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Letter
Combined Interactions with I1-, I2-Imidazoline Binding Sites and #2-Adrenoceptors to Manage Opioid Addiction Maria Elena Giusepponi, Carlo Cifani, Maria Vittoria Micioni Di Bonaventura, Laura Mattioli, Alan L. Hudson, Eleonora Diamanti, Fabio Del Bello, Mario Giannella, Valerio Mammoli, Corinne Dalila Paoletti, Alessandro Piergentili, Maria Pigini, and Wilma Quaglia ACS Med. Chem. Lett., Just Accepted Manuscript • DOI: 10.1021/acsmedchemlett.6b00290 • Publication Date (Web): 08 Sep 2016 Downloaded from http://pubs.acs.org on September 10, 2016
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ACS Medicinal Chemistry Letters
Combined Interactions with I1-, I2-Imidazoline Binding Sites and α2Adrenoceptors to Manage Opioid Addiction Maria Elena Giusepponi,† Carlo Cifani,† Maria Vittoria Micioni Di Bonaventura,† Laura Mattioli,† Alan Hudson,§ Eleonora Diamanti,# Fabio Del Bello,#* Mario Giannella,# Valerio Mammoli,# Corinne Dalila Paoletti,# Alessandro Piergentili,# Maria Pigini,# Wilma Quaglia# †
School of Pharmacy, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri 9, 62032 Camerino, Italy. §
Department of Pharmacology, Medical Sciences Building, University of Alberta, Edmonton, Alberta, Canada.
#
School of Pharmacy, Medicinal Chemistry Unit, University of Camerino, Via S. Agostino 1, 62032 Camerino, Italy.
This article is dedicated to Prof. Maria Pigini, who died on February 8, 2016.
KEYWORDS; opioid addiction, imidazolines, α2-adrenoceptors, combined interactions, agmatine biological profile. ABSTRACT: Tolerance and dependence associated with chronic opioid exposure result from molecular, cellular, and neural network adaptations. Such adaptations concern opioid and non-opioid systems, including α2-adrenoceptors (α2-ARs) and I1- and I2-Imidazoline binding sites (IBS). Agmatine, one of the hypothesized endogenous ligands of IBS, targeting several systems including α2-ARs and IBS, proved to be able to regulate opioid-induced analgesia and to attenuate the development of tolerance and dependence. Interested in the complex pharmacological profile of agmatine and considering the nature of its targets, we evaluated two series of imidazolines, rationally designed to simultaneously interact with I1-/I2IBS or I1-/I2-IBS/α2-ARs. The compounds showing the highest affinities for I1-/I2-IBS or I1-/I2-IBS/α2-ARs have been selected for their in vivo evaluation on opiate withdrawal syndrome. Interestingly, 9, displaying I1-/I2-IBS/α2-ARs interaction profile, appears more effective in reducing expression and acquisition of morphine dependence and, therefore, might be considered a promising tool in managing opioid addiction.
Opioid addiction, involving tolerance, drug-seeking, and physical dependence, is defined as a chronic relapsing condition and represents a major health and social problem in most societies. Tolerance and dependence associated with chronic opioid exposure result from molecular, cellular, and neural network adaptations. Such adaptations concern opioid and non-opioid systems, including α2-adrenoceptors (α2-ARs) and imidazoline binding sites (IBS). Therefore, agents directed to these targets can also affect the pharmacological actions of opioids and represent useful tools in managing opioid addiction.1 α2-ARs have been demonstrated to be extremely sensitive to opioid exposure and to play a key role in opiate withdrawal symptoms.2 They are widely distributed both in the central nervous system (CNS) and in peripheral tissues.3 By pharmacological and molecular cloning techniques, α2-ARs have been classified into three subtypes, namely α2A-AR, mediating hypotension, sedation and analgesia, α2B-AR, mediating vasoconstriction, and α2C-AR, modulating many CNS processes and contributing to spi-
nal α2-agonist mediated analgesia and adrenergic-opioid synergy.2-4 IBS, discovered about thirty years ago by Bousquet et al.,5 are distributed in both central and peripheral nervous systems.6 At present they appear to be divided into three subtypes: I1-IBS, preferentially recognized by [3H]clonidine and related compounds, I2-IBS, recognized by [3H]-idazoxan, and I3-IBS, atypical site constituting a potential target for the treatment of diabetes.6,7 I1-IBS are involved in the regulation of cardiovascular function, in the modulation of ocular pressure, and in the secretion of renal sodium. I2-IBS are involved in CNS pathologies such as Parkinson’s disease, depression, tolerance and addiction to opioids, and food intake in rats.6,8 For many years, the non subtype selective α2-AR agonist clonidine (Chart 1) has been the mainstay of non-opioid treatment for relief of withdrawal symptoms during detoxification.2 Since clonidine also interacts with I1-IBS and is endowed with preferential I1-IBS/α2-AR selectivity (selectivi-
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ty ratio = 4), a potential role of I1-IBS signalling in addiction is hypothesized. It has also been reported that, as observed with moxonidine (I1-IBS/α2-AR selectivity ratio = 40), the coincident stimulation of α2-ARs and I1-IBS prevents relapse of cocaine-seeking, indicating novel pharmacological approaches for addiction treatment.9
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Chart 2. Chemical structures of imidazolines 1-13 sharing the common scaffold I.
Chart 1. Chemical structures of clonidine, moxonidine, 2-BFI and agmatine
Moreover, a significant number of studies suggested that some substances such as 2-BFI (Chart 1), displaying high affinity for I2-IBS over α2-ARs, were able to regulate the opioid-induced analgesia,10 and to attenuate the development of tolerance and dependence.11 Positive effects in managing opioid addiction are also provided by agmatine (Chart 1), which has been considered one of the endogenous ligands for IBS.12 Several studies demonstrated that agmatine potentiates opioid analgesia and attenuates opioid tolerance and dependence mainly by interaction with IBS.13 Moreover, it attenuates ethanol withdrawal symptoms14 and displays anxiolytic, antidepressant, anticonvulsive, antiproliferative and neuroprotective effects.15 Nevertheless, the efficacy of agmatine is weakened by the fact that, similarly to the other monoamine transmitter molecules, its fast peripheral metabolization reduces its penetration into the brain, limiting its use as a therapeutic agent. Moreover, only high and frequent doses of exogenous agmatine induced significant effects in animal models.16 Agmatine is one of the few neurotransmitters with multireceptorial affinities. Indeed, it interacts with serotonin 5-HT receptors, antagonizes NMDA receptors, inhibits nitric oxide synthase, binds to α2-ARs, I1- and I2-IBS.12,15,16 The multiplicity of systems recognized by agmatine makes it difficult to identify its certain targets modulating opioid functions as well as other interesting aforementioned effects. Some advantageous combined interactions also emerged by our studies regarding imidazolines able to interact with different systems, including IBS and α2-ARs, and built on the common scaffold I characterized by an aromatic area (Ar) linked to the position 2 of the imidazoline nucleus by a biatomic bridge (X) (Chart 2). Interestingly, our results highlighted that the peculiar chemical nature of X addressed the ligand to specific biological targets, whereas the ortho-phenyl substituents were responsible for its functional behaviour.
In particular, the -OCH(CH3)- bridge proved to be suitable for α2-AR and 5-HT1A receptor (5-HT1A-R) interactions,17 whereas the -O-CH2- linker promoted the simultaneous α2-AR/I2-IBS recognition (Chart 2).18 Indeed, we demonstrated that ligands such as allyphenyline (1), displaying effective α2C-AR agonism/α2A-AR antagonism/5HT1A-R agonism, or compound 2, producing significant α2C-AR agonism/α2A-AR antagonism/I2-IBS interaction, behaved as multifunctional agents and were able, at the same dose, to reduce opioid withdrawal syndrome and associated depression.17-19 At low dose 1 also reduced hyperanxiety-like behaviour after alcohol intoxication.20 In contrast, the -CH=CH- bridge induced efficacious I1and I2-IBS recognition, as demonstrated by tracizoline (3) (pKi: I1-IBS 7.72, I2-IBS 8.72, α2-ARs
