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白血病抑制因子(LIF)增强阿片类药物的镇痛活性并抑制其耐受的诱导。

Leukemia inhibitory factor (LIF) potentiates antinociception activity and inhibits tolerance induction of opioids.

机构信息

Pharmacological Institute, College of Medicine, National Taiwan University, No.1, Sec.1, Jen-Ai Road, Taipei 100, Taiwan.

Department of Neurology, National Taiwan University Hospital, No. 7, Chung-Shan S. Road, Taipei 100, Taiwan.

出版信息

Br J Anaesth. 2016 Oct;117(4):512-520. doi: 10.1093/bja/aew247. Epub 2016 Oct 17.

Abstract

BACKGROUND

The efficacy of opioids typically decreases after long-term use owing to the development of tolerance. Glial activation and the upregulation of proinflammatory cytokines are related to the induction of tolerance. We investigated the effect of leukemia inhibitory factor (LIF) on morphine analgesia and tolerance.

METHODS

LIF concentrations in rat spinal cords were measured by polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) after morphine administration. LIF distribution was examined using confocal microscopy. To evaluate the effects of LIF on morphine analgesia and tolerance, LIF was intrathecally administered 30 min before morphine injection. The analgesic effect of morphine was evaluated by measuring tail-flick latency. Human LIF concentrations from the cerebrospinal fluid (CSF) of opioid tolerant patients were also determined by specific ELISA.

RESULTS

Chronic morphine administration upregulated LIF concentrations in rat spinal cords. Intrathecal injection of LIF potentiated the analgesic action of morphine. Patch clamp recording of spinal cord slices showed that LIF enhanced DAMGO ([D-Ala, N-MePhe, Gly-ol]-enkephalin)-induced outward potassium current. The development of tolerance was markedly suppressed by exogenous LIF, whereas neutralizing the endogenously released LIF with anti-LIF antibodies accelerated the tolerance induction. Moreover, LIF concentrations in the CSF of opioid-tolerant patients were higher than those in the opioid-naive controls.

CONCLUSIONS

Intrathecal administration of LIF potentiated morphine antinociceptive activity and attenuated the development of morphine tolerance. Upregulation of endogenously released LIF by long-term use of opioids might counterbalance the tolerance induction effects of other proinflammatory cytokines. LIF might be a novel drug candidate for inhibiting opioid tolerance induction.

摘要

背景

由于耐受的发展,阿片类药物的疗效通常在长期使用后会降低。神经胶质细胞的激活和促炎细胞因子的上调与耐受的诱导有关。我们研究了白血病抑制因子(LIF)对吗啡镇痛和耐受的影响。

方法

用聚合酶链反应(PCR)和酶联免疫吸附测定(ELISA)测量吗啡给药后大鼠脊髓中的 LIF 浓度。用共聚焦显微镜检查 LIF 分布。为了评估 LIF 对吗啡镇痛和耐受的影响,在吗啡注射前 30 分钟鞘内给予 LIF。通过测量尾巴闪烁潜伏期来评估吗啡的镇痛作用。还通过特定的 ELISA 测定来自阿片类药物耐受患者脑脊液(CSF)的人 LIF 浓度。

结果

慢性吗啡给药上调大鼠脊髓中的 LIF 浓度。鞘内注射 LIF 增强了吗啡的镇痛作用。脊髓切片的膜片钳记录显示,LIF 增强了 DAMGO([D-Ala,N-MePhe,Gly-ol]-脑啡肽)诱导的外向钾电流。外源性 LIF 明显抑制了耐受的发展,而用抗 LIF 抗体中和内源性释放的 LIF 则加速了耐受的诱导。此外,阿片类药物耐受患者的 CSF 中的 LIF 浓度高于阿片类药物未耐受的对照组。

结论

鞘内给予 LIF 增强了吗啡的镇痛作用,并减轻了吗啡耐受的发展。长期使用阿片类药物上调内源性释放的 LIF 可能抵消其他促炎细胞因子诱导耐受的作用。LIF 可能是抑制阿片类药物耐受诱导的新型候选药物。

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