Höcker Jan, Paris Andrea, Scholz Jens, Tonner Peter H, Nielsen Martin, Bein Berthold
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
Anesthesiology. 2008 Jul;109(1):95-100. doi: 10.1097/ALN.0b013e31817c02fc.
Meperidine proved to be more effective in treatment of shivering than equianalgesic doses of other opioids, especially pure mu-agonists. Further, meperidine has well known nonopioid actions including agonistic effects at alpha2-adrenoceptors in vitro. Accordingly, the authors investigated nonopioid receptor-mediated effects of meperidine on thermoregulation using a mice model of nonshivering thermogenesis. To differentiate conceivable alpha2-adrenoceptor subtype specific interactions the authors analyzed wild-type mice and knock-out mice with deletion of the alpha2A-, alpha2B-, or alpha2C-adrenoceptor.
Ten mice per group (n = 60) were injected with saline, meperidine (20 mg/kg), saline plus naloxone (125 microg/kg), meperidine plus naloxone, fentanyl (50 microg/kg) plus naloxone, or meperidine plus atipamezole (2 mg/kg) intraperitoneally. Each mouse was subjected to the six different treatments. Then they were positioned into a plexiglas chamber where rectal temperature and mixed expired carbon dioxide were measured while whole body cooling was performed. Maximum response intensity and thermoregulatory threshold temperature of nonshivering thermogenesis were analyzed.
Meperidine decreased the thermoregulatory threshold temperature in wild-type mice and alpha2B- and alpha2C-adrenoceptor knock-out mice. This effect ended after injection of the alpha2-adrenoceptor antagonist atipamezole. In wild-type and alpha2B-adrenoceptor knock-out mice, the decrease of thermoregulatory threshold was not reversible by administration of the opioid receptor antagonist naloxone. In contrast, in alpha2A-adrenoceptor knock-out mice, no decline of thermoregulatory threshold following meperidine injection was detectable. Maximum response intensity of nonshivering thermogenesis was comparable in all groups.
The authors' results suggest a major role of alpha2-adrenoceptors, especially the alpha2A subtype, in the mediation of thermoregulatory effects caused by meperidine in mice.
事实证明,与等效镇痛剂量的其他阿片类药物(尤其是纯μ受体激动剂)相比,哌替啶在治疗寒颤方面更有效。此外,哌替啶具有众所周知的非阿片类作用,包括在体外对α2肾上腺素能受体的激动作用。因此,作者使用非寒颤性产热的小鼠模型研究了哌替啶对体温调节的非阿片类受体介导的作用。为了区分可能的α2肾上腺素能受体亚型特异性相互作用,作者分析了野生型小鼠以及α2A-、α2B-或α2C-肾上腺素能受体缺失的基因敲除小鼠。
每组10只小鼠(n = 60)腹腔注射生理盐水、哌替啶(20 mg/kg)、生理盐水加纳洛酮(125 μg/kg)、哌替啶加纳洛酮、芬太尼(50 μg/kg)加 纳洛酮或哌替啶加阿替美唑(2 mg/kg)。每只小鼠接受六种不同的处理。然后将它们放入一个有机玻璃室中,在进行全身冷却的同时测量直肠温度和呼出的混合二氧化碳。分析非寒颤性产热的最大反应强度和体温调节阈值温度。
哌替啶降低了野生型小鼠以及α2B-和α2C-肾上腺素能受体基因敲除小鼠的体温调节阈值温度。注射α2肾上腺素能受体拮抗剂阿替美唑后,这种作用结束。在野生型和α2B-肾上腺素能受体基因敲除小鼠中,给予阿片受体拮抗剂纳洛酮不能逆转体温调节阈值的降低。相反,在α2A-肾上腺素能受体基因敲除小鼠中,注射哌替啶后未检测到体温调节阈值的下降。所有组中非寒颤性产热的最大反应强度相当。
作者的结果表明,α2肾上腺素能受体,尤其是α2A亚型,在介导哌替啶对小鼠体温调节作用中起主要作用。