2. The Opioid Receptors and Endogenous Opioid Peptides
The opiates derived from opium have been used for thousands of years. However, the concept of opiate receptors was only proposed several decades ago based on the strict structural requirements needed for opiate activity [
24,
25,
26,
27,
28,
29]. Subsequently, Martin proposed the existence of opioid subtypes in his proposal of receptor dualism [
30] and then suggested M and N receptors, which later were referred to mu (morphine) and kappa (ketocyclazocine) receptors, respectively [
31]. Soon afterwards, the delta-opioid receptor was proposed as the recognition sites for the enkephalins [
32,
33,
34]. In 1973, three laboratories experimentally demonstrated opioid binding sites in the central nervous system for the first time using various
3H-labeled ligands, including
3H-naloxone [
5],
3H-dihydromorphine [
6] and
3H-etorphine [
7]. The high stereospecificity and selectivity of the binding for opiates were consistent with the basis for a receptor [
35]. Biochemical and pharmacological studies further confirmed the protein nature of the binding sites by their sensitivity to proteases, including trypsin and chymotrypsin [
7,
36,
37], as well as the reagents targeting sulfhydryl groups [
36,
37], and their insensitivity to DNase, RNase, neuraminidase and phospholipase C [
7,
36,
37].
The identification of opioid receptor binding sites in the brain quickly let to the quest of their endogenous ligands. The endogenous opioid-like substances in the brain were first disclosed by several labs at a meeting of the Neuroscience Research Program in Boston in 1974 sponsored by the Massachusetts Institute of Technology [
38]. Subsequently, Kosterlitz and Hughes were the first to report the sequences of two pentapeptide enkephalins [
32]. This was quickly followed by the isolation of two other endogenous opioid peptides, dynorphin and β-endorphin [
1,
2,
3,
4,
39]. Similar to most neuropeptides, all these peptides are produced through post-translational modifications of their precursors, proenkephalin, prodynorphin and proopiomelanocortin (POMC), by several processing enzymes and peptidases () [
40]. Both proenkephalin and prodynorphin generate several opioid peptides, while POMC yields only β-endorphin in addition to some non-opioid peptides such as adrenocorticotropin and α-melanocyte-stimulating hormone.
Figure 1. Schematic of the major endogenous peptides processed from human proenkephalin (PENK), prodynorphin (PDYN) and proopiomelanocortin (POMC). BAM: bovine adrenal medulla peptide; MSH: melanocyte stimulating hormone; ACTH: adrenocorticotropic hormone; CLIP: corticotropin-like intermediate lobe peptide; LPH: lipotropin.
All the endogenous opioid peptides contain the enkephalin sequence, Tyr-Gly-Gly-Phe-Leu or Tyr-Gly-Gly-Phe-Met, at the
N-terminus with different
C-terminal sequences (). The enkephalins are the endogenous ligands for the delta-opioid receptor (DOR-1). Although dynorphins are considered endogenous agonists for the kappa1-opioid receptor (KOR-1), they bind to the mu-opioid receptor (MOR-1) and DOR-1 with high affinities as well [
41,
42]. Additionally, β-endorphin is thought to be an endogenous agonist of MOR-1, but has high affinity for DOR-1 [
42].
Table 1. Amino acid sequences of selected human endogenous opioid peptides.
Another group of endogenous opioid peptides are endomorphins, including endomorphin-1 (Tyr-Pro-Trp-Phe-NH2) and endomorphin-2 (Tyr-Pro-Phe-Phe-NH2) [
43]. Both endomorphins lack the common enkephalin motif (Try-Gly-Gly-Phe) shared by other opioid peptides. However, they are the ligands highly selective for the mu-opioid receptor (MOR-1). The distribution and function of endomorphins have been extensively studied [
44]. However, the precursors for these endomorphins or their genes remain to be identified.
Enkephalins are widely distributed in the central nervous system, such as the striatum, hypothalamus, thalamus, hippocampus, pons, medulla and spinal cord. Dynorphins have similar distributions as enkephalins with a few exceptions. POMC is mainly synthesized in the pituitary gland. POMC mRNA is highly expressed in the hypothalamus and detected in the caudal nucleus tractus solitarius and the commissural nucleus, as well as in peripheral tissues such as testis, gut, kidney, adrenal and skin. Extensive studies showed that all these endogenous opioid peptides play important roles in a variety of biological functions. In addition to analgesia, they can modulate reward, addiction, stress response, emotion and feeding (see reviews: [
42,
45,
46,
47,
48,
49,
50,
51]). Several transgenic mouse models targeting either the precursors or encoded peptides were generated to study in vivo function of these endogenous opioid peptides [
52,
53,
54,
55,
56].
3. Alternative Splicing of Mu-Opioid Receptor Gene, OPRM1
The mu-opioid receptor has a special place within the opioid receptor family because it mediates the actions of most of the clinically used opioids such as morphine and fentanyl, as well as drugs of abuse such as heroin. The existence of multiple mu-opioid receptors has been long suggested by clinical observations that patients often show different sensitivities towards various mu opioids not only in analgesia, but also in their side-effects including tolerance, dependence, itch, constipation and addiction. Furthermore, incomplete cross tolerance in patients has led to the clinical practice of opioid rotation in which patients who develop tolerance to one mu opioid must use much higher doses of the opioid for pain relief can take back analgesic control by switching to another mu opioid with lower doses. Similar observations were seen in animal models [
57,
58,
59,
60,
61]. It is difficult to interpret these observations using a single mu receptor mechanism. Early pharmacological studies defined mu
1 and mu
2 receptors using in vivo behavioral assays and in vitro opioid receptor binding assays with newly synthesized antagonists including naloxazone and naloxonazine [
62,
63,
64,
65,
66,
67] and also morphine-6β-glucuronide (M6G) receptor [
68,
69,
70,
71]. However, genomic characterization of the MOR gene using the MOR cDNA clones and the human genome sequencing project revealed only a single copy of the MOR gene, OPRM1, raising questions about how a single copy of OPRM1 gene reconciles multiple mu-opioid receptors suggested by clinical observations and the pharmacological studies.
One hypothesis to address these questions is that the single copy of the OPRM1 gene creates multiple mu-opioid receptor splice variants or isoforms through alternative pre-mRNA splicing. Driven by this hypothesis, many efforts have been made to isolate alternatively spliced MOR variants in the past decades. We now know that the OPRM1 gene goes through extensive alternative splicing, generating an array of splice variants, which is far more complex than those suggested by the early pharmacological studies (see review: [
17,
18,
19]). The OPRM1 alternative splicing is conserved from rodent to human. Interestingly, only the OPRM1 gene, but no other opioid receptor genes, underwent extensive and conserved alternative splicing, suggesting the evolutionary importance of the OPRM1 gene.
The OPRM1 splice variants can be categorized into three main types [
18,
19]: (1) the full-length 7 transmembrane (TM)
C-terminal variants produced by alternative 3′ splicing (). These 7TM
C-terminal variants have identical receptor structures including the
N-terminus, TM regions, intra-/extra-cellular loops and part of intracellular
C-terminus, except for their differences at the
C-terminal tails; (2) the truncated 6TM variants that lack the extracellular
N-terminus and the first TM, generated by a combination of alternative promoter, exon skipping, alternative 5′ and/or 3′ splicing; (3) the truncated 1TM variants that contain only the extracellular
N-terminus and the first TM, generated by exon skipping or insertion.
Figure 2. Predicted amino acid sequences from 7TM
C-terminal variants (modified from [
17]. The top panel is an animation that shows structures of MORs and adjacent proteins on membrane. TM domains are indicated by cylinders. Splice junctions are shown by arrows. Calcium (Ca++) and potassium (K+) channels are indicated by opened canals across membrane. Gα, Gβ and Gγ: G proteins; PLCβ: phospholipase Cβ; PLA2: phospholipase A2; The bottom panel listed predicted amino acid sequences encoded by downstream exons of exon 3 in mouse (mMOR), rat (rMOR) and human (hMOR) splice variants. Italic red S, T and Y are predicted phosphorylation sites. Underlined sequences are predicted phosphorylation codes, PxPxxE/D or PxxPxxE/D, for β-arrestin binding based on crystal G protein coupled receptors (GPCR) structures [
72].
The functional relevance of the full-length 7TM
C-terminal variants has been indicated by their differences in mu agonist-induced G protein coupling [
73,
74,
75,
76,
77,
78,
79], β-arrestin2 recruitment [
80,
81], internalization [
82,
83], phosphorylation [
82] and post-endocytic sorting [
84] when expressed in cell lines. The 7TM
C-terminal variants were differentially expressed in various brain regions or different inbred mouse strains at the mRNA level [
85,
86], and at the protein level [
87,
88]. Dysregulation of these variant mRNAs was observed in the medial prefrontal cortex of human heroin abusers and heroin self-administering rats [
89], multiple brain regions of morphine tolerant mice [
85], and HIV patients [
90,
91]. Importantly, in vivo functions of these 7TM
C-terminal variants were demonstrated in morphine-induced tolerance, dependence and reward using several
C-terminal truncation mouse models [
80]. For example, truncating exon 7-encoded
C-terminal sequences reduced morphine tolerance and reward without the effect on morphine dependence. Conversely, truncating exon 4-encoded
C-terminal sequences facilitated morphine tolerance and reduced morphine dependence without the effect on morphine reward. The mouse MOR-1D and human MOR-1Y involved morphine-induced itch (pruritus) [
92,
93].
The truncated 6TM variants mediated the analgesic actions of a subset of mu opioids including heroin, M6G [
94], buprenorphine [
95] and a novel class of opioid analgesics such as 3′-iodobenzoyl-6β-naltrexamide (IBNtxA) that are potent against a broad spectrum of pain models without many side-effects associated with traditional opiates [
96,
97]. The 1TM variants did not bind any opioids. However, the 1TM variants can increase expression of 7TM MOR-1 at the protein level as a molecular chaperon to enhance morphine analgesia [
98]. The 6TM variants can also facilitate expression of 7TM MOR-1 at protein level through heterodimerization [
99].
4. Binding Affinities of Endogenous Opioid Peptides in the Full-Length 7TM C-terminal Splice Variants
Soon after each 7TM variant cDNAs were cloned, the cell lines that stably expressed each of the individual 7TM variants in Chinese Hamster Ovary (CHO) and Human embryonic kidney (HEK) 293 cells were established [
74,
75,
76,
78,
79,
82,
100] and initially used in opioid receptor binding assays to define their binding profiles. Saturation studies using [
3H][
D-Ala
2,N-MePhe
4,Gly-ol]-enkephalin (DAMGO), a synthetic opioid peptide and a full mu agonist, as indicated by the K
d values at subnanomolar range, suggest that [
3H]DAMGO has a high affinity to all these 7TM
C-terminal variants. Competition studies using [
3H]DAMGO with various opioids, such as morphine, M6G and naloxone, further established their mu selectivity by the fact that all mu opioids competed the binding potently, as indicated by the K
i values at subnanomolar range, while delta or kappa drugs failed to compete at the concentration of over 500 nM. These results were not surprising because all these 7TM
C-terminal variants contain the same binding pocket, which is mainly constituted by the transmembrane domains and extracellular loops. However, several endogenous opioid peptides displayed differential binding affinities among the 7TM
C-terminal variants. summaries the results of the K
i values of several endogenous opioid peptides against the mouse, rat and human 7TM
C-terminal variants from several early studies [
73,
74,
75,
76,
77,
78,
79,
100]. Although these studies were performed at different times when the variants were isolated, the complied data provides reasonable comparisons regarding the binding affinities of the indicated endogenous opioid peptides among the 7TM
C-terminal variants because all the competition assays were performed using [
3H]DAMGO with membranes isolated from the stable cell lines using the same parental CHO cells. The K
i values of DAMGO and morphine are also listed for the comparison.
Table 2. Competition of [3H]DAMGO binding in Chinese Hamster Ovary (CHO) cells stably expressing mouse, rat and human Oprm1 7TM C-terminal variants.
|
Ligand |
Ki Value (nM) |
DAMGO |
Morphine |
Fentanyl |
Methadone |
M6G |
β-Endorphin |
Dynorphin A |
Endomorphin 1 |
Endomorphin 2 |
[Met]5Enkephalin-Arg6-Phe7 |
Refs. |
Mouse |
|
|
|
|
|
|
|
|
|
|
|
mMOR-1 |
1.8 ± 0.5 |
5.3 ± 2.0 |
2.3 ± 1.0 |
1.4 ± 0.1 |
5.2 ± 1.8 |
11 ± 2.9 |
11 ± 0.5 |
2.1 ± 0.8 |
4.2 ± 1.8 |
4.1 ± 1.0 |
[73,100] |
mMOR-1A |
1.0 ± 0.3 |
3.1 ± 0.5 |
1.5 ± 0.6 |
0.7 ± 0.1 |
5.0 ± 1.5 |
4.3 ± 1.0 |
8.2 ± 2.8 |
|
|
3.5 ± 1.3 |
[73,77] |
mMOR-1C |
0.93 ± 0.2 |
2.4 ± 0.6 |
1.2 ± 0.4 |
0.5 ± 0.1 |
4.1 ± 1.2 |
5.8 ± 0.5 |
5.6 ± 0.8 |
1.4 ± 0.4 |
1.6 ± 0.2 |
2.1 ± 0.7 |
[73,100] |
mMOR-1D |
0.71 ± 0.1 |
1.5 ± 0.2 |
3.3 ± 1.5 |
1.4 ± 0.1 |
4.8 ± 0.8 |
1.7 ± 0.4 |
2.2 ± 0.8 |
1.8 ± 0.3 |
2.0 ± 0.3 |
3.7 ± 1.2 |
[73,100] |
mMOR-1E |
1.2 ± 0.5 |
2.3 ± 0.4 |
1.2 ± 0.5 |
0.7 ± 0.3 |
5.6 ± 0.7 |
5.0 ± 1.2 |
8.9 ± 1.1 |
2.4 ± 0.1 |
4.4 ± 0.8 |
4.4 ± 0.9 |
[73,100] |
mMOR-1B1 |
1.4 ± 0.2 |
5.3 ± 1.0 |
|
|
10 ± 1.6 |
6.8 ± 3.2 |
15 ± 7.1 |
11 ± 5.6 |
12 ± 1.5 |
|
[75] |
mMOR-1B2 |
1.3 ± 0.1 |
3.9 ± 0.4 |
|
|
8.4 ± 1.3 |
4.9 ± 1.7 |
34 ± 18 |
5.0 ± 1.8 |
8.4 ± 1.1 |
|
[75] |
mMOR-1B3 |
1.8 ± 0.9 |
1.5 ± 0.5 |
|
|
3.9 ± 1.3 |
3.1 ± 1.4 |
8.7 ± 1.8 |
3.2 ± 0.6 |
3.2 ± 0.8 |
|
[75] |
mMOR-1B5 |
1.0 ± 0.3 |
1.4 ± 0.6 |
|
|
5.2 ± 0.1 |
5.7 ± 1.2 |
8.9 ± 2.3 |
4.3 ± 0.8 |
11 ± 1.8 |
|
[75] |
mMOR-1F |
1.1 ± 0.2 |
2.9 ± 0.5 |
1.7 ± 0.5 |
1.3 ± 0.2 |
9.6 ± 0.8 |
6.0 ± 1.6 |
12 ± 1.0 |
2.9 ± 0.5 |
4.1 ± 1.3 |
3.9 ± 0.8 |
[73,78] |
mMOR-1O |
3.3 ± 1.2 |
2.7 ± 0.6 |
|
|
17 ± 1.0 |
16 ± 5.3 |
58 ± 26 |
|
|
|
[77] |
mMOR-1P |
0.8 ± 0.3 |
1.2 ± 0.8 |
|
|
11 ± 3.4 |
5.9 ± 2.4 |
103 ± 23 |
|
|
|
[77] |
Rat |
|
|
|
|
|
|
|
|
|
|
|
rMOR-1 |
3.3 ± 0.6 |
5.6 ± 0.8 |
|
|
17 ± 2.2 |
3.7 ± 0.4 |
12 ± 3.0 |
4.1 ± 0.7 |
8.0 ± 2.0 |
|
[74] |
rMOR-1A |
6.0 ± 0.9 |
8.0 ± 0.4 |
|
|
26 ± 2.1 |
11 ± 0.6 |
23 ± 1.6 |
6.5 ± 0.3 |
12 ± 0.6 |
|
[74] |
rMOR-1C1 |
4.5 ± 0.9 |
7.4 ± 0.3 |
|
|
25 ± 2.4 |
8.8 ± 0.5 |
13 ± 2.3 |
3.9 ± 0.1 |
10 ± 0.6 |
|
[74] |
rMOR-1D |
4.7 ± 1.2 |
7.4 ± 0.5 |
|
|
21 ± 1.8 |
8.5 ± 0.6 |
11 ± 1.7 |
3.9 ± 0.4 |
7.5 ± 0.4 |
|
[74] |
Human |
|
|
|
|
|
|
|
|
|
|
|
hMOR-1 |
1.2 ± 0.2 |
2.2 ± 0.9 |
|
|
10 ± 0.3 |
15 ± 11.0 |
87 ± 14 |
4.2 ± 1.4 |
15 ± 7.1 |
|
[76] |
hMOR-1B1 |
1.2 ± 0.4 |
2.4 ± 1.1 |
|
|
5.0 ± 0.2 |
7.8 ± 1.5 |
19 ± 6.6 |
3.8 ± 0.8 |
5.4 ± 0.6 |
|
[76] |
hMOR-1B2 |
5.2 ± 1.4 |
11 ± 3.5 |
|
|
42 ± 7.9 |
25 ± 5.1 |
49 ± 22 |
12 ± 0.1 |
20 ± 1.3 |
|
[76] |
hMOR-1B3 |
1.8 ± 0.5 |
3.2 ± 0.6 |
|
|
16 ± 1.2 |
8.2 ± 2.2 |
14 ± 2.3 |
4.9 ± 1.5 |
6.3 ± 1.5 |
|
[76] |
hMOR-1B4 |
2.3 ± 0.6 |
5.5 ± 1.7 |
|
|
23 ± 7.4 |
16 ± 0.4 |
71 ± 30 |
9.9 ± 2.3 |
23 ± 2.0 |
|
[76] |
hMOR-1B5 |
2.1 ± 0.4 |
3.9 ± 0.9 |
|
|
12 ± 2.6 |
10 ± 3.4 |
53 ± 23 |
4.6 ± 0.3 |
9.6 ± 3.0 |
|
[76] |
hMOR-1O |
2.2 ± 0.6 |
2.0 ± 0.7 |
|
|
16 ± 2.6 |
|
25 ± 8.5 |
|
|
|
[79] |
hMOR-1X |
2.1 ± 0.2 |
2.7 ± 1.0 |
|
|
17 ± 5.3 |
|
187 ± 27 |
|
|
|
[79] |
hMOR-1Y |
2.5 ± 0.8 |
4.3 ± 1.7 |
|
|
8.3 ± 2.2 |
8.4 ± 1.8 |
25 ± 13 |
5.1 ± 1.1 |
9.4 ± 3.0 |
|
[76] |