta opioid receptor agonists (DORs) could be related to agonist-specific recycling. A first series of experiments revealed that DOR internalization by DPDPE and SNC-80 was similar, but only DPDPE induced recycling. We then established that the non-recycling agonist SNC-80 generated acute analgesic tolerance that was absent in mice treated with DPDPE. Furthermore, both agonists stabilized different conformations, whose distinct interaction with Gβγ subunits led to different modalities of β-arrestin2 (βarr2) recruitment. In particular, bioluminescence resonance energy transfer (BRET) assays revealed that sustained activation by SNC-80 drew the receptor C terminus in close proximity of the N-terminal domain of Gγ2, causing βarr2 to interact with receptors and Gβγ subunits. DPDPE moved the receptor C-tail away from the Gβγ dimer, resulting in βarr2 recruitment to the receptor but not in the vicinity of Gγ2. These differences were associated with stable DOR-βarr2 association, poor recycling, and marked desensitization following exposure to SNC-80, while DPDPE promoted transient receptor interaction with βarr2 and effective recycling, which conferred protection from desensitization. Together, these data indicate that DORs may adopt ligand-specific conformations whose distinct recycling properties determine the extent of desensitization and are predictive of analgesic tolerance. Based on these findings, we propose that the development of functionally selective DOR ligands that favor recycling could constitute a valid strategy for the production of longer acting opioid analgesics.
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http://dx.doi.org/10.1523/JNEUROSCI.3734-11.2012 | DOI Listing |
Proc Natl Acad Sci U S A
January 2025
Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405.
Dysregulation of GABAergic inhibition is associated with pathological pain. Consequently, enhancement of GABAergic transmission represents a potential analgesic strategy. However, therapeutic potential of current GABA agonists and modulators is limited by unwanted side effects.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2024
Ruth and Bruce Rappaport, Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel; Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel.
Introduction: The rising prevalence of pelvic organ prolapse (POP) in the aging population underscores the need to reevaluate treatment options. This study examines obliterative procedures, specifically colpocleisis performed with (CH) and without (C) concomitant vaginal hysterectomy, as management strategies for frail, non-sexually active elderly patients with advanced prolapse.
Methods: This retrospective study analyzed data from patients who underwent either colpocleisis with concomitant vaginal hysterectomy (CH) or colpocleisis alone (C) at our institution between 2006 and 2020.
JCO Oncol Pract
January 2025
Division of Medical Oncology, Yonsei Cancer Center, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Purpose: Patient-controlled analgesia (PCA) has been considered for managing cancer pain; however, limited research has been conducted on optimizing continuous infusion rates with PCA. This study aimed to evaluate the efficacy and safety of a method that optimizes background infusion (BI) alongside PCA for titrating intravenous (IV) morphine in managing cancer-related pain.
Methods: Forty-four patients with solid tumors who could not manage pain with oral or transdermal opioid analgesics were randomly assigned in a 1:1 ratio to receive IV morphine through PCA or the conventional method.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
December 2024
Department of Nursing, Guizhou Provincial People's Hospital, Guiyang 550004, Guizhou, China. Corresponding author: Yao Huan, Email:
Objective: To investigate the current status and influencing factors of feeding intolerance (FI) during enteral nutrition (EN) in intensive care unit (ICU) patients.
Methods: A retrospective case-control study was conducted, including patients from two ICU wards of a tertiary hospital in Guizhou Province from July 2019 to December 2022. Clinical data were collected using a self-designed data collection form, including general information [age, gender, acute physiology and chronic health evaluation II (APACHE II)], clinical treatment (mechanical ventilation, mild hypothermia therapy), medication use (vasoactive drugs, glucocorticoids, analgesics, sedatives), EN implementation (types of EN fluids, EN methods, tube feeding rate), EN tolerance, and blood glucose status.
J Opioid Manag
January 2025
Harvard Medical School; MGH/Harvard Center for Addiction Medicine, Massachusetts General Hospital; Addiction Leadership, Charlestown Community Health Care Center for Pain Management; HOME BASE Veterans and Family Care, Boston, Massachusetts.
Buprenorphine was synthesized in the 1960s as a result of a search for a safe and effective opioid analgesic. Present formulations of buprenorphine are approved for the treatment of both acute and chronic pain. Its long duration of action, high affinity, and partial agonism at the µ-opioid receptor have established it as a mainstay treatment for opioid use disorder (OUD).
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