The ␦ opioid receptor (␦R) is a promising alternate target for pain management because ␦R agonists show decreased abuse potential compared with current opioid analgesics that target the opioid receptor. A critical limitation in developing ␦R as an analgesic target, however, is that ␦R agonists show relatively low efficacy in vivo, requiring the use of high doses that often cause adverse effects, such as convulsions. Here we tested whether intracellular retention of ␦R in sensory neurons contributes to this low ␦R agonist efficacy in vivo by limiting surface ␦R expression. Using direct visualization of ␦R trafficking and localization, we define a phosphatase and tensin homolog (PTEN)-regulated checkpoint that retains ␦R in the Golgi and decreases surface delivery in rat and mice sensory neurons. PTEN inhibition releases ␦R from this checkpoint and stimulates delivery of exogenous and endogenous ␦R to the neuronal surface both in vitro and in vivo. PTEN inhibition in vivo increases the percentage of TG neurons expressing ␦R on the surface and allows efficient ␦R-mediated antihyperalgesia in mice. Together, we define a critical role for PTEN in regulating the surface delivery and bioavailability of the ␦R, explain the low efficacy of ␦R agonists in vivo, and provide evidence that active ␦R relocation is a viable strategy to increase ␦R antinociception.
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