The genesis of designing
bivalent or bitopic molecules that engender
unique pharmacological properties began with Portoghese’s work
directed toward opioid receptors, in the early 1980s. This strategy
has evolved as an attractive way to engineer highly selective compounds
for targeted G-protein coupled receptors (GPCRs) with optimized efficacies
and/or signaling bias. The emergence of X-ray crystal structures of
many GPCRs and the identification of both orthosteric and allosteric
binding sites have provided further guidance to ligand drug design
that includes a primary pharmacophore (PP), a secondary pharmacophore
(SP), and a linker between them. It is critical to note the synergistic
relationship among all three of these components as they contribute
to the overall interaction of these molecules with their receptor
proteins and that strategically designed combinations have and will
continue to provide the GPCR molecular tools of the future.