Stanfa L, Dickenson A
Department of Pharmacology, University College London, UK.
Inflamm Res. 1995 Jun;44(6):231-41. doi: 10.1007/BF01782974.
Until recently, basic science studies, both behavioural and electrophysiological, have concentrated on the antinociceptive actions of opioids primarily gauged against acute nociceptive responses. However, of more relevance to clinical situations are the actions of opioids in more persistent/prolonged pain states. This review sets out to examine the central actions of opioids against nociception of inflammatory origins. The first section deals with the response of the endogenous opioid system to the development of an inflammatory state and the second examines the ability of exogenous opioids to modulate inflammatory nociception. There are complex changes in the roles of endogenous opioids, in particular dynorphin, at the spinal level after inflammation although the physiological consequences remain unclear. With regard to exogenous opioids, the effectiveness of spinal morphine is rapidly enhanced after inflammation, likely to be due to changes in the interaction between the peptide cholecystokinin and the mu opioid receptor. The ability of inflammatory processes to alter both endogenous opioids and morphine analgesia at the spinal level illustrates the considerable degree of plasticity observed in opioid function.
直到最近，行为学和电生理学方面的基础科学研究主要集中于阿片类药物针对急性伤害性反应的抗伤害感受作用。然而，对于临床情况而言，阿片类药物在更持久/长期疼痛状态下的作用更具相关性。本综述旨在研究阿片类药物针对炎症性起源伤害感受的中枢作用。第一部分探讨内源性阿片系统对炎症状态发展的反应，第二部分研究外源性阿片类药物调节炎症性伤害感受的能力。炎症后脊髓水平内源性阿片类物质，特别是强啡肽的作用发生了复杂变化，尽管其生理后果尚不清楚。关于外源性阿片类药物，炎症后脊髓吗啡的有效性迅速增强，这可能是由于肽缩胆囊素与μ阿片受体之间相互作用的变化所致。炎症过程改变脊髓水平内源性阿片类物质和吗啡镇痛的能力说明了阿片类药物功能中观察到的相当程度的可塑性。
