Exploiting the angiotensin-converting enzyme pathway to augment endogenous opioid signaling

Angiotensin Converting Enzyme (ACE) impacts hemodynamics by regulating the conversion of angiotensin I to the vasoconstricting angiotensin II. We recently identified a non-canonical central role of ACE in the degradation of enkephalin heptapeptide, Met-enkephalin-Arg-Phe (MERF). Enkephalins are short-lived, endogenous opioid peptides that mediate the body's intrinsic analgesic response. Here we identify chemically diverse ACE inhibitors using an optimized high throughput screening assay to boost endogenous opioid signaling. Our primary hits (thiorphan, D609, and raloxifene) were selected for dose-response characterization, in vitro enkephalin release, in vivo analgesic potency, and in silico analysis. Intracerebroventricular administration of these compounds significantly attenuated pain response, alone and in combination with MERF, which was reversed by opioid receptor antagonist naloxone. Molecular docking provided additional insight into the active site interactions of these scaffolds, which could be exploited further for creation of more potent inhibitors. These results showcase the potential of central ACE inhibitors to modulate endogenous MERF signaling.