“…Studies have shown that allosteric ligands of the MOR show varying abilities to modulate the orthosteric ligand’s affinity, efficacy, or both. , Allosteric ligands bind to a site on the receptor, termed as allosteric binding site, that is distinct from the site that endogenous orthosteric ligands bind (orthosteric binding site). − An allosteric ligand can act as a positive allosteric modulator (PAM) which enhances the affinity or efficacy of an orthosteric ligand, a negative allosteric modulator (NAM) which inhibits the intrinsic affinity or efficacy, or a silent allosteric modulator (SAM) which occupies the allosteric binding site and has no effect on the affinity or efficacy. In addition, bitopic (dual steric) ligands which bind to both the orthosteric and allosteric binding sites of a single receptor monomer have been shown to have higher affinity, increase or decrease intrinsic efficacy, improve off-rates and induce functional selectivity. ,,,− Thus, bitopic compounds may combine the advantages of orthosteric and allosteric ligands and carry unique pharmacological properties, e.g., higher selectivity.…”