Methylnaltrexone crosses the blood-brain barrier and attenuates centrally-mediated behavioral effects of morphine and oxycodone in mice

Neuropharmacology. 2021 Mar 1:185:108437. doi: 10.1016/j.neuropharm.2020.108437. Epub 2020 Dec 11.

Abstract

Background: Antagonism of peripheral opioid receptors by methylnaltrexone (MNTX) was recently proposed as a potential mechanism to attenuate the development of opioid analgesic tolerance based on experiments conducted in mice. However, reports indicate that MNTX is demethylated to naltrexone (NTX) in mice, and NTX may subsequently cross the blood-brain barrier to antagonize centrally-mediated opioid effects. The goal of this study was to determine whether MNTX alters centrally-mediated behaviors elicited by the opioid analgesics, morphine and oxycodone, and to quantify concentrations of MNTX and NTX in blood and brain following their administration in mice.

Methods: Combinations of MNTX and morphine were tested under acute and chronic conditions in thermal nociceptive assays. Effects of MNTX and NTX pretreatment were assessed in an oxycodone discrimination operant procedure. Blood and brain concentrations of these antagonists were quantified after their administration using liquid chromatography-mass spectrometry.

Results: MNTX dose-dependently attenuated acute and chronic morphine antinociception. MNTX and NTX dose-dependently antagonized the discriminative stimulus effects of oxycodone. MNTX and NTX were detected in both blood and brain after administration of MNTX, confirming its demethylation and demonstrating that MNTX itself can cross the blood-brain barrier.

Conclusions: These results provide converging behavioral and analytical evidence that MNTX administration in mice attenuates centrally-mediated effects produced by opioid analgesics and results in functional concentrations of MNTX and NTX in blood and brain. Collectively, these findings indicate that MNTX cannot be administered systemically in mice for making inferences that its effects are peripherally restricted.

Keywords: Antinociception; Methylnaltrexone; Morphine; Mouse; Oxycodone; Tolerance.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics, Opioid / antagonists & inhibitors
  • Analgesics, Opioid / pharmacology*
  • Animals
  • Blood-Brain Barrier / drug effects*
  • Blood-Brain Barrier / metabolism
  • Dose-Response Relationship, Drug
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Morphine / antagonists & inhibitors
  • Morphine / pharmacology*
  • Naltrexone / analogs & derivatives*
  • Naltrexone / metabolism
  • Naltrexone / pharmacology
  • Narcotic Antagonists / metabolism
  • Narcotic Antagonists / pharmacology*
  • Oxycodone / antagonists & inhibitors
  • Oxycodone / pharmacology*
  • Pain Measurement / drug effects
  • Pain Measurement / methods
  • Quaternary Ammonium Compounds / metabolism
  • Quaternary Ammonium Compounds / pharmacology

Substances

  • Analgesics, Opioid
  • Narcotic Antagonists
  • Quaternary Ammonium Compounds
  • methylnaltrexone
  • Naltrexone
  • Morphine
  • Oxycodone