Mount Sinai Scientists Reveal New Insights and Possible Solutions for Opioid Epidemics Using Machine Learning
Findings could lead to improved, non-addictive opioid drugs
Mount Sinai researchers have identified unique structural, biological and chemical insights in the way different opioid drugs activate the receptors and specific signaling pathways responsible for the drug’s beneficial and adverse effects, according to a study to be published in Nature’s Scientific Reports.
Opioid overdoses are the leading cause of accidental death in the United States. The findings of this study may provide a blueprint for designing improved painkillers.
“These new insights will provide a roadmap to develop a new class of drugs that are non-addictive and less harmful for patients,” said Marta Filizola, PhD, Professor of Pharmacological Science and Professor of Neuroscience, Dean of The Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, and lead investigator of the study. “These insights may help us engineer new painkillers with reduced side effects, particularly respiratory depression. An alternative, non-addictive medication for chronic pain will help us combat the ongoing national crisis of addiction to opioid drugs and the devastating overdose epidemic deriving from it.”
There have been many attempts to develop better opioid drugs but this has been largely unsuccessful due to incomplete understanding of the molecular signatures underlying the analgesic effects as opposed to the unwanted side effects. Potent opioid drugs that are often tied to fatal overdoses (e.g., heroin, fentanyl, or carfentanil) work by binding to opioid receptors in the nervous system. These drugs also provoke dopamine release, which causes euphoria leading to addiction and inhibits nerve cells in a region of the brain that regulates breathing, which can lead to respiratory depression and accidental death by overdose.
The therapeutic effect of opioid drugs is mainly attributed to mu-opioid receptor (MOR) activation leading to G protein signaling, meaning that the drug binds to the MOR receptor and causes a change in its molecular structure, which then activates a protein called the G protein. However, the drug’s side effects have mostly been linked to a different process known as β-arrestin signaling, which plays a role in the regulation of these receptors. To shed light on this, the researchers carried out molecular dynamics simulations in mouse models of MOR bound to a classical opioid drug (morphine) or a potent G protein-biased agonist (TRV-130) that is currently being evaluated in human clinical trials for its potent analgesic effect with less respiratory depression and constipation than morphine.
The results of rigorous machine learning analyses of these simulations revealed unique structural, dynamic, and kinetic insights that have a direct utilization in the design of improved therapeutics targeting MOR.
In addition to postdoctoral researchers Abhijeet Kapoor, PhD, and Assistant Professor Davide Provasi, PhD, in the Filizola lab, researchers from Universitat Pompeu Fabra in Barcelona, Spain, contributed to this National Institute on Drug Abuse (NIDA)-funded study. The findings will inform other studies conducted at the Addiction Institute at Mount Sinai (AIMS) led by Yasmin Hurd, PhD, Professor of Psychiatry and Ward-Coleman Chair of Translational Neuroscience at Mount Sinai and the Friedman Brain Institute led by Eric Nestler, MD, PhD, Professor of Neuroscience and Dean for Academic and Scientific Affairs at Mount Sinai.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 11 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals” and by U.S. News & World Report's® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2024-2025.
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