Assessment of the potential of novel and classical opioids to induce respiratory depression in mice

Br J Pharmacol. 2023 Dec;180(24):3160-3174. doi: 10.1111/bph.16199. Epub 2023 Aug 22.

Abstract

Background and purpose: Opioid-induced respiratory depression limits the use of μ-opioid receptor agonists in clinical settings and is the main cause of opioid overdose fatalities. The relative potential of different opioid agonists to induce respiratory depression at doses exceeding those producing analgesia is understudied despite its relevance to assessments of opioid safety. Here we evaluated the respiratory depressant and anti-nociceptive effects of three novel opioids and relate these measurements to their in vitro efficacy.

Experimental approach: Respiration was measured in awake, freely moving male CD-1 mice using whole body plethysmography. Anti-nociception was measured using the hot plate test. Morphine, oliceridine and tianeptine were administered intraperitoneally, whereas methadone, oxycodone and SR-17018 were administered orally. Receptor activation and arrestin-3 recruitment were measured in HEK293 cells using BRET assays.

Key results: Across the dose ranges examined, all opioids studied depressed respiration in a dose-dependent manner, with similar effects at the highest doses, and with tianeptine and oliceridine showing reduced duration of effect, when compared with morphine, oxycodone, methadone and SR-17018. When administered at doses that induced similar respiratory depression, all opioids induced similar anti-nociception, with tianeptine and oliceridine again showing reduced duration of effect. These data were consistent with the in vitro agonist activity of the tested compounds.

Conclusion and implications: In addition to providing effective anti-nociception, the novel opioids, oliceridine, tianeptine and SR-17018 depress respiration in male mice. However, the different potencies and kinetics of effect between these novel opioids may be relevant to their therapeutic application in different clinical settings.

Keywords: anti-nociception; opioid; opioid receptor; respiratory depression; therapeutic window.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid*
  • Animals
  • HEK293 Cells
  • Humans
  • Male
  • Methadone / adverse effects
  • Mice
  • Morphine / pharmacology
  • Oxycodone / pharmacology
  • Respiratory Insufficiency* / chemically induced
  • Respiratory Insufficiency* / drug therapy

Substances

  • Analgesics, Opioid
  • ((3-methoxythiophen-2-yl)methyl)((2-(9-(pyridin-2-yl)-6-oxaspiro(4.5)decan-9-yl)ethyl))amine
  • tianeptine
  • Oxycodone
  • Morphine
  • Methadone