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Fentanyl activates opposing opioid and non-opioid receptor systems that control breathing.

作者信息

Baby Santhosh M, May Walter J, Getsy Paulina M, Coffee Gregory A, Nakashe Tej, Bates James N, Levine Alan, Lewis Stephen J

机构信息

Department of Drug Discovery, Galleon Pharmaceuticals, Inc., Horsham, PA, United States.

Pediatric Respiratory Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.

出版信息

Front Pharmacol. 2024 Apr 18;15:1381073. doi: 10.3389/fphar.2024.1381073. eCollection 2024.


DOI:10.3389/fphar.2024.1381073
PMID:38698814
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11063261/
Abstract

Fentanyl elicits profound disturbances in ventilatory control processes in humans and experimental animals. The traditional viewpoint with respect to fentanyl-induced respiratory depression is that once the effects on the frequency of breathing (Freq), tidal volume (TV), and minute ventilation (MV = Freq × TV) are resolved, then depression of breathing is no longer a concern. The results of the present study challenge this concept with findings, as they reveal that while the apparent inhibitory effects of fentanyl (75 μg/kg, IV) on Freq, TV, and MV in adult male rats were fully resolved within 15 min, many other fentanyl-induced responses were in full effect, including opposing effects on respiratory timing parameters. For example, although the effects on Freq were resolved at 15 min, inspiratory duration (Ti) and end inspiratory pause (EIP) were elevated, whereas expiratory duration (Te) and end expiratory pause (EEP) were diminished. Since the effects of fentanyl on TV had subsided fully at 15 min, it would be expected that the administration of an opioid receptor (OR) antagonist would have minimal effects if the effects of fentanyl on this and other parameters had resolved. We now report that the intravenous injection of a 1.0 mg/kg dose of the peripherally restricted OR antagonist, methyl-naloxone (naloxone methiodide, NLXmi), did not elicit arousal but elicited some relatively minor changes in Freq, TV, MV, Te, and EEP but pronounced changes in Ti and EIP. In contrast, the injection of a 2.5 mg/kg dose of NLXmi elicited pronounced arousal and dramatic changes in many variables, including Freq, TV, and MV, which were not associated with increases in non-apneic breathing events such as apneas. The two compelling conclusions from this study are as follows: 1) the blockade of central ORs produced by the 2.5 mg/kg dose of NLXmi elicits pronounced increases in Freq, TV, and MV in rats in which the effects of fentanyl had apparently resolved, and 2) it is apparent that fentanyl had induced the activation of two systems with counter-balancing effects on Freq and TV: one being an opioid receptor inhibitory system and the other being a non-OR excitatory system.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/b81b734d1a37/fphar-15-1381073-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/1050e0efc568/fphar-15-1381073-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/7914cb1182ee/fphar-15-1381073-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/68b49cba9d7c/fphar-15-1381073-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/4f9890ffb9ec/fphar-15-1381073-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/13ad071fe170/fphar-15-1381073-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/dad4ba51e76d/fphar-15-1381073-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/4af2b64fdc9d/fphar-15-1381073-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/985f7074e553/fphar-15-1381073-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/669c6b4df3f5/fphar-15-1381073-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/0f9e8fedeee8/fphar-15-1381073-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/56aa41b96eda/fphar-15-1381073-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/b81b734d1a37/fphar-15-1381073-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/1050e0efc568/fphar-15-1381073-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/7914cb1182ee/fphar-15-1381073-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/68b49cba9d7c/fphar-15-1381073-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/4f9890ffb9ec/fphar-15-1381073-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/13ad071fe170/fphar-15-1381073-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/dad4ba51e76d/fphar-15-1381073-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/4af2b64fdc9d/fphar-15-1381073-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/985f7074e553/fphar-15-1381073-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/669c6b4df3f5/fphar-15-1381073-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/0f9e8fedeee8/fphar-15-1381073-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/56aa41b96eda/fphar-15-1381073-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b3/11063261/b81b734d1a37/fphar-15-1381073-g012.jpg

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本文引用的文献

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L-cysteine ethylester reverses the adverse effects of morphine on breathing and arterial blood-gas chemistry while minimally affecting antinociception in unanesthetized rats.

Biomed Pharmacother. 2024-2

[2]
Hypoxia releases S-nitrosocysteine from carotid body glomus cells-relevance to expression of the hypoxic ventilatory response.

Front Pharmacol. 2023-10-11

[3]
Effects of sub-lethal doses of fentanyl on vital physiologic functions and withdrawal-like behaviors in adult goats.

Front Physiol. 2023-10-11

[4]
Long-Acting Opioid Analgesics for Acute Pain: Pharmacokinetic Evidence Reviewed.

Vet Sci. 2023-5-24

[5]
Loss of ganglioglomerular nerve input to the carotid body impacts the hypoxic ventilatory response in freely-moving rats.

Front Physiol. 2023-3-16

[6]
Hypercapnic signaling influences hypoxic signaling in the control of breathing in C57BL6 mice.

J Appl Physiol (1985). 2023-5-1

[7]
Heroin- and Fentanyl-Induced Respiratory Depression in a Rat Plethysmography Model: Potency, Tolerance, and Sex Differences.

J Pharmacol Exp Ther. 2023-5

[8]
The ventilatory depressant actions but not the antinociceptive effects of morphine are blunted in rats receiving intravenous infusion of L-cysteine ethyl ester.

Biomed Pharmacother. 2022-12

[9]
L-cysteine methyl ester overcomes the deleterious effects of morphine on ventilatory parameters and arterial blood-gas chemistry in unanesthetized rats.

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S-nitroso-L-cysteine stereoselectively blunts the adverse effects of morphine on breathing and arterial blood gas chemistry while promoting analgesia.

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