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长期纳洛酮诱导的超敏反应对下丘脑-垂体-肾上腺皮质轴上吗啡的耐受性和身体依赖性均无影响。

Chronic naloxone-induced supersensitivity affects neither tolerance to nor physical dependence on morphine at hypothalamus-pituitary-adrenocortical axis.

作者信息

Alcaraz C, Vargas M L, Milanés M V

机构信息

Department of Physiology & Pharmacology, University School of Medicine, Murcia, Spain.

出版信息

Neuropeptides. 1996 Feb;30(1):29-36. doi: 10.1016/s0143-4179(96)90051-7.

Abstract

This study reports the endocrine effects of chronic mu-blockade induced by naloxone on morphine tolerance and withdrawal at hypothalamus-pituitary-adrenocortical (HPA) axis level. Naloxone (0.5 mg/kg/h) or vehicle (1 microliter/h) were infused s.c. to Sprague-Dawley rats via osmotic minipumps for 7 days, concomitantly with morphine or placebo pellets for 7-8 days. In opiate-naive rats, the mu-preferring opioid agonist morphine (30 mg/kg) increased plasma corticosterone in a partial but significant naloxone-reversible manner. In vehicle-perfused rats, chronic morphine treatment produced tolerance to its neuroendocrine effect, while the development of morphine tolerance was antagonized in the naloxone-treated group. An enhancement of plasma corticosterone levels after acute morphine (30 mg/kg) occurred 24 h after removal of chronic naloxone treatment in vehicle-perfused rats, as a functional index of supersensitivity to the neuroendocrine effects of the mu agonist. By contrast, 24 h after naloxone removal, rats implanted with morphine pellets were significantly less sensitive to acute morphine (tolerance) than its control-placebo group. Substantial elevation of plasma corticosterone, accompanied by motor and behavioural signs, was observed after acute naloxone injection (1 mg/kg) to tolerant rats 24 h after naloxone-pumps removal, which indicates withdrawal. No endocrine, motor or behavioural signs appeared in the naloxone group with pumps in place. These results indicated that morphine desensitizes mu-opioid receptors that were probably upregulated by chronic naloxone in presence of chronic agonist administration, and suggest that opioid tolerance/dependence as well as opioid supersensitivity simultaneously and independently can occur at mu-opioid receptors mediating HPA function.

摘要

本研究报告了纳洛酮诱导的慢性μ-阿片受体阻断对下丘脑-垂体-肾上腺皮质(HPA)轴水平的吗啡耐受性和戒断反应的内分泌影响。通过渗透微型泵将纳洛酮(0.5毫克/千克/小时)或赋形剂(1微升/小时)皮下注射给Sprague-Dawley大鼠,持续7天,同时给予吗啡或安慰剂丸剂7至8天。在未接触过阿片类药物的大鼠中,选择性作用于μ-阿片受体的阿片类激动剂吗啡(30毫克/千克)以部分但显著的纳洛酮可逆方式增加血浆皮质酮水平。在灌注赋形剂的大鼠中,慢性吗啡治疗使其对神经内分泌作用产生耐受性,而在纳洛酮治疗组中,吗啡耐受性的发展受到拮抗。在灌注赋形剂的大鼠中,去除慢性纳洛酮治疗24小时后,急性给予吗啡(30毫克/千克)后血浆皮质酮水平升高,这是对μ-激动剂神经内分泌作用超敏反应的功能指标。相比之下,去除纳洛酮24小时后,植入吗啡丸剂的大鼠对急性吗啡的敏感性显著低于其对照安慰剂组(耐受性)。在去除纳洛酮泵24小时后,对耐受大鼠急性注射纳洛酮(1毫克/千克)后,观察到血浆皮质酮大幅升高,并伴有运动和行为体征,这表明出现了戒断反应。在仍留置泵的纳洛酮组中未出现内分泌、运动或行为体征。这些结果表明,吗啡使μ-阿片受体脱敏,在慢性激动剂给药的情况下,这些受体可能被慢性纳洛酮上调,并表明阿片类耐受性/依赖性以及阿片类超敏反应可同时且独立地发生在介导HPA功能的μ-阿片受体上。

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