Cullen Joshua M., Cascella Marco
Touro University California
Istituto Nazionale Tumori - IRCCS - Fondazione Pascale, Via Mariano Semmola 80100, Napoli. Italy
The term opiate, or more appropriately opioids, is commonly referred to as a class of compounds, such as the alkaloids morphine, codeine, and thebaine, derived from the opium poppy (), and known and utilized by humankind for millennia for both analgesia and sedation. This class of substances also includes semi-synthetic compounds such as heroin, oxycodone, hydrocodone, and hydromorphone, obtained from these natural molecules, as well as fully synthetic compounds, including fentanyl, pethidine, levorphanol, methadone, tramadol, and dextropropoxyphene. Morphine was first isolated in 1806, followed by the isolation of codeine several years later. Following the development of the hypodermic needle and hollow needle in the 1850s, physicians began to use morphine for various surgical procedures as well as for the treatment of chronic pain and postoperative pain. With the discovery of different opioid agonists, antagonists, and partial agonist compounds such as nalorphine, various researchers postulated and later proved that there are multiple stereospecific opioid binding sites in the central nervous system (CNS) through which they exert their physiological effects. Researchers further surmised that these receptors were most likely targets of endogenous opioid compounds, which researchers then began to isolate and study. John Hughes and Hans Kosterlitz reported the first evidence of endogenous opioids in brain extracts in 1975. They noted that these extracts could inhibit acetylcholine release from nerves in the guinea pig ileum. Further, they indicated that when treated with the opioid receptor antagonist naloxone, the inhibition was blocked. The compounds that they first isolated were termed enkephalins. Structurally, the enkephalins are pentapeptides distinguished into 2 subgroups by their carboxy-terminal amino acids, leucine or methionine. As a consequence, the enkephalins are classified as met-encephalins and leu-encephalins, respectively: The present the amino acid sequence Tyr-Gly-Gly-Phe-Met. The present the amino acid sequence Tyr-Gly-Gly-Phe-Leu. The enkephalins are 1 of the 3 peptide systems that also include beta-endorphins and dynorphins. Of note, the 3 classes of endogenous opioid peptides share a common N terminus sequence of Tyr-Gly-Gly-Phe and lack a C terminus amide. In molecular terms, Tyr and Phe bind the receptor, and the glycine pair acts as a spacer. These peptides act as neurotransmitters and neuromodulators throughout the nervous system and various end-organ targets. Additionally, research has found that met-enkephalin is essential in cell proliferation and tissue organization during development. When discussed in this context, met-enkephalin is often referred to as the opioid growth factor (OGF).
术语阿片制剂,或更确切地说是阿片类药物,通常指一类化合物,如源自罂粟的生物碱吗啡、可待因和蒂巴因,人类已经认识并使用了数千年,用于镇痛和镇静。这类物质还包括从这些天然分子中获得的半合成化合物,如海洛因、羟考酮、氢可酮和氢吗啡酮,以及全合成化合物,包括芬太尼、哌替啶、左啡诺、美沙酮、曲马多和右丙氧芬。吗啡于1806年首次分离出来,几年后可待因也被分离出来。19世纪50年代皮下注射针和空心针发明后,医生开始将吗啡用于各种外科手术以及慢性疼痛和术后疼痛的治疗。随着不同阿片类激动剂、拮抗剂和部分激动剂化合物如烯丙吗啡的发现,众多研究人员提出并随后证明中枢神经系统(CNS)中存在多个立体特异性阿片类结合位点,它们通过这些位点发挥生理作用。研究人员进一步推测这些受体很可能是内源性阿片类化合物的靶点,随后研究人员开始对其进行分离和研究。1975年,约翰·休斯和汉斯·科斯特利茨报道了脑提取物中内源性阿片类物质的首个证据。他们指出这些提取物可以抑制豚鼠回肠神经释放乙酰胆碱。此外,他们还表明,用阿片受体拮抗剂纳洛酮处理后,这种抑制作用被阻断。他们最初分离出的化合物被称为脑啡肽。从结构上看,脑啡肽是五肽,根据其羧基末端氨基酸分为2个亚组,亮氨酸或甲硫氨酸。因此,脑啡肽分别被归类为甲硫氨酸脑啡肽和亮氨酸脑啡肽:甲硫氨酸脑啡肽呈现氨基酸序列Tyr - Gly - Gly - Phe - Met。亮氨酸脑啡肽呈现氨基酸序列Tyr - Gly - Gly - Phe - Leu。脑啡肽是3种肽系统之一,另外两种是β - 内啡肽和强啡肽。值得注意的是,这3类内源性阿片肽共有一个Tyr - Gly - Gly - Phe的N末端序列,且缺少C末端酰胺。从分子角度来看,Tyr和Phe与受体结合,而甘氨酸对起间隔作用。这些肽在整个神经系统和各种终末器官靶点中充当神经递质和神经调节剂。此外,研究发现甲硫氨酸脑啡肽在发育过程中的细胞增殖和组织形成中至关重要。在这种背景下讨论时,甲硫氨酸脑啡肽通常被称为阿片生长因子(OGF)。