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用μ阿片受体拮抗剂纳洛嗪逆转吗啡引起的呼吸抑制会导致呼吸兴奋和不稳定。

Reversal of morphine-induced respiratory depression with the µ-opioid receptor antagonist naloxonazine engenders excitation and instability of breathing.

作者信息

Getsy Paulina M, May Walter, Henderson Fraser, Coffee Gregory A, Baby Santhosh M, Hsieh Yee-Hsee, Lewis Stephen J

机构信息

Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, United States.

Department of Pediatrics, University of Virginia, Charlottesville, Virginia, United States.

出版信息

Am J Physiol Lung Cell Mol Physiol. 2025 Jul 1;329(1):L97-L111. doi: 10.1152/ajplung.00045.2025. Epub 2025 May 14.


DOI:10.1152/ajplung.00045.2025
PMID:40366705
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12213126/
Abstract

The administration of opioid receptor antagonists is believed to overcome ventilatory depressant effects of opioids. Here we show that many ventilatory depressant effects of morphine are converted to excitatory responses after µ-opioid receptor blockade, and that these responses are accompanied by ventilatory instability. In this study, we report ) ventilatory responses elicited by morphine (10 mg/kg, iv) and ) ventilatory responses elicited by a subsequent hypoxic-hypercapnic (HH) gas challenge and return to room air in male Sprague Dawley rats pretreated with ) vehicle, ) the centrally acting selective µ-opioid receptor antagonist, naloxonazine (1.5 mg/kg, iv), or ) the centrally acting (delta 1,2) δ-opioid receptor antagonist, naltrindole (1.5 mg/kg, iv). The morphine-induced decreases in frequency of breathing, peak inspiratory flow, peak expiratory flow, expiratory flow at 50% expired TV, inspiratory drive, and expiratory drive in vehicle-treated rats were converted to profound increases in naloxonazine-treated rats. Additionally, the adverse effects of morphine on expiratory delay and apneic pause were augmented in naloxonazine-treated rats, and administration of morphine increased ventilatory instability (i.e., noneupneic breathing index) in naloxonazine-treated rats, which was not due to increases in ventilatory drive. Subsequent exposure to a HH gas challenge elicited qualitatively similar responses in both groups, whereas the responses upon return to room air (e.g., frequency of breathing, inspiratory time, expiratory time, end expiratory pause, relaxation time, expiratory delay, and noneupneic breathing index) were substantially different in naloxonazine-treated versus vehicle-treated rats. The above mentioned effects of morphine were only marginally affected in naltrindole-treated rats. These novel data highlight the complicated effects that µ-opioid receptor antagonism exerts on the ventilatory effects of morphine. This study shows that the systemic injection of morphine elicits a pronounced overshoot in ventilation in freely-moving Sprague Dawley rats pretreated with the centrally-acting selective µ-opioid receptor antagonist, naloxonazine, but not with the centrally-acting δ-opioid receptor antagonist, naltrindole. This suggests that morphine can recruit a non-µ-opioid receptor system that promotes breathing.

摘要

据信,给予阿片受体拮抗剂可克服阿片类药物的呼吸抑制作用。在此我们表明,吗啡的许多呼吸抑制作用在μ-阿片受体被阻断后转变为兴奋反应,并且这些反应伴有呼吸不稳定。在本研究中,我们报告了在雄性Sprague Dawley大鼠中,用)溶剂、)中枢作用的选择性μ-阿片受体拮抗剂纳洛嗪(1.5 mg/kg,静脉注射)或)中枢作用的(δ1,2)δ-阿片受体拮抗剂纳曲吲哚(1.5 mg/kg,静脉注射)预处理后,吗啡(10 mg/kg,静脉注射)引起的)通气反应以及随后的低氧高碳酸血症(HH)气体刺激和恢复至室内空气所引起的)通气反应。在溶剂处理的大鼠中,吗啡引起的呼吸频率、吸气峰值流速、呼气峰值流速、呼出潮气量50%时的呼气流速、吸气驱动力和呼气驱动力降低,在纳洛嗪处理的大鼠中转变为显著增加。此外,在纳洛嗪处理的大鼠中,吗啡对呼气延迟和呼吸暂停的不良影响增强,并且给予吗啡增加了纳洛嗪处理的大鼠的呼吸不稳定(即非均匀呼吸指数),这并非由于呼吸驱动力增加所致。随后暴露于HH气体刺激在两组中引起了定性相似的反应,而在恢复至室内空气时的反应(例如呼吸频率、吸气时间、呼气时间、呼气末暂停、舒张时间、呼气延迟和非均匀呼吸指数)在纳洛嗪处理的大鼠与溶剂处理的大鼠之间有很大差异。吗啡的上述作用在纳曲吲哚处理的大鼠中仅受到轻微影响。这些新数据突出了μ-阿片受体拮抗作用对吗啡呼吸作用所产生的复杂影响。本研究表明,在经中枢作用的选择性μ-阿片受体拮抗剂纳洛嗪预处理而非经中枢作用的δ-阿片受体拮抗剂纳曲吲哚预处理的自由活动Sprague Dawley大鼠中,全身注射吗啡会引起通气的明显过冲。这表明吗啡可激活促进呼吸的非μ-阿片受体系统。

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本文引用的文献

[1]
Endogenous opiates and behavior: 2023.

Peptides. 2024-9

[2]
Fentanyl activates opposing opioid and non-opioid receptor systems that control breathing.

Front Pharmacol. 2024-4-18

[3]
The Reducing Agent Dithiothreitol Modulates the Ventilatory Responses That Occur in Freely Moving Rats during and following a Hypoxic-Hypercapnic Challenge.

Antioxidants (Basel). 2024-4-22

[4]
Ventilatory Effects of Fentanyl, Heroin, and -Methamphetamine, Alone and in Mixtures in Male Rats Breathing Normal Air .

J Pharmacol Exp Ther. 2024-1-17

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Elife. 2023-6-14

[6]
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Front Physiol. 2023-3-16

[7]
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[8]
Heroin- and Fentanyl-Induced Respiratory Depression in a Rat Plethysmography Model: Potency, Tolerance, and Sex Differences.

J Pharmacol Exp Ther. 2023-5

[9]
Molecular recognition of morphine and fentanyl by the human μ-opioid receptor.

Cell. 2022-11-10

[10]
L-cysteine methyl ester overcomes the deleterious effects of morphine on ventilatory parameters and arterial blood-gas chemistry in unanesthetized rats.

Front Pharmacol. 2022-9-28

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