Centre for Clinical Science, Respiratory Medicine, Hull York Medical School, University of Hull, Castle Hill Hospital, Cottingham, UK.
Expert Opin Pharmacother. 2024 Nov;25(16):2167-2175. doi: 10.1080/14656566.2024.2418983. Epub 2024 Oct 24.
Chronic cough has increasingly been recognized as a distinct clinical entity that affects a significant portion of the global population. Despite advancements in understanding its pathophysiology, treatment options remain limited. Opioid analgesics have long been used for cough, and some have proven clear antitussive potential. However, these have yet to be approved by regulatory authorities for the treatment of chronic cough. Several novel synthetic opioid modulators that demonstrated antitussive effects in early-stage studies also failed to translate into clinical practice.
This mini review aims to summarize the implications of opioid receptors in the development of cough medicines and highlight recent advances in opioid analgesics in cough trials. PUB MED/CINAHL/Web of Science/Scopus was searched (September 2024).
Our understanding of the precise sites of action and the involvement of peripheral opioid receptors in cough remains limited. Despite these gaps in knowledge, opioids remain a viable option for some patients until more novel effective treatments are available. Due to the frequent opioid side effects, new opioid derivatives with improved properties are needed. The development of tailored or biased delta-opioid receptor ligands and mixed agonists of opioid receptor-like 1/mu receptors may offer hope for new opioid-based drug discovery for chronic cough.
慢性咳嗽已逐渐被认为是一种独特的临床实体，影响着全球很大一部分人群。尽管人们对其病理生理学的认识有所提高，但治疗选择仍然有限。阿片类镇痛药长期以来一直被用于咳嗽治疗，其中一些已被证明具有明显的镇咳潜力。然而，这些药物尚未获得监管机构批准用于治疗慢性咳嗽。一些新型合成阿片类调节剂在早期研究中显示出了镇咳作用，但也未能转化为临床实践。
本篇迷你综述旨在总结阿片受体在咳嗽药物开发中的意义，并强调阿片类镇痛药在咳嗽试验中的最新进展。检索了 PUB MED/CINAHL/Web of Science/Scopus（2024 年 9 月）。
我们对作用部位的确切了解以及外周阿片受体在咳嗽中的参与仍然有限。尽管存在这些知识空白，但在更有效的新型治疗方法出现之前，阿片类药物仍然是一些患者的可行选择。由于阿片类药物的常见副作用，需要具有改善特性的新型阿片类药物衍生物。针对阿片受体样 1/μ 受体的定制或偏向性 δ-阿片受体配体和混合激动剂的开发可能为慢性咳嗽的新型基于阿片类药物的药物发现带来希望。
