We have examined the endocytic trafficking of epitopetagged ␦ and opioid receptors expressed in human embryonic kidney (HEK) 293 cells. These receptors are activated by peptide agonists (enkephalins) as well as by the alkaloid agonist drugs etorphine and morphine. Enkephalins and etorphine cause opioid receptors to internalize rapidly (t1 ⁄2 ϳ 6 min) by a mechanism similar to that utilized by a number of other classes of receptor, as indicated by localization of internalized opioid receptors in transferrin-containing endosomes and inhibition of opioid receptor internalization by hypertonic media. Remarkably, morphine does not stimulate the rapid internalization of either ␦ or opioid receptors, even at high concentrations that strongly inhibit adenylyl cyclase. These data indicate that agonist ligands, which have similar effects on receptor-mediated signaling, can have dramatically different effects on the intracellular trafficking of a G protein-coupled receptor.Opioid receptors constitute a class of G protein-coupled receptors that mediate the effects of endogenously produced opioid peptides in the central and peripheral nervous systems. An interesting feature of these receptors is that they are activated both by native peptides and by structurally distinct non-peptide alkaloid ligands (1). Following activation, opioid receptors are regulated by multiple mechanisms, which modulate the functional plasticity of the endogenous opioid system and contribute to the development of opiate tolerance and dependence (2-5).Previous studies have described two distinguishable processes of opioid receptor regulation, termed desensitization and down-regulation (3, 4, 6 -9). Both desensitization and downregulation of opioid receptors are stimulated by peptide and alkaloid agonists (4, 6). However, individual agonists may have substantially different effects on the rapid regulation of opioid receptors (10 -12). We have observed that opioid receptors are regulated by a process of rapid internalization that exhibits a remarkable degree of agonist specificity not observed previously in studies of the intracellular trafficking of other receptors. EXPERIMENTAL PROCEDURES Construction and Expression of Epitope-tagged ␦ and OpioidReceptors-cDNAs encoding murine ␦ (13) and (14) opioid receptors were epitope-tagged in the amino-terminal extracellular domain utilizing a shuttle vector containing a signal-FLAG cassette (kindly provided by Drs. Jeff Reagan and Brian Kobilka) (15) and subcloned into pcDNA3 (Invitrogen) for transfection. The structure of each mutant cDNA was confirmed by dideoxy sequencing (Sequenase, U. S. Biochemical Corp.).Human embryonic kidney (HEK) 1 293 cells (ATCC) were grown in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum (University of California San Francisco Cell Culture Facility) and transfected using calcium phosphate coprecipitation (16). Stably transfected cells were isolated following neomycin selection (Geneticin, Life Technologies, Inc.) as described previously (17), and satur...

mu-Opioid receptors are the pharmacological targets of endogenous opioid peptides and morphine-like alkaloid drugs. Previous studies of transfected cells and peripheral neurons indicate that opioid receptors are rapidly internalized after activation by the alkaloid agonist etorphine but not after activation by morphine. To determine whether opioid receptors in the central nervous system are regulated by a similar process of agonist-selective internalization, mu-opioid receptors were examined in rat brain neurons after treatment of animals with opioid drugs. Internalized mu receptors were observed within 30 min after intraperitoneal injection of the alkaloid agonist etorphine, and this process was blocked by the antagonist naloxone. Colocalization of internalized opioid receptors with transferrin receptors in confocal optical sections indicated that receptor internalization observed in vivo is mediated by a membrane trafficking pathway similar to that observed previously in vitro using transfected human embryonic kidney 293 cells. Morphine failed to induce detectable rapid internalization of receptors, even when administered to animals at doses far in excess of those required to induce analgesia. To quantify these agonist-selective differences and to analyze an array of opioid ligands for their ability to trigger internalization, we used flow cytometry on stably transfected 293 cells. These studies indicated that the different effects of individual agonists are not correlated with their potencies for receptor activation and that a variety of clinically important agonists differ significantly in their relative abilities to stimulate the rapid internalization of opioid receptors.

A number of pharmacologic treatments examined in recent randomized clinical trials (RCTs) have failed to show statistically significant superiority to placebo in conditions in which their efficacy had previously been demonstrated. Assuming the validity of previous evidence of efficacy and the comparability of the patients and outcome measures in these studies, such results may be a consequence of limitations in the ability of these RCTs to demonstrate the benefits of efficacious analgesic treatments vs placebo ("assay sensitivity"). Efforts to improve the assay sensitivity of analgesic trials could reduce the rate of falsely negative trials of efficacious medications and improve the efficiency of analgesic drug development. Therefore, an Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials consensus meeting was convened in which the assay sensitivity of chronic pain trials was reviewed and discussed. On the basis of this meeting and subsequent discussions, the authors recommend consideration of a number of patient, study design, study site, and outcome measurement factors that have the potential to affect the assay sensitivity of RCTs of chronic pain treatments. Increased attention to and research on methodological aspects of clinical trials and their relationships with assay sensitivity have the potential to provide the foundation for an evidence-based approach to the design of analgesic clinical trials and expedite the identification of analgesic treatments with improved efficacy and safety.

Distinct subtypes of glutamate receptors often are colocalized at individual excitatory synapses in the mammalian brain yet appear to subserve distinct functions. To address whether neuronal activity may differentially regulate the surface expression at synapses of two specific subtypes of ionotropic glutamate receptors we epitope-tagged an AMPA (␣-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) receptor subunit (GluR1) and an NMDA (N-methyl-Daspartate) receptor subunit (NR1) on their extracellular termini and expressed these proteins in cultured hippocampal neurons using recombinant adenoviruses. Both receptor subtypes were appropriately targeted to the synaptic plasma membrane as defined by colocalization with the synaptic vesicle protein synaptophysin. Increasing activity in the network of cultured cells by prolonged blockade of inhibitory synapses with the ␥-aminobutyric acid type A receptor antagonist picrotoxin caused an activity-dependent and NMDA receptor-dependent decrease in surface expression of GluR1, but not NR1, at synapses. Consistent with this observation identical treatment of noninfected cultures decreased the contribution of endogenous AMPA receptors to synaptic currents relative to endogenous NMDA receptors. These results indicate that neuronal activity can differentially regulate the surface expression of AMPA and NMDA receptors at individual synapses.Information about the mechanisms of synaptic transmission and synaptic plasticity in the mammalian brain derives primarily from electrophysiological studies of excitatory synapses in the hippocampus. These synapses use the neurotransmitter glutamate, which can act on distinct subtypes of ionotropic and metabotropic receptors that frequently colocalize at individual synapses but appear to subserve distinct functions (1-3). Two major subtypes of ionotropic receptors, AMPA (␣-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) and NMDA (Nmethyl-D-aspartate) receptors, have been found at virtually all excitatory synaptic connections in the mammalian brain. AMPA receptors (AMPARs) are heteromers of the homologous subunits GluR1-4 and mediate the bulk of synaptic transmission during basal neural activity (1-3). NMDA receptors (NMDARs) also exist as heteromers formed from the NR1 subunit and one or more NR2A-D subunits (1-3). Because of their voltage dependence and high calcium permeability, NMDARs are particularly important for triggering several different forms of synaptic plasticity, including longterm potentiation and long-term depression. When inappropriately activated during a variety of pathological conditions, NMDARs also contribute to neuronal injury and death.It has commonly been assumed that AMPARs and NMDARs are colocalized at individual synapses (1-4), although it is now clear that these receptor subtypes interact with different proteins at the synapse (5). The distinct molecular interactions and functions of these receptor subtypes raise the possibility that their surface expression at synapses may be independently regulated....