Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Bialystok, Poland
Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Bialystok, Poland.
Clin Med Res. 2022 Dec;20(4):195-203. doi: 10.3121/cmr.2022.1731.
The neurotoxic effect of opioid has not been thoroughly described. No studies have been conducted to explain the effect of opioids in chronic non-cancer pain therapy on the neurotrophic factors level. Due to the ability to cross the blood-brain barrier, it seems the determination of serum Brain-derived neurotrophic factor (BDNF) concentration is a reliable presentation of the concentration in the central nervous system. The aim of the study was to explore the changes of plasma BDNF concentration during long-term opioid therapy. The study group included 28 patients with chronic low back pain treated with opioid therapy buprenorphine (n=10), tramadol (n=8), oxycodone (n=6), morphine (n=3), fentanyl (n=1). The control group included 11 patients. Measurements of plasma BDNF concentrations were performed, and information about opioid therapy were recorded (age, sex, opioid substance type, daily dose and the duration of opioid therapy). Data were analyzed using nonparametric tests. The median BDNF level in the study group was significantly lower (2.73 ng/mL) than that in the control group (5.04 ng/mL, <0.05). BDNF levels did not differ among groups based on the type of opioid substance used, but the lowest median value was observed for tramadol (2.62 ng/mL), and the highest median value was observed for buprenorphine (2.73 ng/mL). The widest minimum-maximum ranges of BDNF for oxycodone were noted, minimum 1.23 ng/mL and maximum 4.57 ng/mL, respectively. BDNF concentrations were correlated with age in the tramadol group and with the duration of opioid therapy in the buprenorphine group. Chronic opioid therapy for noncancer pain induces specific changes in the BDNF concentration. Tramadol and buprenorphine exerted an important effect on BDNF levels in the examined patients. The BDNF level depends on duration of opioid therapy with buprenorphine, and age in tramadol therapy.
阿片类药物的神经毒性作用尚未得到充分描述。没有研究解释慢性非癌痛治疗中阿片类药物对神经营养因子水平的影响。由于能够穿过血脑屏障，因此似乎测定血清脑源性神经营养因子（BDNF）浓度是中枢神经系统浓度的可靠表现。本研究的目的是探讨长期阿片类药物治疗过程中血浆 BDNF 浓度的变化。研究组包括 28 例接受阿片类药物治疗的慢性腰痛患者（n=10），其中布诺啡（n=10），曲马多（n=8），羟考酮（n=6），吗啡（n=3），芬太尼（n=1）。对照组包括 11 例患者。测定血浆 BDNF 浓度，并记录阿片类药物治疗信息（年龄、性别、阿片类药物类型、日剂量和阿片类药物治疗时间）。使用非参数检验进行数据分析。研究组的 BDNF 中位数水平明显低于对照组（2.73ng/ml 比 5.04ng/ml，<0.05）。基于使用的阿片类药物类型，各组之间的 BDNF 水平没有差异，但曲马多的中位数最低（2.62ng/ml），布诺啡的中位数最高（2.73ng/ml）。羟考酮的 BDNF 最小-最大值范围最宽，分别为 1.23ng/ml 和 4.57ng/ml。在曲马多组中，BDNF 浓度与年龄相关，在布诺啡组中与阿片类药物治疗时间相关。慢性非癌痛阿片类药物治疗会引起 BDNF 浓度的特定变化。曲马多和布诺啡对研究患者的 BDNF 水平有重要影响。BDNF 水平取决于布诺啡的阿片类药物治疗时间，以及曲马多治疗中的年龄。
