Opioid-Induced Respiratory Depression: From Mechanisms to Therapeutic Strategies

Opioid-induced respiratory depression (OIRD) remains one of the most life-threatening adverse effects of opioid analgesics, representing a major clinical and public health concern worldwide. Despite decades of opioid use in pain management, palliative care, and anesthesia, the precise molecular and neurophysiological mechanisms underlying OIRD are still incompletely understood, and safe, effective countermeasures remain limited.This Research Topic aims to bring together cutting-edge research on the pharmacology of OIRD, spanning from molecular receptor biology to clinical interventions. It will address the complex interplay between opioid receptor signaling, brainstem respiratory control centers, peripheral chemoreceptors, and individual vulnerability factors, including genetics, sex, age, sleep-disordered breathing, and comorbidities.Topics of interest include, but are not limited to:- Molecular mechanisms of µ-, κ-, δ-opioid receptor and NOP receptor signaling in respiratory control- Brainstem circuits involved in opioid-induced respiratory rhythm disruption (Pre-Bötzinger complex and beyond)- Peripheral vs. central contributions to OIRD- Biased agonism and the development of safer opioids with reduced respiratory side effects- Tolerance and sensitization in OIRD following chronic opioid exposure- Pharmacokinetics and pharmacodynamics of opioids in the respiratory system- Drug interactions potentiating respiratory depression (benzodiazepines, gabapentinoids, alcohol, SSRIs, anti-epileptics)- Reversal strategies: naloxone pharmacology, novel agnostic antagonists, and emerging rescue therapies- Non-opioid alternatives for pain management to reduce OIRD risk- Sleep and circadian factors modulating susceptibility to OIRD- Genetic and sex-based variability in opioid respiratory sensitivity- Neonatal and pediatric opioid-induced respiratory depression- Animal models of OIRD: translational relevance and limitations- Clinical monitoring and detection technologies for respiratory depression- Simulation models for better understanding opioid-induced respiratory depression and reversal strategiesTopic Editor Dr. Albert Dahan is CEO of MediD Consultancy BV. Topic Editor Dr. Ying-Xian Pan is Co-Scientific Founder of Sparian Biosciences. Topic editors: Ying-Xian Pan, Erica S Levitt, Albert Dahan, George Blike Source: https://www.frontiersin.org/research-topics/82798/opioid-induced-respiratory-depression-from-mechanisms-to-therapeutic-strategies