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Ultra low dose naltrexone, lets talk mode(s) of action

Limpet_Chicken

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Oct 13, 2005
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Doing some research, it seems like there is a peptide binding site on filamin A, that acts as a high affinity binding site for naltrexone, and seems to regulate tolerance, I could do with finding more on this though.

Also, there appear to be two very distinct populations of the opioid receptor in question. First, there are Mu1 and Mu2, also Mu3 (this appears to be coupled to NO production, and possibly have little to do with pain regulation or euphoria, although its activated by morphine and opiate alkaloids but is insensitive to peptidic agonists like DAMGO, and the like.

Mu1 is the one that is responsible, primarily, as I understand it, for euphoric effects (there are some 15 splice variants in the human MOR1 gene, of interest, I'll throw in that some derivatives of naltrexone have been shown to be splice variant-specific, for the exon 11 splice variant, is iodobenzoylnaltrexamide for instance, this appears to lack reinforcing and possibly euphorigenic properties, but likewise, most of the side effects such as constipation, respiratory depression, dependence, tolerance formation)

MOR2 also mediates pain relief IIRC, to a degree, but is also expressed in the gut, and agonism here results in respiratory depression and inhibition of G.I tract motility.

There appear to be distinct populations of MOR1, a high affinity subtype of excitatory nature, and a lower affinity subtype which produces the well known, and sought after characteristic effects of MOR1 agonists in vivo. Not sure what the other population do when activated.

Naltrexone is known to inhibit a switch in G-protein association (MOR, is a 7-transmembrane G-protein coupled receptor, or 6-TM-GCPR in the case of some of the known truncated splice variants), from the inhibitory GαI/o coupling (leading via intracellular effectors to a decrease in cAMP formation) to the excitatory GαS and possibly Gβγ heterodimers, this switch with tolerance and continued use of opioid agonists seems to trigger a switch from analgesic, to promotion of hyperalgesia and allodynia-obviously this does not occur with all isoforms of the hMOR, else we would see a complete switch eventually from the effects we seek to pain causing with continued use, outside the context of withdrawal, would we not? At any rate, analgesia seems to be one of the last to go, as far as Mu1-OR mediated opioid effects go.

I read an interesting paper just tonight, sorry I can't post the link right now, its a paper print, but it shows at least in the murine conditioned place avoidance/preference testing paradigm, that oxycodone, and morphine ? the controlled place preference graph corresponding to morphine just has single paired bar graphs for morphine/saline and morphine/NTX) exhibited a biphasic response to ultra low dose NTX, with the lowest levels, the very lowest tested (5mg/kg morphine used in all cases bar placebo control, dose of oxy 3mg/kg), I find this very interesting, and wonder if it holds true for morphine also. Oxycodone at 3mg/kg produced CPP that was VERY dramatically blocked by 0.003 ng/kg (damn....so this high affinity binding site must bind naltrexone with at least picomolar affinity.), this increased CPP at 0.3ng/kg, still further at 3ng/kg and interestingly again, time spent in the active drug (vs saline) compartment of the testing chamber by the rats dropped down but produced only place-preference conditioning again, forming a bell curve.

Psychopharmacology (2005) 181: 576-581
DOI 10.1007/s00213-005-005-0022-7

ultra low dose naltrexone suppresses rewarding effects of opiates and aversive effects of opiate withdrawal in rats.



I'll have to try and find the other paper again, but this was something I dug up off the wayback machine called 'naltrexone trial diary' from dilaudid.net, about a guy doing some practical trials ala Ott, with dose titration etc.

Un-be-fucking-lievable! guy was taking some 40-50mg of hydromorphone a day, and more, yet managed to get down to a state where 8mg per os flattened him. Look for it people, I'm not sure if I have the address saved or could find it again, I only have a paper copy.
 
I do have plenty questions, thoughts, stuff to add, but I have to go, not my computer so I am very pressed for time atm.

So, anyone have other theories on how ULD-NTX acts? delta receptors are interesting...
 
Zeta receptors AKA opioid like growth factor receptors are places to look, other than that maybe look up some of the immunological receptors. I know a TLR has been implicated. Sorry getting into a meeting.
 
Thanks for reminding me....gods...my doc is going to shit himself when I bring my pipe of papers in and dig through to find the right ones =D

TLR? toll-like receptor? the cytokine receptor responsible for binding those bacterial lipopolysaccharide endotoxins?

Interesting....IIRC, some of the un-natural opioid isomers of racemic compounds, especially morphine, and IIRC possibly..was it the benzomorphans? can't remember, were found to be ligands at the toll-like receptor type IV, so I couldn't rule it out. BUT.....the zeta receptors have pretty slim pickings in the way of genetic homology to other, more well known receptors, MOR, DOR, KOR, NOP, and hell if I know if epsilon receptors have been examined thoroughly enough for such an esoteric question.

So..given that hMOR3, which DOES bear a significant, very much so, genetic homology to the other hMOR genes is entirely selective (at least naturally) for peptidic agonists vs alkaloids/synthetic opioids, bugger...that just leads to more questions.

One thing I like about biochem that, although when I have to come up with a bunch of interesting papers quick time, every question leading to ten more, and every one of 'em taking at least a few hours study (thats a hyperfocussing autie set of wetware for you :p )...but when something needs working out on a deadline, I SO shouldn't be trying to figure all this out right now..but damn it, You got me interested in the zeta opioid growth factor receptors again.

Oh yes...what was I wondering again...thats it..with so little homology to nonpeptide-selective opioid receptors, what are the chances naltrexone binds there at all?

And, if someone might be so kind, anyone know Ki/IC:50 values for DOR1/2, KOR and nociceptin receptors of both NTX and oxycodone off the top of their heads?

I doubt I have time yet to dig deep into cytokine receptors though, as damn, been reading up plenty there, and the immune system is SO complex. I thought memorizing a few hundred ionotropic receptors and GCPRs and their agonist/antagonist native and synthetic ligands and their pharmacology took time........its always interesting to be reminded how little one yet understands, relatively speaking.

(if not entirely productive, I could too easily start on that topic and remember I need to move, piss and eat about a week later, hah)
 
http://www.scielo.br/scielo.php?pid=S1806-00132012000100014&script=sci_arttext&tlng=en

This seems to imply that MOR2 might be selective for morphine over naloxone, etc. ...but...weren't quaternized derivatives like methylnaltrexone tested for opioid induced constipation (which IIRC is MOR2 dependent)?

It is, however, appallingly written, obviously not by somebody familiar with the subject.

And what the blazes are iota- and lambda opioid receptors. S'blood, the more I read, the more I really want to know. ORL1 looks interesting, although naloxone apparently is inactive, or very poorly active as an antagonist at this target, does the same follow for naltrexone?
 
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