Department of Cardiac Surgery and Transplantation, University Hospital Nancy-Brabois, Nancy, France.
Adv Neurobiol. 2024;35:381-395. doi: 10.1007/978-3-031-45493-6_19.
The opioid system involves opioid receptors (OPRs) and endogenous opioid peptides.This chapter will focus on the distribution of OPRs in the cardiovascular system, the expression pattern in the heart, the activation by opioid peptides, and the effects of OPRs activation with potential relevance in cardiovascular performance. In the heart, OPRs are co-expressed with beta adrenergic receptors (β-ARs) in the G-protein-coupled receptor (GPCR) superfamily, functionally cross-talk with β-Ars and modify catecholamine-induced effects. They are involved in cardiac contractility, energy metabolism, myocyte survival or death, vascular resistance. The effects of the opioid system in the regulation of systemic circulation at both the central and peripheral level are presented. The pathways are discussed under physiological (i.e., aging) and pathological conditions (atherosclerosis, heart failure, essential hypertension, ischemic stress). Stimulation of OPRs not only inhibits cardiac excitation-contraction coupling, but also protects the heart against hypoxic and ischemic injury. An enhanced sensitivity to opioids of endocrine organs and neuronal systems is operative in hypertensive patients. The opioid system can be pharmacologically engaged to selectively mimic these responses via cardiac and nervous signaling. The clinical opportunities for the use of cardioprotective effects of opioids require future investigations to provide more specific details of the impact on cardiac performance and electrophysiological properties.
阿片样物质系统涉及阿片受体（OPRs）和内源性阿片肽。本章将重点介绍 OPR 在心血管系统中的分布、在心脏中的表达模式、阿片肽的激活作用，以及 OPR 激活对心血管功能的潜在影响。在心脏中，OPRs 与β肾上腺素能受体（β-ARs）共同表达于 G 蛋白偶联受体（GPCR）超家族中，与β-ARs 功能相互作用，并调节儿茶酚胺诱导的作用。它们参与心肌收缩力、能量代谢、心肌存活或死亡、血管阻力的调节。本文介绍了阿片样物质系统在调节全身循环方面的中枢和外周水平的作用。讨论了在生理（如衰老）和病理条件（动脉粥样硬化、心力衰竭、原发性高血压、缺血应激）下的途径。OPR 的刺激不仅抑制心脏兴奋-收缩偶联，而且还保护心脏免受缺氧和缺血损伤。在高血压患者中，内分泌器官和神经元系统对阿片类药物的敏感性增强。阿片样物质系统可以通过心脏和神经信号来进行药理学干预，以选择性模拟这些反应。需要进一步研究阿片类药物的心脏保护作用的临床应用机会，以提供对心脏功能和电生理特性影响的更具体细节。
