Ligand binding is an
equilibrium process. Ligands bind to receptors and dissociate from them according to the
law of mass action in the following equation, for a ligand L and receptor, R. The brackets around chemical species denote their concentrations. : {[\ce{L}] + [\ce{R}] \ce{[{K_d}]} [\text{LR}]} One measure of how well a molecule fits a receptor is its binding affinity, which is inversely related to the
dissociation constant Kd. A good fit corresponds with high affinity and low
Kd. The final biological response (e.g.
second messenger cascade, muscle-contraction), is only achieved after a significant number of receptors are activated. Affinity is a measure of the tendency of a ligand to bind to its receptor. Efficacy is the measure of the bound ligand to activate its receptor.
Agonists versus antagonists Not every ligand that binds to a receptor also activates that receptor. The following classes of ligands exist: •
(Full) agonists are able to activate the receptor and result in a strong biological response. The natural
endogenous ligand with the greatest
efficacy for a given receptor is by definition a full agonist (100% efficacy). •
Partial agonists do not activate receptors with maximal efficacy, even with maximal binding, causing partial responses compared to those of full agonists (efficacy between 0 and 100%). •
Antagonists bind to receptors but do not activate them. This results in a receptor blockade, inhibiting the binding of agonists and inverse agonists. Receptor antagonists can be competitive (or reversible), and compete with the agonist for the receptor, or they can be irreversible antagonists that form
covalent bonds (or extremely high affinity non-covalent bonds) with the receptor and completely block it. The proton pump inhibitor
omeprazole is an example of an irreversible antagonist. The effects of irreversible antagonism can only be reversed by synthesis of new receptors. •
Inverse agonists reduce the activity of receptors by inhibiting their constitutive activity (negative efficacy). •
Allosteric modulators: They do not bind to the agonist-binding site of the receptor but instead on specific allosteric binding sites, through which they modify the effect of the agonist. For example,
benzodiazepines (BZDs) bind to the BZD site on the
GABAA receptor and potentiate the effect of endogenous GABA. Note that the idea of receptor agonism and antagonism only refers to the interaction between receptors and ligands and not to their biological effects.
Constitutive activity A receptor which is capable of producing a biological response in the absence of a bound ligand is said to display "constitutive activity". The constitutive activity of a receptor may be blocked by an
inverse agonist. The anti-obesity drugs
rimonabant and
taranabant are inverse agonists at the cannabinoid
CB1 receptor and though they produced significant weight loss, both were withdrawn owing to a high incidence of depression and anxiety, which are believed to relate to the inhibition of the constitutive activity of the cannabinoid receptor. The
GABAA receptor has constitutive activity and conducts some basal current in the absence of an agonist. This allows
beta carboline to act as an inverse agonist and reduce the current
below basal levels. Mutations in receptors that result in increased constitutive activity underlie some inherited diseases, such as
precocious puberty (due to mutations in luteinizing hormone receptors) and
hyperthyroidism (due to mutations in thyroid-stimulating hormone receptors). == Theories of drug-receptor interaction ==