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April 30, 2026International Journal of Molecular Sciences0 citationsOpen Access

Structure-Guided Repurposing of Approved Drugs Identifies Aprepitant and Mavorixafor as Putative δ-Opioid Receptor Agonist Candidates

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RBRocco BuccheriCRC. RealeACAlessandro Coco

Key Points

  • This research aims to repurpose existing FDA-approved drugs as agonists for the delta-opioid receptor (DOR) to enhance pain management and neuroprotection.
  • Applied a structure-guided drug-repurposing workflow using docking protocols and an active-state DOR model.
  • Screened 2342 approved compounds, identifying 39 candidates with high binding affinities for further evaluation.
  • Conducted molecular dynamics simulations and binding pocket analyses to prioritize leading candidates.
  • Identified aprepitant and mavorixafor as leading candidates with submicromolar binding affinities.
  • Both drugs formed stable receptor-ligand complexes and maintained interactions with critical receptor sites.
  • Supported by favorable redocking scores on refined receptor conformations.

Abstract

δ-opioid receptor (DOR) is a promising therapeutic target for developing safer treatments for pain and neuroprotection. In this study, we applied a structure-guided drug-repurposing workflow to identify FDA-approved drugs with predicted DOR-binding and agonist-like structural features. Using a validated GNINA-based docking protocol with an active-state DOR model (PDB ID: 6PT3), we screened 2342 approved compounds and identified 39 candidates with predicted submicromolar binding affinities. These hits were further evaluated through molecular dynamics simulations, binding pocket volume analysis, and principal component analysis, which enabled the prioritization of two leading candidates, aprepitant and mavorixafor. Both compounds formed stable receptor-ligand complexes, maintained persistent interactions with Asp128, promoted contraction of the orthosteric pocket, and retained favorable redocking scores on the MD-refined receptor conformations. Overall, these results identify aprepitant and mavorixafor as promising putative DOR agonists and provide a rational foundation for their experimental validation through binding, functional, and in vivo pain studies in the future.

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Cite This Study

Buccheri et al. (2026) studied this question.

synapsesocial.com/papers/69f2f1dc1e5f7920c63878dfhttps://doi.org/10.3390/ijms27093823
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