Paul D, Standifer K M, Inturrisi C E, Pasternak G W
Cotzias Laboratory of Neuro-Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.
J Pharmacol Exp Ther. 1989 Nov;251(2):477-83.
Morphine-6 beta-glucuronide is a major metabolite of morphine with potent analgesic actions. To define more fully the importance of this compound in morphine action, we have compared the analgesic actions of morphine and its 6 beta-glucuronide metabolite after both peripheral and central administration. Given s.c., morphine-6 beta-glucuronide elicited analgesia with an effect approximately twice that of morphine due, in part, to its long duration of action and also inhibited gastrointestinal motility. Both actions were easily reversed by naloxone (s.c.). However, when injected either i.c.v. or intrathecally, morphine-6 beta-glucuronide was approximately 90- and 650-fold more potent an analgesic than morphine, respectively. Whereas morphine in these studies was equipotent at both levels of the neuraxis as an analgesic, the 6 beta-glucuronide was approximately 5-fold more effective at the level of the spinal cord than supraspinally. The mu 1-selective antagonist naloxonazine blocked the analgesic effect of systemic and i.c.v. morphine-6 beta-glucuronide much as it blocked morphine, implying a role for mu1 receptors in these actions. Like morphine, morphine-6 beta-glucuronide analgesia after intrathecal injection was not sensitive to naloxonazine, suggesting a mu2 mechanism within the spinal cord. Together, these results imply that morphine-6 beta-glucuronide elicited its analgesic actions through the same receptor mechanisms as morphine. Mice highly tolerant to morphine after implantation of morphine pellets showed cross-tolerance to morphine-6 beta-glucuronide (s.c.). The high potency of morphine-6 beta-glucuronide strongly suggests that this metabolite plays an important role in morphine's actions.
吗啡-6β-葡萄糖醛酸是吗啡的一种主要代谢产物,具有强效镇痛作用。为了更全面地确定该化合物在吗啡作用中的重要性,我们比较了吗啡及其6β-葡萄糖醛酸代谢产物在外周和中枢给药后的镇痛作用。皮下注射时,吗啡-6β-葡萄糖醛酸引起的镇痛效果约为吗啡的两倍,部分原因是其作用持续时间长,并且还抑制胃肠蠕动。这两种作用都很容易被纳洛酮(皮下注射)逆转。然而,当脑室内或鞘内注射时,吗啡-6β-葡萄糖醛酸的镇痛效力分别比吗啡强约90倍和650倍。在这些研究中,吗啡在神经轴的两个水平上作为镇痛药的效力相当,而6β-葡萄糖醛酸在脊髓水平上的效力比脊髓以上水平约高5倍。μ1选择性拮抗剂纳洛嗪阻断全身和脑室内注射吗啡-6β-葡萄糖醛酸的镇痛作用,其方式与阻断吗啡的作用相同,这意味着μ1受体在这些作用中发挥作用。与吗啡一样,鞘内注射吗啡-6β-葡萄糖醛酸后的镇痛作用对纳洛嗪不敏感,提示脊髓内存在μ2机制。总之,这些结果表明吗啡-6β-葡萄糖醛酸通过与吗啡相同的受体机制发挥其镇痛作用。植入吗啡丸后对吗啡高度耐受的小鼠对吗啡-6β-葡萄糖醛酸(皮下注射)表现出交叉耐受性。吗啡-6β-葡萄糖醛酸的高效力强烈表明该代谢产物在吗啡的作用中起重要作用。