Department of Pharmacology, University of Minnesota, Minneapolis, MN 55455.
Department of Surgery, University of Miami, Miami, FL 33136.
Proc Natl Acad Sci U S A. 2019 Jul 2;116(27):13523-13532. doi: 10.1073/pnas.1901182116. Epub 2019 Jun 17.
Prolonged exposure to opioids results in analgesic tolerance, drug overdose, and death. The mechanism underlying morphine analgesic tolerance still remains unresolved. We show that morphine analgesic tolerance was significantly attenuated in germfree (GF) and in pan-antibiotic-treated mice. Reconstitution of GF mice with naïve fecal microbiota reinstated morphine analgesic tolerance. We further demonstrated that tolerance was associated with microbial dysbiosis with selective depletion in and Probiotics, enriched with these bacterial communities, attenuated analgesic tolerance in morphine-treated mice. These results suggest that probiotic therapy during morphine administration may be a promising, safe, and inexpensive treatment to prolong morphine's efficacy and attenuate analgesic tolerance. We hypothesize a vicious cycle of chronic morphine tolerance: morphine-induced gut dysbiosis leads to gut barrier disruption and bacterial translocation, initiating local gut inflammation through TLR2/4 activation, resulting in the activation of proinflammatory cytokines, which drives morphine tolerance.
长期接触阿片类药物会导致镇痛耐受、药物过量和死亡。吗啡镇痛耐受的机制仍未解决。我们发现,在无菌(GF)和全抗生素处理的小鼠中,吗啡的镇痛耐受明显减弱。用幼稚粪便微生物群重建 GF 小鼠恢复了吗啡的镇痛耐受。我们进一步证明,这种耐受与微生物失调有关,选择性地减少了 和 。富含这些细菌群落的益生菌,可减弱吗啡处理小鼠的镇痛耐受。这些结果表明,在给予吗啡时进行益生菌治疗可能是一种有前途、安全且廉价的治疗方法,可以延长吗啡的疗效并减轻镇痛耐受。我们假设慢性吗啡耐受的恶性循环:吗啡诱导的肠道菌群失调导致肠道屏障破坏和细菌易位,通过 TLR2/4 激活引发局部肠道炎症,导致促炎细胞因子的激活,从而导致吗啡耐受。