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Mechanistic Insights into G Protein-Biased κ-Opioid Receptor Signaling Using Dual-Charged Naltrexamine Amides

Niklas Piet DoeringInstitute of Molecular Biology
Kristina M. PulsInstitute of Molecular Biology
Marta DiceglieLeibniz-Forschungsinstitut für Molekulare Pharmakologie
Anja MeranerUniversität Innsbruck
Axel HentschLeibniz-Forschungsinstitut für Molekulare Pharmakologie
Siriwat HongnakUniversität Innsbruck
Armin WurzerUniversität Innsbruck
Helmut SchmidhammerUniversität Innsbruck
Mariana SpeteaUniversität Innsbruck
Marc NazareLeibniz-Forschungsinstitut für Molekulare Pharmakologie
Journal of Medicinal Chemistry·February 5, 2026
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Abstract

Opioids remain a cornerstone of pain management, but currently used therapeutics are associated with serious side effects. While κ-opioid receptor (KOR) agonists offer an alternative to classical μ-opioid receptor (MOR) agonists, their clinical potential is limited by severe adverse effects. G protein-biased KOR agonists are a promising strategy for developing safer analgesics. In this study, we used virtual screening to develop novel dual-charged naltrexamine amide derivatives as tool compounds for investigating biased agonism at the KOR. All of the predicted ligands demonstrate low-nanomolar activity and G protein bias at both the KOR and MOR. Molecular dynamics simulations revealed a key allosteric communication involving TM4, TM5, and ICL2. These compounds achieve their effects through interactions with residues E209<sup>ECL2</sup>, D223<sup>5.35</sup>, E297<sup>6.58</sup>, and K227<sup>5.39</sup>. These findings provide insight into the structural mechanisms of KOR signaling bias and inform the rational design of improved KOR therapeutics.

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