Search

Opioid analgesics are elective for treating moderate to severe pain but their use is restricted by severe side effects. Signaling bias has been proposed as a viable means for improving this situation. To exploit this opportunity, continuous efforts are devoted to understand how ligand-specific modulations of receptor functions could mediate the different in vivo effects of opioids. Advances in the field have led to the development of biased agonists based on hypotheses that allocated desired and undesired effects to specific signaling pathways. However, the prevalent hypothesis associating β-arrestin to opioid side effects was recently challenged and multiple of the newly developed biased drugs may not display the superior side effects profile that was sought. Moreover, biased agonism at opioid receptors is now known to be time- and cell-dependent, which adds a new layer of complexity for bias estimation. Here, we first review the signaling mechanisms underlying desired and undesired effects of opioids. We then describe biased agonism at opioid receptors and discuss the different perspectives that support the desired and undesired effects of opioids in view of exploiting biased signaling for therapeutic purposes. Finally, we explore how signaling kinetics and cellular background can influence the magnitude and directionality of bias at those receptors.

The delta opioid receptor (DOP) belongs to the Class A, rhodopsin-like family of G protein-coupled receptors. Although this receptor has a high level of similarity with the other opioid receptors, it displays unique aspects and functions. Indeed, as opposed to most membrane receptors, DOP is poorly addressed to the plasma membrane. In this chapter, we first review the molecular and cellular mechanisms regulating the expression and the cellular trafficking/sorting of DOP. We then summarize the structural insights of this receptor through the analysis of the existing crystal structures, with a particular focus on the role of the sodium binding site. Finally, we review the current signaling mechanisms mediating receptor function and desensitization.

Les opioïdes sont les analgésiques les plus efficaces dans le traitement des douleurs sévères. Ils produisent leurs effets en ciblant spécifiquement les récepteurs opioïdes localisés tout le long de la voie de perception de la douleur où ils modulent la transmission de l'information douloureuse. La plupart des études dans ce domaine essaient de caractériser les récepteurs opioïdes à l'état isolé de tout partenaire de signalisation. Cette thèse, par contre, montre que le récepteur opioïde delta (DOR) peut former un complexe avec sa protéine G et l'un de ses effecteurs impliqués dans la production de l'effet analgésique, le canal potassique à rectification entrante activée par les protéines G (Kir3 ou GIRK). Après avoir établi la présence de ce complexe constitutif, on a ensuite caractérisé sa stabilité, modulation et régulation suite à une stimulation avec des agonistes opioïdes. En premier lieu, on a caractérisé la transmission de l'information du récepteur DOR, suite à son activation par un agoniste, vers le canal Kir3. On a remarqué que cette transmission ne suit pas le modèle de collision, généralement accepté, mais nécessite plutôt un simple changement dans la conformation du complexe préformé. Ensuite, on a déterminé que même suite à l'activation prolongée du récepteur DOR par un agoniste complet, le complexe DOR/Kir3 maintenait son intégrité et a été reconnu par la βarrestine (βarr) comme une seule unité signalétique provoquant ainsi l'internalisation de DOR et Kir3 par un mécanisme clathrine et dynamine-dépendant. Ainsi, prises ensemble, ces données montrent que l'activation du récepteur DOR déclenche non seulement l'activation de l'effecteur Kir3 mais également un mécanisme de régulation qui élimine cet effecteur de la membrane plasmique., Opioids are the most effective analgesics in the treatment of severe pain. They produce their effects by specifically targeting opioid receptors located all along the pain perception pathway where they modulate the transmission of pain information. Most studies in this area try to characterize the opioid receptor in isolation from any signaling partner. This thesis, on the other hand, shows that the delta opioid receptor (DOR) can form a complex with its G protein and one of its effectors involved in the production of the analgesic effect, the G protein coupled inward rectifying potassium channel (Kir3 or GIRK). Having established the presence of this constitutive complex, we then characterized its stability, modulation and regulation following stimulation with opioid agonists. First, we characterized the transmission of information from DOR, following its activation by an agonist, to the Kir3 channel. We have noticed that this transmission does not follow the collision model, generally accepted, but rather requires a simple change in the conformation within the preformed complex. Then, we have determined that even following prolonged DOR activation by a full agonist, the DOR/Kir3 complex maintained its integrity and was recognized by βarrestin (βarr) as a single signaling unit producing the internalization of DOR and Kir3 by a clathrin and dynamin-dependent mechanism. Thus, taken together, these data show that DOR activation triggers not only activation of the Kir3 effector but also a regulatory mechanism that removes this effector from the plasma membrane.