Disulfiram Abrogates Morphine Tolerance-A Possible Role of µ-Opioid Receptor-Related G-Protein Activation in the Striatum

Int J Mol Sci. 2021 Apr 14;22(8):4057. doi: 10.3390/ijms22084057.

Abstract

One of the key strategies for effective pain management involves delaying analgesic tolerance. Early clinical reports indicate an extraordinary effectiveness of off-label disulfiram-an agent designed for alcohol use disorder-in potentiating opioid analgesia and abrogation of tolerance. Our study aimed to determine whether sustained µ-opioid signaling upon disulfiram exposure contributes to these phenomena. Wistar rats were exposed to acute and chronic disulfiram and morphine cotreatment. Nociceptive thresholds were assessed with the mechanical Randal-Selitto and thermal tail-flick tests. µ-opioid receptor activation in brain structures important for pain processing was carried out with the [35S]GTPγS assay. The results suggest that disulfiram (12.5-50 mg/kg i.g.) augmented morphine antinociception and diminished morphine (25 mg/kg, i.g.) tolerance in a supraspinal, opioid-dependent manner. Disulfiram (25 mg/kg, i.g.) induced a transient enhancement of µ-opioid receptor activation in the periaqueductal gray matter (PAG), rostral ventromedial medulla (RVM), hypothalamus, prefrontal cortex and the dorsal striatum at day 1 of morphine treatment. Disulfiram rescued µ-opioid receptor signaling in the nucleus accumbens and caudate-putamen 14 days following morphine and disulfiram cotreatment. The results of this study suggest that striatal µ-opioid receptors may contribute to the abolition of morphine tolerance following concomitant treatment with disulfiram.

Keywords: G-proteins; analgesic tolerance; disulfiram; striatum; μ-opioid receptor.

MeSH terms

  • Alcoholism* / drug therapy
  • Alcoholism* / genetics
  • Alcoholism* / pathology
  • Analgesics, Opioid / pharmacology
  • Animals
  • Corpus Striatum / drug effects
  • Corpus Striatum / pathology
  • Disulfiram* / pharmacology
  • Drug Tolerance* / genetics
  • GTP-Binding Proteins / genetics
  • Gray Matter / drug effects
  • Humans
  • Male
  • Morphine / adverse effects
  • Pain Management
  • Rats
  • Receptors, Opioid, mu* / genetics

Substances

  • Analgesics, Opioid
  • Disulfiram
  • GTP-Binding Proteins
  • Morphine
  • Receptors, Opioid, mu