Heteromers of μ-δ opioid receptors: new pharmacology and novel therapeutic possibilities

Br J Pharmacol. 2015 Jan;172(2):375-87. doi: 10.1111/bph.12663. Epub 2014 Jul 1.


Several studies suggest that heteromerization between μ (MOP) and δ (DOP) opioid receptors modulates the signalling properties of the individual receptors. For example, whereas activation of MOP receptors by an agonist induces G protein-mediated signalling, the same agonist induces β-arrestin-mediated signalling in the context of the MOP-DOP receptor heteromer. Moreover, heteromer-mediated signalling is allosterically modulated by a combination of MOP and DOP receptor ligands. This has implications in analgesia given that morphine-induced antinociception can be potentiated by DOP receptor ligands. Recently reagents selectively targeting the MOP-DOP receptor heteromer such as bivalent ligands, antibodies or membrane permeable peptides have been generated; these reagents are enabling studies to elucidate the contribution of endogenously expressed heteromers to analgesia as well as to the development of side-effects associated with chronic opioid use. Recent advances in drug screening technology have led to the identification of a MOP-DOP receptor heteromer-biased agonist that activates both G protein-mediated and β-arrestin-mediated signalling. Moreover, this heteromer-biased agonist exhibits potent antinociceptive activity but with reduced side-effects, suggesting that ligands targeting the MOP-DOP receptor heteromer form a basis for the development of novel therapeutics for the treatment of pain. In this review, we summarize findings regarding the biological and functional characteristics of the MOP-DOP receptor heteromer and the in vitro and in vivo properties of heteromer-selective ligands.

Linked articles: This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2.

Keywords: antinociception; dependence; heteromer; high-throughput screening; opioid; signalling; tolerance; trafficking.

Publication types

  • Review

MeSH terms

  • Animals
  • Humans
  • Ligands
  • Pain / drug therapy
  • Pain / metabolism
  • Protein Multimerization
  • Receptors, Opioid, delta / metabolism*
  • Receptors, Opioid, mu / metabolism*


  • Ligands
  • Receptors, Opioid, delta
  • Receptors, Opioid, mu