ABSTRACT:We report the discovery of spiro [cyclohexanepyrano[3,4-b]indole]-amines, as functional nociceptin/orphanin FQ peptide (NOP) and opioid receptor agonists with strong efficacy in preclinical models of acute and neuropathic pain. Utilizing 4-(dimethylamino)-4-phenylcyclo-hexanone 1 and tryptophol in an oxa-Pictet−Spengler reaction led to the formation of spiroether 2, representing a novel NOP and opioid peptide receptor agonistic chemotype. This finding initially stems from the systematic derivatization of 1, which resulted in alcohols 3−5, ethers 6 and 7, amines 8−10, 22−24, and 26−28, amides 11 and 25, and urea 12, many with low nanomolar binding affinities at the NOP and mu opioid peptide (MOP) receptors. KEYWORDS: NOP receptor agonist, MOP receptor agonist F or decades, opioid peptide receptors have been targeted for the treatment of pain, and the present day opioids remain the most effective clinically used drugs for the treatment of moderate to severe acute and chronic pain. However, opioids also carry the risk of severe side effects such as respiratory depression, nausea, vomiting, and constipation, and their use may lead to physical dependence and tolerance.1 The nociceptin receptor and its endogenous ligand nociceptin/ orphanin FQ (N/OFQ), a 17-amino acid neuropeptide, have been described almost 20 years ago.2,3 Because of its partial homology to the three opioid peptide receptor subtypes mu opioid peptide (MOP), kappa opioid peptide (KOP), and delta opioid peptide (DOP) and its insensitivity to opioid agonists (e.g., morphine) and antagonists (e.g., naloxone), the receptor was initially termed "opioid-receptor-like 1" (ORL 1). More recently, however, it was renamed after its endogenous ligand to nociceptin/orphanin FQ peptide (NOP) receptor. Despite its structural and functional homology to opioid receptors, the NOP receptor is not an opioid peptide receptor from a pharmacological perspective and, as such, is considered a nonopioid member of the opioid peptide receptor family. 4 NOP and MOP receptor agonists modulate pain and nociception via distinct yet related targets. Addressing both mechanisms may constitute a novel approach for the development of innovative analgesics. Indeed, recent publications indicate that concurrent activation of NOP and MOP receptors may potentiate opiate analgesia and at the same time lead to an improved side effect profile. 5,6 We therefore aimed at identifying highly potent, small molecule NOP and MOP receptor agonists.This endeavor started with a literature-to-lead approach based on cyclohexanone 1, which has previously been reported by Lednicer et al. as representing a novel class of analgesics. 7,8 As a starting point it was clear that, due to its size, compound 1 would lack key interactions within the binding pocket of both the NOP and MOP receptors and therefore would have only minimal receptor binding affinities (K i (NOP) = 1.5 μM; K i (MOP) = 1.7 μM). It was our strategy to utilize 1 as a core and its ketone moiety for functionalization. Thus, fixing the 4-...