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μ和κ阿片受体激动剂的镇痛作用及不良反应:吗啡与U50488-H的比较

Antinociceptive and adverse effects of mu- and kappa-opioid receptor agonists: a comparison of morphine and U50488-H.

作者信息

Gallantine Elizabeth L, Meert Theo F

机构信息

Johnson & Johnson Pharmaceutical Research and Development, Beerse, Belgium.

出版信息

Basic Clin Pharmacol Toxicol. 2008 Nov;103(5):419-27. doi: 10.1111/j.1742-7843.2008.00306.x. Epub 2008 Aug 11.

DOI:10.1111/j.1742-7843.2008.00306.x
PMID:18699797
Abstract

Although mu-opioids such as morphine are undoubtedly effective in the treatment of acute and postoperative pain, kappa-opioids are of interest for the modulation of visceral pain. In the present study, we compared a kappa-opioid agonist (U50488-H; 0.63-40 mg/kg) with a mu-opioid agonist (morphine; 0.63-40 mg/kg) in different pain models (tail withdrawal, writhing, formalin and plantar test) to represent acute, peritoneovisceral and inflammatory pain states in rats. The effects of the respective receptor agonists on gastrointestinal motility, muscle rigidity and abuse liability were also studied in appropriate animal models (charcoal, castor oil, rotarod and drug discrimination learning). Morphine was highly efficacious in all the nociceptive models employed, but also elicited a potent inhibition of gastric motility, caused severe muscle rigidity and locomotor disturbances and displayed a potential for abuse liability at the higher doses tested (> or =10 mg/kg morphine). In contrast, U50488-H was inactive in the tail withdrawal test, but was more effective in visceral and inflammatory pain settings. Although U50488-H did not elicit any gastrointestinal inhibition, a loss of muscle tone following administration of the compound led to detrimental effects on rotarod performance. The findings presented here indicate that kappa-opioids possess antinociceptive efficacy in visceral and inflammatory pain settings, but their administration can lead to a loss of muscle tone. In contrast, mu-opioids are highly active as analgesics against a range of nociceptive stimuli, but also concomitantly elicit strongly adverse effects.

摘要

尽管诸如吗啡之类的μ阿片类药物在治疗急性疼痛和术后疼痛方面无疑是有效的,但κ阿片类药物对于调节内脏疼痛具有重要意义。在本研究中,我们在不同的疼痛模型(甩尾、扭体、福尔马林和足底试验)中,将一种κ阿片类激动剂(U50488-H;0.63 - 40毫克/千克)与一种μ阿片类激动剂(吗啡;0.63 - 40毫克/千克)进行比较,以模拟大鼠的急性、腹膜内脏和炎性疼痛状态。还在适当的动物模型(活性炭、蓖麻油、转棒和药物辨别学习)中研究了各自受体激动剂对胃肠蠕动、肌肉强直和成瘾倾向的影响。吗啡在所采用的所有伤害性感受模型中都具有高效性,但也会强烈抑制胃蠕动,导致严重的肌肉强直和运动障碍,并且在较高测试剂量(≥10毫克/千克吗啡)时显示出成瘾倾向。相比之下,U50488-H在甩尾试验中无活性,但在内脏和炎性疼痛环境中更有效。尽管U50488-H未引起任何胃肠抑制,但该化合物给药后肌肉张力丧失对转棒试验表现产生了不利影响。此处呈现的研究结果表明,κ阿片类药物在内脏和炎性疼痛环境中具有抗伤害感受作用,但给药后会导致肌肉张力丧失。相比之下,μ阿片类药物作为针对一系列伤害性刺激的镇痛药具有高度活性,但同时也会引发强烈的不良反应。

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