[Opioid tolerance: what if it was just a question of receptor internalization?]

Nicolas Marie1, Philippe Jauzac, Stéphane Allouche

  • 1Laboratoire de Pharmacologie Moléculaire de la Tolérance aux Opiacés, Centre Hospitalier et Universitaire de Caen, Université de Caen, France.

Annales De Medecine Interne
|February 5, 2004
PubMed

Insights

Opioid agonists effectively relieve pain but cause tolerance, a major limitation. Receptor internalization and sorting are key steps in opioid receptor desensitization, contributing to this tolerance development.

Area of Science:

  • Pharmacology
  • Molecular Biology
  • Neuroscience

Context:

  • Opioid agonists are vital for pain management but chronic use leads to tolerance.
  • Opioid receptor desensitization is a critical mechanism underlying tolerance.
  • Understanding these molecular processes is essential for improving pain therapies.

Purpose:

  • To review the molecular mechanisms of opioid receptor desensitization.
  • To highlight the role of receptor internalization and sorting in tolerance.
  • To provide insights into the cellular events following opioid receptor activation.

Summary:

  • Opioid receptor desensitization, involving phosphorylation, internalization, and degradation, is central to tolerance.
  • Receptor internalization and subsequent sorting pathways are crucial for modulating opioid signaling.
  • Cellular models reveal complex protein interactions and trafficking events in desensitization.

Impact:

  • Informs the development of strategies to mitigate opioid tolerance.
  • Enhances understanding of drug side effects and therapeutic limitations.
  • Contributes to the design of more effective and safer analgesics.

Related Concept Videos

Quantitative Aspects of Drug-Receptor Interaction01:30

Quantitative Aspects of Drug-Receptor Interaction

The receptor occupancy theory connects a drug's response to the number of occupied receptors. With higher drug concentrations, more receptors are occupied, leading to increased responses. The formation of drug-receptor complexes involves association and dissociation rates, which reach equilibrium when the forward and backward reactions are equal. The equilibrium association constant (Ka) and its inverse, the equilibrium dissociation constant (Kd), indicate drug affinity. Higher Ka and lower Kd...
The Two-State Receptor Model01:29

The Two-State Receptor Model

The two-state receptor model explains a drug's interaction with receptors, such as G protein-coupled receptors and ligand-gated ion channels, to induce or inhibit a biological response. When no natural ligands are present, a receptor exists in an equilibrium of inactive (Ri) and active (Ra) conformations. The inactive form does not produce a response, while the active form generates a basal effect known as constitutive activity.
The binding affinity of a drug determines its interaction with one...
Desensitization and Tachyphylaxis01:20

Desensitization and Tachyphylaxis

Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
Several...
Drug Abuse and Addiction: Pharmacological Phenomena01:15

Drug Abuse and Addiction: Pharmacological Phenomena

Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not necessarily...
Opioid Receptors: Overview01:22

Opioid Receptors: Overview

Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2, D-Pen5]-enkephalin or DPDPE for...
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...