Czapla Marc A, Zadina James E
Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70118, USA.
Brain Res. 2005 Oct 19;1059(2):159-66. doi: 10.1016/j.brainres.2005.08.020. Epub 2005 Oct 11.
Opioids are among the most effective analgesics, but a major limitation for their therapeutic usefulness is their induction of respiratory depression. Endomorphin-1 (EM1), in contrast to several other mu opioids, exhibits a threshold for respiratory depression that is well above its threshold for analgesia. Its effect on sensitivity to CO(2), however, remains unknown. Minute ventilation (V(E)) in 2, 4, and 6% CO(2) was measured before and after systemic administration of EM1, endomorphin-2 (EM2), DAMGO, and morphine in the conscious rat. EM1 and EM2 attenuated the hypercapnic ventilatory response (HCVR) only in high doses, while DAMGO and morphine diminished the HCVR in much lower doses. The ventilatory effects of high doses of all 4 agonists were blocked by the mu-opioid antagonist naloxone (0.4 mg/kg i.v.), but not by the peripherally restricted mu-opioid antagonist, methyl-naloxone (0.4 mg/kg i.v.). It was concluded that the endomorphins attenuated the HCVR only in large doses, well beyond the analgesic threshold, and did so through a centrally mediated mu-opioid mechanism.
阿片类药物是最有效的镇痛药之一,但其治疗效用的一个主要限制是会引发呼吸抑制。与其他几种μ阿片类药物不同,内吗啡肽-1(EM1)引发呼吸抑制的阈值远高于其镇痛阈值。然而,其对二氧化碳敏感性的影响尚不清楚。在清醒大鼠中,在全身给予EM1、内吗啡肽-2(EM2)、DAMGO和吗啡之前和之后,测量了2%、4%和6%二氧化碳条件下的分钟通气量(V(E))。EM1和EM2仅在高剂量时减弱高碳酸通气反应(HCVR),而DAMGO和吗啡在低得多的剂量时就减弱了HCVR。所有4种激动剂高剂量的通气作用均被μ阿片受体拮抗剂纳洛酮(0.4mg/kg静脉注射)阻断,但未被外周受限的μ阿片受体拮抗剂甲基纳洛酮(0.4mg/kg静脉注射)阻断。得出的结论是,内吗啡肽仅在远高于镇痛阈值的大剂量时减弱HCVR,并且是通过中枢介导的μ阿片机制实现的。