The sigma-1 receptor (σ
1R), one of two
sigma receptor
Sigma receptors (σ-receptors) are protein receptors that bind ligands such as 4-PPBP (4-phenyl-1-(4-phenylbutyl) piperidine), SA 4503 (cutamesine), ditolylguanidine, dimethyltryptamine, and siramesine. There are two subtypes, sigma-1 rec ...
subtypes, is a
chaperone protein at the
endoplasmic reticulum
The endoplasmic reticulum (ER) is a part of a transportation system of the eukaryote, eukaryotic cell, and has many other important functions such as protein folding. The word endoplasmic means "within the cytoplasm", and reticulum is Latin for ...
(ER) that modulates
calcium signaling through the
IP3 receptor.
In humans, the σ
1 receptor is encoded by the ''SIGMAR1''
gene
In biology, the word gene has two meanings. The Mendelian gene is a basic unit of heredity. The molecular gene is a sequence of nucleotides in DNA that is transcribed to produce a functional RNA. There are two types of molecular genes: protei ...
.
The σ
1 receptor is a
transmembrane protein
A transmembrane protein is a type of integral membrane protein that spans the entirety of the cell membrane. Many transmembrane proteins function as gateways to permit the transport of specific substances across the membrane. They frequently un ...
expressed in many different tissue types. It is particularly concentrated in certain regions of the central nervous system.
It has been implicated in several phenomena, including cardiovascular function,
schizophrenia
Schizophrenia () is a mental disorder characterized variously by hallucinations (typically, Auditory hallucination#Schizophrenia, hearing voices), delusions, thought disorder, disorganized thinking and behavior, and Reduced affect display, f ...
,
clinical depression
Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Intro ...
, the effects of
cocaine
Cocaine is a tropane alkaloid and central nervous system stimulant, derived primarily from the leaves of two South American coca plants, ''Erythroxylum coca'' and ''Erythroxylum novogranatense, E. novogranatense'', which are cultivated a ...
abuse,
bipolar disorder
Bipolar disorder (BD), previously known as manic depression, is a mental disorder characterized by periods of Depression (mood), depression and periods of abnormally elevated Mood (psychology), mood that each last from days to weeks, and in ...
, and cancer.
Much is known about the binding affinity of hundreds of synthetic compounds to the σ
1 receptor.
An endogenous
ligand
In coordination chemistry, a ligand is an ion or molecule with a functional group that binds to a central metal atom to form a coordination complex. The bonding with the metal generally involves formal donation of one or more of the ligand's el ...
for the σ
1 receptor has yet to be conclusively identified, but
tryptamine
Tryptamine is an indolamine metabolite of the essential amino acid tryptophan. The chemical structure is defined by an indole—a fused benzene and pyrrole ring, and a 2-aminoethyl group at the second carbon (third aromatic atom, with the firs ...
rgic
trace amine
Trace amines are an endogenous group of trace amine-associated receptor 1 (TAAR1) agonists – and hence, monoaminergic neuromodulators – that are structurally and metabolically related to classical monoamine neurotransmitters. Compared to ...
s and
neuroactive steroid
Neurosteroids, also known as neuroactive steroids, are endogenous or exogenous steroids that rapidly alter neuronal excitability through interaction with ligand-gated ion channels and other cell surface receptors. The term ''neurosteroid'' was coi ...
s have been found to activate the receptor. Especially
progesterone
Progesterone (; P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the ma ...
, but also
testosterone
Testosterone is the primary male sex hormone and androgen in Male, males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testicles and prostate, as well as promoting se ...
,
pregnenolone sulfate,
N,N-dimethyltryptamine
Dimethyltryptamine (DMT), also known as ''N'',''N''-dimethyltryptamine (''N'',''N''-DMT), is a serotonergic hallucinogen and investigational drug of the tryptamine family that occurs naturally in many plants and animals, including humans. ...
(DMT) and
dehydroepiandrosterone sulfate
Dehydroepiandrosterone sulfate, abbreviated as DHEA sulfate or DHEA-S, also known as androstenolone sulfate, is an endogenous androstane steroid that is produced by the adrenal cortex. It is the 3β-sulfate ester and a metabolite of dehydroepia ...
(DHEA-S) bind to the σ
1 receptor.
Structure
The mammalian σ
1 receptor is an integral membrane protein composed of 223
amino acid
Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although over 500 amino acids exist in nature, by far the most important are the 22 α-amino acids incorporated into proteins. Only these 22 a ...
s.
Despite being found in mammals, it shows no sequence homology to other mammalian proteins. However, it shares 30% sequence identity and 69% similarity with the ERG2 gene product of yeast, a C8–C7 sterol
isomerase
In biochemistry, isomerases are a general class of enzymes that convert a molecule from one isomer to another. Isomerases facilitate intramolecular rearrangements in which chemical bond, bonds are Bond cleavage, broken and formed. The general form ...
involved in the
ergosterol
Ergosterol (ergosta-5,7,22-trien-3β-ol) is a mycosterol found in cell membranes of fungi and protozoa, serving many of the same functions that cholesterol serves in animal cells. Because many fungi and protozoa cannot survive without ergostero ...
biosynthesis pathway. Hydropathy analysis reveals three
hydrophobic
In chemistry, hydrophobicity is the chemical property of a molecule (called a hydrophobe) that is seemingly repelled from a mass of water. In contrast, hydrophiles are attracted to water.
Hydrophobic molecules tend to be nonpolar and, thu ...
regions within the σ
1 receptor.
A crystal structure of the human σ
1 receptor was first published in 2016.
The sigma-1 receptor is a small, unique integral membrane protein predominantly localized to the
endoplasmic reticulum
The endoplasmic reticulum (ER) is a part of a transportation system of the eukaryote, eukaryotic cell, and has many other important functions such as protein folding. The word endoplasmic means "within the cytoplasm", and reticulum is Latin for ...
(ER). It is structurally distinct from all other known mammalian proteins. High-resolution crystal structures have shown that the receptor forms a homotrimer, with each protomer consisting of a single
N-terminal
The N-terminus (also known as the amino-terminus, NH2-terminus, N-terminal end or amine-terminus) is the start of a protein or polypeptide, referring to the free amine group (-NH2) located at the end of a polypeptide. Within a peptide, the amin ...
transmembrane helix, a
cupin-like
β-barrel
In protein structures, a beta barrel (β barrel) is a beta sheet (β sheet) composed of Protein tandem repeats, tandem repeats that twists and coils to form a closed toroidal structure in which the first strand is bonded to the last strand (hydrog ...
domain that contains the ligand-binding site, and a
C-terminal
The C-terminus (also known as the carboxyl-terminus, carboxy-terminus, C-terminal tail, carboxy tail, C-terminal end, or COOH-terminus) is the end of an amino acid chain (protein or polypeptide), terminated by a free carboxyl group (-COOH). When t ...
V-shaped two-helix bundle that functions as a lid over this pocket.
The ligand-binding pocket is highly conserved and predominantly
hydrophobic
In chemistry, hydrophobicity is the chemical property of a molecule (called a hydrophobe) that is seemingly repelled from a mass of water. In contrast, hydrophiles are attracted to water.
Hydrophobic molecules tend to be nonpolar and, thu ...
, shielded from the aqueous environment. Key residues such as Glu172 and Asp126 play crucial roles in coordinating ligand interactions.
This structural organization enables the receptor to bind a wide variety of ligands and interact with multiple effector proteins. Conformational changes in the β-barrel domain and the helical lid are believed to regulate ligand access and receptor activation.
The receptor's architecture supports its function as a chaperone and modulator of numerous intracellular signaling pathways.
Function
A variety of specific physiological functions have been attributed to the σ
1 receptor. Chief among these are modulation of Ca
2+ release, modulation of cardiac
myocyte
A muscle cell, also known as a myocyte, is a mature contractile Cell (biology), cell in the muscle of an animal. In humans and other vertebrates there are three types: skeletal muscle, skeletal, smooth muscle, smooth, and Cardiac muscle, cardiac ...
contractility, and inhibition of
voltage gated K+ channels.
The reasons for these effects are not well understood, even though σ
1 receptors have been linked circumstantially to a wide variety of signal transduction pathways. Links between σ
1 receptors and G-proteins have been suggested such as σ
1 receptor antagonists showing GTP-sensitive high-affinity binding; there is also, however, some evidence against a G-protein coupled hypothesis.
The σ
1 receptor has been shown to appear in a complex with voltage gated K
+ channels (K
v1.4 and K
v1.5), leading to the idea that σ
1 receptors are auxiliary subunits.
σ
1 receptors apparently co-localize with
IP3 receptors on the
endoplasmic reticulum
The endoplasmic reticulum (ER) is a part of a transportation system of the eukaryote, eukaryotic cell, and has many other important functions such as protein folding. The word endoplasmic means "within the cytoplasm", and reticulum is Latin for ...
where they may be involved in preventing endoplasmic reticulum stress in neurodegenerative diseases.
Also, σ
1 receptors have been shown to appear in galactoceramide enriched domains at the endoplasmic reticulum of mature
oligodendrocytes.
The wide scope and effect of ligand binding on σ
1 receptors has led some to believe that σ
1 receptors are intracellular signal transduction amplifiers.
Recently, σ
1R has been implicated in
autophagosome formation
and maturation.
Autophagy
Autophagy (or autophagocytosis; from the Greek language, Greek , , meaning "self-devouring" and , , meaning "hollow") is the natural, conserved degradation of the cell that removes unnecessary or dysfunctional components through a lysosome-depe ...
is a broad homeostatic, metabolic, cytoplasmic quality control, and metabolic process affecting many functions in the cell. σ
1R is targeted by the nsp6 protein of
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the Novel coronavirus, provisional nam ...
to inhibit autophagosome formation
as a process competing with the
coronavirus
Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. Mild illnesses in humans include some cases of the comm ...
for cellular
endomembranes that the virus needs for its own replication. This along with the observed beneficial effects of sigma-1 receptor agonist and SSRI fluvoxamine in patients with SARS-COV-2 infection has led to the hypothesis that the sigma-1 receptor could be a target for the treatment of SARS-COV-2.
Pharmacology
The σ
1 receptor is defined by its unique pharmacological profile. In 1976 Martin reported that the effects of
N-allylnormetazocine (SKF-10,047) could not be due to activity at the μ and κ receptors (named from the first letter of their selective ligands
morphine
Morphine, formerly also called morphia, is an opiate that is found naturally in opium, a dark brown resin produced by drying the latex of opium poppies (''Papaver somniferum''). It is mainly used as an analgesic (pain medication). There are ...
and
ketazocine
Ketazocine ( INN), also known as ketocyclazocine, is a benzomorphan derivative used in opioid receptor research. Ketazocine, for which the receptor is named, is an exogenous opioid that binds to the κ opioid receptor.
Activation of this rec ...
, respectively) and a new type of
opioid receptor
Opioid receptors are a group of inhibitory G protein-coupled receptors with opioids as ligands. The endogenous opioids are dynorphins, enkephalins, endorphins, endomorphins and nociceptin. The opioid receptors are ~40% identical to somatostati ...
was proposed; σ (from the first letter of SKF-10,047).
The opioid classification was eventually dropped however resulting from it not possessing the canonical opioid G-protein coupled receptor structure and the receptor was later referred to as simply the σ
1 receptor. It was found to have affinity for the (+)-
stereoisomers
In stereochemistry, stereoisomerism, or spatial isomerism, is a form of isomerism in which molecules have the same molecular formula and sequence of bonded atoms (constitution), but differ in the three-dimensional orientations of their atoms i ...
of several
benzomorphans (''e.g.'', (+)-
pentazocine and (+)-
cyclazocine), as well as various structurally and pharmacologically distinct psychoactive chemicals such as
haloperidol
Haloperidol, sold under the brand name Haldol among others, is a typical antipsychotic medication. Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, delirium, agitation, acute psychos ...
(which irreversibly blocks this receptor) and
cocaine
Cocaine is a tropane alkaloid and central nervous system stimulant, derived primarily from the leaves of two South American coca plants, ''Erythroxylum coca'' and ''Erythroxylum novogranatense, E. novogranatense'', which are cultivated a ...
, and
neuroactive steroid
Neurosteroids, also known as neuroactive steroids, are endogenous or exogenous steroids that rapidly alter neuronal excitability through interaction with ligand-gated ion channels and other cell surface receptors. The term ''neurosteroid'' was coi ...
s like
progesterone
Progesterone (; P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the ma ...
.
Pharmacological studies with σ
1 agonists often follow a bell-shaped dose-response curve.
Thus care should be taken when designing experiments and choosing doses of ligands.
Ligands
The following ligands have high affinity for the σ
1 receptor and possess high binding selectivity over the subtype σ
2:
Agonists
*
Amantadine
Amantadine, sold under the brand name Gocovri among others, is a medication used to treat dyskinesia associated with parkinsonism and influenza caused by type A influenzavirus, though its use for the latter is no longer recommended because ...
*
Amitriptyline
Amitriptyline, sold under the brand name Elavil among others, is a tricyclic antidepressant primarily used to treat major depressive disorder, and a variety of pain syndromes such as neuropathic pain, fibromyalgia, migraine and tension headac ...
*
Blarcamesine
*
Citalopram
Citalopram, sold under the brand name Celexa among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used to treat major depressive disorder, obsessive compulsive disorder, panic disorder, and soci ...
*
Cocaine
Cocaine is a tropane alkaloid and central nervous system stimulant, derived primarily from the leaves of two South American coca plants, ''Erythroxylum coca'' and ''Erythroxylum novogranatense, E. novogranatense'', which are cultivated a ...
*
Cutamesine
*
Dextromethorphan
Dextromethorphan, sold under the brand name Robitussin among others, is a cough suppressant used in many cough and Common cold, cold medicines. In 2022, the US Food and Drug Administration (FDA) approved the combination dextromethorphan/bupropi ...
*
Dimethoxanate
*
Dimethyltryptamine
Dimethyltryptamine (DMT), also known as ''N'',''N''-dimethyltryptamine (''N'',''N''-DMT), is a Psychedelic drug, serotonergic hallucinogen and Investigational New Drug, investigational drug of the substituted tryptamine, tryptamine family tha ...
*
Dipentylamine and its hydrochloride salt (dipentylammonium chloride)
*
Donepezil
Donepezil, sold under the brand name Aricept among others, is a medication used to treat dementia of the Alzheimer's type. It appears to result in a small benefit in mental function and ability to function. Use, however, has not been shown to ...
*
Fabomotizole
*
Fluoxetine
Fluoxetine, sold under the brand name Prozac, among others, is an Antidepressant, antidepressant medication of the selective serotonin reuptake inhibitor (SSRI) class used for the treatment of major depressive disorder, Anxiety disorder, anx ...
*
Fluvoxamine
Fluvoxamine, sold under the brand name Luvox among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is primarily used to treat major depressive disorder and, perhaps more-especially, obsessive–compu ...
*
L-687,384
*
Methamphetamine
Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug use, recreational or Performance-enhancing substance, performance-enhancing drug and less commonly as a secon ...
*
Opipramol
* (+)-
Pentazocine (the "unnatural"
enantiomer
In chemistry, an enantiomer (Help:IPA/English, /ɪˈnænti.əmər, ɛ-, -oʊ-/ Help:Pronunciation respelling key, ''ih-NAN-tee-ə-mər''), also known as an optical isomer, antipode, or optical antipode, is one of a pair of molecular entities whi ...
, which lacks affinity for the
μ-opioid and
κ-opioid receptors.)
*
Pipazetate
*
Pitolisant
Pitolisant, sold under the brand name Wakix among others, is a medication used for the treatment of excessive daytime sleepiness in adults with narcolepsy. It is an inverse agonist of the histamine H3 receptor. It represents the first commerc ...
*
PRE-084
Antagonists
*
BD 1047
*
LMH-2
*
FTC-146
*
Sertraline
Sertraline, sold under the brand name Zoloft among others, is an Antidepressant, antidepressant medication of the selective serotonin reuptake inhibitor (SSRI) class used to treat major depressive disorder, generalized anxiety disorder, socia ...
*
S1RA (E-52862)
*
NE-100
NE-100 or 4-methoxy-3-(2-phenylethoxy)-N,N-dipropylbenzeneethanamine is a selective sigma-1 receptor antagonist, with a reported binding affinity of ''K''i = 1.03 ± 0.01 nM, and more than 205 times selectivity over the sigma-2 receptor.
NE-100 ...
*
WQ-1
* 1-benzyl-6′-methoxy-6′,7′-dihydrospiro
iperidine-4,4′-thieno[3.2-''c''yran">.2-''c''.html" ;"title="iperidine-4,4′-thieno[3.2-''c''">iperidine-4,4′-thieno[3.2-''c''yran putative antagonist, selective against 5-HT
1A, 5-HT
6, 5-HT
7, α
1A and α
2 adrenergic, and NMDA receptors
Positive allosteric modulators (PAMs)
* Methylphenylpiracetam
* SOMCL-668
Uncategorized
* Clorgiline
*
D-Deprenyl
*
PD 144418
*
RHL-033
*
Selegiline
Selegiline, also known as L-deprenyl and sold under the brand names Eldepryl, Zelapar, and Emsam among others, is a medication which is used in the treatment of Parkinson's disease and major depressive disorder. It has also been studied and us ...
* 4-IPBS
*
Spipethiane
* (−)-(''S'')-4-methyl-1-
-(4-chlorophenoxy)-1-methylethyliperidine
* 1'-
4-fluorophenyl)methylpiro
''H''-isobenzofuran-3,4'-piperidineref name="pmid19394833">
* 1'-benzyl-6-methoxy-1-phenyl-spiro
''H''-furo[3,4-''c''yrazole-4,4'-piperidine">,4-''c''.html" ;"title="''H''-furo[3,4-''c''">''H''-furo[3,4-''c''yrazole-4,4'-piperidineref name="pmid18221879">
* 3-1-[(4-chlorophenyl)methyl]-4-piperidyl]methyl]-1,3-benzoxazol-2-one: very high affinity and subtype selectivity
Agents exist that have high σ
1 affinity but either lack subtype selectivity or have high affinity at other binding sites, thus being more or less
dirty/multifunctional, like
haloperidol
Haloperidol, sold under the brand name Haldol among others, is a typical antipsychotic medication. Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, delirium, agitation, acute psychos ...
. Furthermore, there is a wide range of agents with an at least moderate σ
1 involvement in their binding profile.
Clinical significance
Mutation
In biology, a mutation is an alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA. Viral genomes contain either DNA or RNA. Mutations result from errors during DNA or viral replication, ...
s in the ''SIGMAR1'' gene have been associated with
distal spinal muscular atrophy type 2.
There has been much interest in the sigma-1 receptor and its role in age-related neurodegenerative diseases such as
Alzheimer's disease
Alzheimer's disease (AD) is a neurodegenerative disease and the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems wit ...
. During healthy ageing, the density of sigma-1 receptors has been to increase. However, in diseases such as
Alzheimer's disease
Alzheimer's disease (AD) is a neurodegenerative disease and the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems wit ...
, there appears to be a reduction in sigma-1 receptor expression. It has been suggested that targeting the sigma-1 receptor along with other receptors could increase neuron survival and function in neurodegenerative disease.
The activation of autophagy has also been suggested as a downstream mechanism linked to sigma-1 receptor activation.
As a drug target
(Sig-1R) has emerged as a promising therapeutic strategy across multiple neurological, psychiatric, and degenerative conditions. The receptor’s role as a molecular chaperone at the endoplasmic reticulum (ER)-mitochondria interface and its modulation of calcium signaling, neurotransmitter systems, and cellular stress responses underpin its therapeutic potential.
Sig-1R ligands show efficacy in preclinical models of
depression,
anxiety
Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
, and
schizophrenia
Schizophrenia () is a mental disorder characterized variously by hallucinations (typically, Auditory hallucination#Schizophrenia, hearing voices), delusions, thought disorder, disorganized thinking and behavior, and Reduced affect display, f ...
. Antidepressants like
fluvoxamine
Fluvoxamine, sold under the brand name Luvox among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is primarily used to treat major depressive disorder and, perhaps more-especially, obsessive–compu ...
and
sertraline
Sertraline, sold under the brand name Zoloft among others, is an Antidepressant, antidepressant medication of the selective serotonin reuptake inhibitor (SSRI) class used to treat major depressive disorder, generalized anxiety disorder, socia ...
act partly through Sig-1R agonism, enhancing synaptic plasticity and restoring excitatory/inhibitory balance.
Clinical trials with selective agonists (e.g.,
SA4503,
pridopidine) have demonstrated mixed results, but the receptor remains a focus for developing fast-acting antidepressants.
In
amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) or—in the United States—Lou Gehrig's disease (LGD), is a rare, Terminal illness, terminal neurodegenerative disease, neurodegenerative disorder that results i ...
(ALS), Sig-1R agonists (PRE-084, SA4503) improve motor function and motoneuron survival in animal models by modulating ER stress and autophagy.
Similarly, Sig-1R activation shows neuroprotective effects in Alzheimer’s and Parkinson’s models, potentially slowing disease progression.
Despite setbacks in clinical trials (e.g., igmesine for depression), the receptor’s broad regulatory roles continue to drive drug discovery, with candidates like ANAVEX2-73 and T-817MA in development for cognitive disorders.
Knockout mice
σ
1 receptor
knockout mice
A knockout mouse, or knock-out mouse, is a genetically modified mouse (''Mus musculus'') in which researchers have inactivated, or " knocked out", an existing gene by replacing it or disrupting it with an artificial piece of DNA. They are importan ...
were created in 2003 to study the effects of endogenous
DMT. Strangely, the mice demonstrated no overt phenotype.
As expected, however, they did lack locomotor response to the σ ligand (+)-SKF-10,047 and displayed reduced response to formalin induced pain. Speculation has focused on the ability of other receptors in the σ family (''e.g.'', σ
2, with similar binding properties) to compensate for the lack of σ
1 receptor.
See also
*
Sigma-2 receptor
The sigma-2 receptor (σ2R) is a sigma receptor subtype that has attracted attention due to its involvement in diseases such as neurological diseases, neurodegenerative, neuro-ophthalmic and cancer. It is currently under investigation for its ...
References
57. Déciga-Campos M, Melo-Hernández LA, Torres-Gómez H, Wünsch B, Schepmann D, González-Trujano ME, Espinosa-Juárez J, López-Muñoz FJ, Navarrete-Vázquez G. Design and synthesis of N‑(benzylpiperidinyl)‑4‑fluorobenzamide: A haloperidol analog that reduces neuropathic nociception via σ1 receptor antagonism. Life Sci. 2020 Mar 15;245:117348. doi: 10.1016/j.lfs.2020.117348. Epub 2020 Jan 23. PMID: 31981633.
External links
*
*
*
{{Sigma receptor modulators