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Li M, Pagare PP, Ma H, St Onge CM, Mendez RE, Gillespie JC, Stevens DL, Dewey WL, Selley DE, Zhang Y. Molecular Pharmacology Profiling of Phenylfentanil and Its Analogues to Understand the Putative Involvement of an Adrenergic Mechanism in Fentanyl-Induced Respiratory Depression. J Med Chem 2024; 67:603-619. [PMID: 38156970 DOI: 10.1021/acs.jmedchem.3c01801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
While there are approved therapeutics to treat opioid overdoses, the need for treatments to reverse overdoses due to ultrapotent fentanyls remains unmet. This may be due in part to an adrenergic mechanism of fentanyls in addition to their stereotypical mu-opioid receptor (MOR) effects. Herein, we report our efforts to further understanding of the functions these distinct mechanisms impart. Employing the known MOR neutral antagonist phenylfentanil as a lead, 17 analogues were designed based on the concept of isosteric replacement. To probe mechanisms of action, these analogues were pharmacologically evaluated in vitro and in vivo, while in silico modeling studies were also conducted on phenylfentanil. While it did not indicate MOR involvement in vivo, phenylfentanil yielded respiratory minute volumes similar to those caused by fentanyl. Taken together with molecular modeling studies, these results indicated that respiratory effects of fentanyls may also correlate to inhibition of both α1A- and α1B-adrenergic receptors.
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Affiliation(s)
- Mengchu Li
- Department of Medicinal Chemistry, School of Pharmacy, Virginia Commonwealth University, 800 East Leigh Street, Richmond, Virginia 23298, United States
| | - Piyusha P Pagare
- Department of Medicinal Chemistry, School of Pharmacy, Virginia Commonwealth University, 800 East Leigh Street, Richmond, Virginia 23298, United States
| | - Hongguang Ma
- Department of Medicinal Chemistry, School of Pharmacy, Virginia Commonwealth University, 800 East Leigh Street, Richmond, Virginia 23298, United States
| | - Celsey M St Onge
- Department of Medicinal Chemistry, School of Pharmacy, Virginia Commonwealth University, 800 East Leigh Street, Richmond, Virginia 23298, United States
| | - Rolando E Mendez
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th Street, Richmond, Virginia 23298, United States
| | - James C Gillespie
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th Street, Richmond, Virginia 23298, United States
| | - David L Stevens
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th Street, Richmond, Virginia 23298, United States
| | - William L Dewey
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th Street, Richmond, Virginia 23298, United States
| | - Dana E Selley
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th Street, Richmond, Virginia 23298, United States
| | - Yan Zhang
- Department of Medicinal Chemistry, School of Pharmacy, Virginia Commonwealth University, 800 East Leigh Street, Richmond, Virginia 23298, United States
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th Street, Richmond, Virginia 23298, United States
- Institute for Drug and Alcohol Studies, 203 East Cary Street, Richmond, Virginia 23298, United States
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Torralva R, Eshleman AJ, Swanson TL, Schmachtenberg JL, Schutzer WE, Bloom SH, Wolfrum KM, Reed JF, Janowsky A. Fentanyl but not Morphine Interacts with Nonopioid Recombinant Human Neurotransmitter Receptors and Transporters. J Pharmacol Exp Ther 2020; 374:376-391. [PMID: 32513839 DOI: 10.1124/jpet.120.265561] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/01/2020] [Indexed: 12/13/2022] Open
Abstract
Synthetic opioids, including fentanyl and its analogs, have therapeutic efficacy in analgesia and anesthesia. However, their illicit use in the United States has increased and contributed to the number one cause of death for adults 18-50 years old. Fentanyl and the heroin metabolite morphine induce respiratory depression that can be treated with the μ opioid receptor (MOR) antagonist naloxone. With higher or more rapid dosing, fentanyl, more than morphine, causes chest wall rigidity and can also induce rapid onset laryngospasm. Because non-MORs could mediate differing clinical manifestations, we examined the interactions of fentanyl and morphine at recombinant human neurotransmitter transporters, G protein-coupled receptors, and the N-methyl-D-aspartate glutamate receptor. Both drugs were agonists at MOR, κ, and δ opioid receptors. Morphine had little or no affinity at other human receptors and transporters (K i or IC50 value >100 µM). However, fentanyl had K i values of 1407 and 1100 nM at α 1A and α 1B adrenoceptor subtypes, respectively, and K i values of 1049 and 1670 nM at dopamine D4.4 and D1 receptor subtypes, respectively; it also blocked [3H]neurotransmitter uptake by the vesicular monoamine transporter 2 (IC50 = 911 nM). Pharmacokinetic models indicate that these Ki and IC50 values are pharmacologically relevant. Fentanyl had little affinity for other receptors or transporters. Thus, noradrenergic disposition at specific receptor subtypes in relevant organs may play a role in respiratory and cardiothoracic effects of fentanyl. Data suggest that less selective fentanyl receptor pharmacology could play a role in the different clinical effects of morphine compared with fentanyl, including fentanyl-induced deaths after illicit use. SIGNIFICANCE STATEMENT: The synthetic opioid fentanyl induces different clinical effects, including rapid onset muscular rigidity, vocal cord closure, and rapid death, than the heroin metabolite morphine. Our data indicate for the first time that the two drugs have very different effects at recombinant human neurotransmitter receptors and transporters that might explain those clinical differences.
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Affiliation(s)
- Randy Torralva
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - Amy J Eshleman
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - Tracy L Swanson
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - Jennifer L Schmachtenberg
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - William E Schutzer
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - Shelley H Bloom
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - Katherine M Wolfrum
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - John F Reed
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
| | - Aaron Janowsky
- Research Service, VA Portland Health Care System, Portland, Oregon (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.); Coda Research, Portland, Oregon (R.T.); Departments of Psychiatry (R.T., A.J.E., T.L.S., J.L.S., W.E.S., S.H.B., K.M.W., J.F.R., A.J.), Behavioral Neuroscience (A.J.E., A.J.), Oregon Health & Science University, Portland, Oregon; and The Methamphetamine Abuse Research Center, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (W.E.S., A.J.)
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