Tolerance to repeated morphine administration is associated with increased potency of opioid agonists

Susan L Ingram1, Tara A Macey, Erin N Fossum

  • 1Department of Psychology, WSU Vancouver, Vancouver, WA 98686, USA. ingram@vancouver.wsu.edu

Insights

Opioid tolerance involves complex changes in mu-opioid receptors. Repeated morphine administration in rats enhances receptor response but leads to faster desensitization, contributing to tolerance.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Pain Research

Background:

  • Opioid tolerance limits the clinical efficacy of pain relievers.
  • Cellular mechanisms of morphine tolerance, particularly mu-opioid receptor desensitization, remain unclear.
  • Periaqueductal gray (PAG) neurons are crucial for morphine's pain-relieving effects and tolerance development.

Purpose of the Study:

  • To investigate the cellular mechanisms of mu-opioid receptor desensitization in the PAG of morphine-tolerant rats.
  • To understand the biphasic effects of opioids on G-protein-mediated inwardly rectifying potassium (GIRK) currents in the PAG.

Main Methods:

  • Electrophysiological recordings of GIRK currents in PAG neurons from morphine-tolerant and saline-pretreated rats.
  • Concentration-response curves for met-enkephalin (ME)-induced currents.
  • Assessment of current desensitization kinetics and blockade with mu-opioid receptor antagonist beta-funaltrexamine (beta-FNA).

Main Results:

  • Morphine tolerance potentiated ME-induced GIRK currents, indicated by a leftward shift in the concentration-response curve (EC50=281 nM in tolerant vs. 8.8 microM in saline rats).
  • Beta-funaltrexamine (beta-FNA) inhibited these currents, confirming mu-opioid receptor involvement.
  • Despite enhanced initial potentiation, peak GIRK currents in tolerant rats desensitized significantly more (56%) than in saline-pretreated rats (15%) over 10 minutes.

Conclusions:

  • Repeated morphine administration enhances mu-opioid receptor agonist potency and coupling to G-proteins in the PAG.
  • This enhanced signaling paradoxically leads to accelerated desensitization of GIRK currents.
  • Increased mu-opioid receptor desensitization in the PAG is a key cellular mechanism underlying antinociceptive tolerance.

Related Concept Videos

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...
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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...
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...