Large scale sequencing of the human -opioid receptor (hMOR) gene has revealed polymorphic mutations that occur within the coding region. We have investigated whether the mutations N40D in the extracellular N-terminal region, N152D in the third transmembrane domain, and R265H and S268P in the third intracellular loop alter functional properties of the receptor expressed in mammalian cells. The N152D receptor was produced at low densities. Binding affinities of structurally diverse opioids (morphine, diprenorphine, DAMGO and CTOP) and the main endogenous opioid peptides (-endorphin, [Met]enkephalin, and dynorphin A) were not markedly changed in mutant receptors (<3-fold). Receptor signaling was strongly impaired in the S268P mutant, with a reduction of efficacy and potency of several agonists (DAMGO, -endorphin, and morphine) in two distinct functional assays. Signaling at N40D and R265H mutants was highly similar to wild type, and none of the mutations induced detectable constitutive activity. DAMGO-induced down-regulation of receptor-binding sites, following 20 h of treatment, was identical in wild-type and mutant receptors. Our data show that natural sequence variations in hMOR gene have little influence on ligand binding or receptor down-regulation but could otherwise modify receptor density and signaling. Importantly, the S268P mutation represents a loss-of-function mutation for the human -opioid receptor, which may have an incidence on opioid-regulated behaviors or drug addiction in vivo.The opioid system controls pain perception and mood and is generally implicated in a wide variety of behaviors that are essential in facing threatening situations (1, 2). Opioid receptors also mediate the strong analgesic and addictive actions of opiate drugs. Pharmacological studies indicate that the prototypic opiate morphine, the main clinically useful opiates such as fentanyl or methadone, and the closely related drug of abuse heroin preferably act by activating the -opioid receptor (MOR) 1 rather than ␦-or -opioid receptors (3-5). In support of this, gene targeting experiments have shown the absence of morphine-induced analgesia (6 -10), reward and physical dependence (6), immunosuppression (11, 12), respiratory depression (13), or constipation (14) in MOR-deficient mice, demonstrating unambiguously that the -opioid receptor is a main molecular target for morphine action in vivo. The finding of genetic mutations altering the expression or functional activity of MOR is therefore important to understand inter-individual variable responses to the major opioid drugs, both in the clinical management of pain or heroin addiction. In addition to the direct mediation of opiate-induced euphoria, tolerance, and dependence, -opioid receptors have been shown to regulate the effects of other substances with high addictive potential such as cocaine or alcohol (15). As an example, in humans, the -receptor antagonists naloxone and naltrexone have been shown not only to reverse heroin overdose but also to alter alcohol consumption (16,...