Newly identified protein can make opioid painkillers effective at lower doses thus preventing the mechanism that leads to addiction, finds a research team from Mount Sinai School of Medicine. The findings of the study are published in the journal Proceedings of the National Academy of Sciences.
The protein, RGSz1 (Regulator of G protein signaling z1), which is expressed in brain regions that mediate analgesic responses, is part of an intracellular network that controls the pain-relieving effects of opioid analgesics like morphine, fentanyl, and methadone without increasing the risk of reward or dependence. The mechanisms uncovered in this study may provide novel avenues for pharmacological interventions that can be used to optimize the actions of opioid medications, leading to safer and less addictive treatments.
Opioids are powerful analgesics, but when they are used long-term, they promote dependence and can easily transition to addiction. Patients who receive opioids for chronic pain require higher amounts of the drug over time as they develop analgesic tolerance. The need for higher amounts not only results in severe and often life-threatening adverse effects, but it also increases the risk for dependence and addiction. Amidst the current opioid crisis in the United States, there is an immediate need to develop novel therapeutic interventions for safer and more efficient analgesics.
"Our discovery that RGSz1 and RGSz1 regulated pathways can be targeted to promote analgesia is very exciting because it enables us to develop strategies for the use of low opioid doses for pain relief," says Venetia Zachariou, PhD, Associate Professor in the Fishberg Department of Neuroscience, the Department of Pharmacological Sciences, The Friedman Brain Institute, and The Addiction Institute, Icahn School of Medicine at Mount Sinai.
Additionally, the research team discovered that RGSz1 competes with another RGS protein, Axin 2, and this competition controls the function of the protein β-catenin. β-catenin plays an important role in opioid actions by promoting the expression of genes that counteract the maladaptive changes associated with analgesic tolerance. This is another factor uncovered in this study that provides insight about the cellular and molecular pathways that mediate the actions of opioids in specific brain regions or cell types, which is essential for the development of safer therapeutics for analgesia or addiction.
"RGSz1 is expressed only in subsets of neurons that mediate opioid actions. The actions of opioids in addiction-related networks are mediated by distinct RGS proteins. We are now screening currently prescribed opioids as well as new compounds to determine their abuse potential and analgesic efficacy based on the RGS protein they activate. That knowledge will be power in the fight against this deadly opioid epidemic," says Dr. Zachariou.