7-hydroxymitragynine is an active metabolite of mitragynine and a key mediator of its analgesic effects Journal Article


Authors: Kruegel, A. C.; Uprety, R.; Grinnell, S. G.; Langreck, C.; Pekarskaya, E. A.; Le Rouzic, V.; Ansonoff, M.; Gassaway, M. M.; Pintar, J. E.; Pasternak, G. W.; Javitch, J. A.; Majumdar, S.; Sames, D.
Article Title: 7-hydroxymitragynine is an active metabolite of mitragynine and a key mediator of its analgesic effects
Abstract: Mitragyna speciosa, more commonly known as kratom, is a plant native to Southeast Asia, the leaves of which have been used traditionally as a stimulant, analgesic, and treatment for opioid addiction. Recently, growing use of the plant in the United States and concerns that kratom represents an uncontrolled drug with potential abuse liability, have highlighted the need for more careful study of its pharmacological activity. The major active alkaloid found in kratom, mitragynine, has been reported to have opioid agonist and analgesic activity in vitro and in animal models, consistent with the purported effects of kratom leaf in humans. However, preliminary research has provided some evidence that mitragynine and related compounds may act as atypical opioid agonists, inducing therapeutic effects such as analgesia, while limiting the negative side effects typical of classical opioids. Here we report evidence that an active metabolite plays an important role in mediating the analgesic effects of mitragynine. We find that mitragynine is converted in vitro in both mouse and human liver preparations to the much more potent mu-opioid receptor agonist 7-hydroxymitragynine and that this conversion is mediated by cytochrome P450 3A isoforms. Further, we show that 7-hydroxymitragynine is formed from mitragynine in mice and that brain concentrations of this metabolite are sufficient to explain most or all of the opioid-receptor-mediated analgesic activity of mitragynine. At the same time, mitragynine is found in the brains of mice at very high concentrations relative to its opioid receptor binding affinity, suggesting that it does not directly activate opioid receptors. The results presented here provide a metabolism-dependent mechanism for the analgesic effects of mitragynine and clarify the importance of route of administration for determining the activity of this compound. Further, they raise important questions about the interpretation of existing data on mitragynine and highlight critical areas for further research in animals and humans. © 2019 American Chemical Society.
Keywords: brain; binding energy; mammals; biomolecules; analgesic activity; plants (botany); metabolites; opioid receptors; related compounds; active metabolites; mitragyna speciosa; negative side effects; pharmacological activity; therapeutic effects
Journal Title: ACS Central Science
Volume: 5
Issue: 6
ISSN: 2374-7943
Publisher: American Chemical Society  
Date Published: 2019-06-26
Start Page: 992
End Page: 1001
Language: English
DOI: 10.1021/acscentsci.9b00141
PROVIDER: scopus
PMCID: PMC6598159
PUBMED: 31263758
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Gavril W Pasternak
    414 Pasternak
  2. Rajendra Uprety
    16 Uprety