Estrous (menstrual) cycle and estrogens influence pain sensitivity and analgesic effectiveness of -opioid receptor (MOR)-selective opioids, e.g., our recent finding that the analgesia elicited in female rats by the intrathecal (i.t.) application of the endogenous MOR ligand endomorphin 2 (EM2) is dampened during diestrus but robust and comparable to that of males during proestrus. Uncovering the molecular bases for clamped spinal EM2 analgesia will reveal novel molecular targets for drug interventions that disinhibit, and thus harness, endogenous EM2 analgesia, lessening the use of prescription opioids, and thereby their abuse. The organizing rubric generating Aims is that the phasic nature of spinal EM2 analgesia over the estrous cycle results from the plasticity of interactions among spinal MOR, ?-opioid receptor (KOR), aromatase (Aro), membrane estrogen receptor ? (mER?), mGluRs and their associated signaling partners. The first three aims focus on the molecular components (and their organization) that regulate i.t. EM2 analgesia.
The fourth aim i nvestigates translational relevance of findings.
Aim 1 tests the hypothesis that during diestrus, spinal mER?-mGluR1 signaling, via phospholipase C and ??arrestin, dampens spinal EM2 analgesia.
Aim 2 tests the hypothesis that during proestrus, mER? and ??arrestin are no longer relevant to spinal EM2 analgesia; mGluR1 now organizes with mGluR2/3 to signal via c-Src, facilitating spinal dynorphin release, which enables robust spinal EM2 analgesia to emerge.
Aim 3 tests the hypothesis that spinal cord contains a novel modulatory oligomer comprised of MOR, KOR, Aro (thus locally synthesized estrogens), mER?, mGluR1 and mGluR2/3 that subserves the dynamic modulation of spinal EM2 analgesia over the estrous cycle.
Aim 3 also tests the hypothesis that variable activation of mER? (resulting from fluctuating spinal Aro activity, and thus the synthesis of estrogens immediately proximal to mER?) drives reorganization of the predicted oligomer in diestrus vs. proestrus.
Aim 4 tests the hypothesis that interventions shown in Aim 1 to restore spinal EM2 analgesia (e.g., blockade of spinal mER?, mGluR1, or phospholipase C) will be antinociceptive in diestrous rats undergoing chronic pain, which should augment the endogenous spinal EM2 system. Conversely, Aim 4 will also test the hypothesis that interventions shown in Aim 2 to eradicate spinal EM2 analgesia (e.g., blockade of spinal mGluR2/3, c-Src) will be pronociceptive in proestrous rats experiencing chronic pain. Collectively, proposed research will provide a new paradigm and suggest new molecular targets (e.g., the predicted oligomer, spinal ER?/Aro) for developing novel pharmacotherapies for pain relief that harnesses the powerful endogenous EM2/MOR analgesic system. Therapies that harness endogenous opioids would lessen the need for their exogenous counterparts, thereby circumventing prescription opioid abuse, which has reached epidemic proportions. Additionally, findings will provide insight into etiology of chronic pain in women, since dysfunction of the physiological switch from EM2 analgesically non-responsive to responsive states is likely to facilitate developing and/or sustaining chronic pain.

Public Health Relevance

Endomorphin 2 (EM2) is a naturally occurring potent opioid analgesic that is highly selective for mu-opioid receptors. In female rats, the analgesic effectiveness of EM2 varies over the estrous cycle (and presumably menstrual cycle in women), oscillating between barely detectable and robust (comparable to its analgesic potency in males). Uncovering the molecular bases for clamped spinal EM2 analgesia will reveal novel drug targets for a precision medicine approach for harnessing endogenous EM2 analgesia to manage acute pain (in both sexes) as well as chronic pain (more severe and prevalent in women than men), lessening the need for prescription opioids and thus the current epidemic of prescription opioid abuse.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
Project #
Application #
Study Section
Somatosensory and Chemosensory Systems Study Section (SCS)
Program Officer
Tsai, Shang-Yi Anne
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Suny Downstate Medical Center
Obstetrics & Gynecology
Schools of Medicine
United States
Zip Code