Invited review: Role of receptor regulation in opioid tolerance mechanisms

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Abstract
The molecular basis of opioid tolerance/dependence has long eluded researchers, but recent advances in receptor regulation have suggested a useful conceptual approach to the problem. In NG108‐15 neuroblastoma × glioma hybrid (NG) cells, opioid agonists inhibit adenylate cyclase in a dose‐dependent, naloxone‐antagonizable fashion. Chronic treatment with opioid agonists results in a series of molecular processes that, in a tolerance‐like fashion, counteract this inhibition. These processes include desensitization and down‐regulation of receptors and an increase in adenylate cyclase activity. Opioid inhibition of adenylate cyclase and opioid receptor down‐regulation also have been observed in the brain. However, most studies have found that the receptors coupled to adenylate cyclase are not of the mu type, which a thought to be the primary mediators of opioid analgesia. Down‐regulation has been observed for both mu and delta opioid receptors in the brain. However, in most case, the time course of down‐regulation is not correlated with that for tolerance development, and chronic morphine treatment does not result in down‐regulation. Thus, opioid receptors in the brain, like those in NG cells, are subject to dynamic regulation by agonists, which probably has an important role in their function. However, it remains to be established that opioid receptor regulation is the basis of opioid tolerance and dependence.