Fentanyl-Rewired: A 2-Azaspiro[3.3]heptane Core Preserves μ-Opioid Function

High Resolution Image Download MS PowerPoint Slide Fentanyl is a benchmark μ-opioid analgesic but is constrained by respiratory risk. Searching for new entities with reduced respiratory liability, pharmacophore portability was probed by replacing the piperidine moiety with 2-azaspiro[3.3]heptane while preserving phenethyl/anilide geometry. This spiro analogue retained fentanyl-class behavior─μ-opioid receptor (MOR)-preferred binding (MOR > κ-opioid receptor (KOR) ≫ δ-opioid receptor (DOR)), absent β-arrestin-2 recruitment, and full hot-plate/tail-flick antinociception─despite ∼10 2 -fold right-shift in potency versus fentanyl. In mice, it was stable and short-acting with a serum half-life of ∼27 min after an intravenous bolus dose. Whole-body plethysmography showed rapid, dose-dependent depression of respiration that was evident only at high doses. In sum, these studies present a topology-level core swap; preserving the fentanyl signature while decoupling potency from exposure, mapping the pharmacophore’s boundary conditions and providing an actionable, spiro-enabled blueprint to tune MOR signaling and disposition─and recover affinity via structure–activity relationship (SAR)─for next-generation opioid leads.