Goldberg Joel S
Durham Veterans Affairs Medical Center and Duke University School of Medicine, Durham, NC, USA.
Perspect Medicin Chem. 2011;5:19-26. doi: 10.4137/PMC.S6803. Epub 2011 Jul 25.
Low molecular weight opioid peptide esters (OPE) could become a class of analgesics with different side effect profiles than current opiates. OPE may have sufficient plasma stability to cross the blood brain barrier (BBB), undergo ester hydrolysis and produce analgesia. OPE of dipeptides, tyr-pro and tyr-gly conjugated to ethanol have a structure similar to the anesthestic agent, etomidate. Based upon the analgesic activity of dipeptide opioids, Lipinski's criteria, and permeability of select GABA esters to cross the BBB, opioid peptides (OP) conjugated to ethanol, cholesterol or 3-glucose are lead recommendations. Preliminary animal data suggests that tyr-pro-ethyl ester crosses the BBB and unexpectedly produces hyperalgesia. Currently, there are no approved OP analgesics available for clinical use. Clinical trials of good manufacturing practice OP administered to patients suffering from chronic pain with indwelling intrathecal pumps could resolve the issue that OP may be superior to opiates and may redirect research.
低分子量阿片肽酯(OPE)可能会成为一类与目前阿片类药物副作用特征不同的镇痛药。OPE可能具有足够的血浆稳定性以穿过血脑屏障(BBB),发生酯水解并产生镇痛作用。与乙醇共轭的二肽tyr-pro和tyr-gly的OPE具有与麻醉剂依托咪酯相似的结构。基于二肽阿片类药物的镇痛活性、Lipinski规则以及特定GABA酯穿过BBB的通透性,与乙醇、胆固醇或3-葡萄糖共轭的阿片肽(OP)是主要推荐对象。初步动物数据表明,tyr-pro-乙酯穿过BBB并意外产生痛觉过敏。目前,尚无获批的可用于临床的OP镇痛药。对使用植入式鞘内泵治疗慢性疼痛的患者进行的优质生产规范OP的临床试验可能会解决OP可能优于阿片类药物这一问题,并可能重新引导研究方向。