Combination of a δ-opioid Receptor Agonist and Loperamide Produces Peripherally-mediated Analgesic Synergy in Mice.

Abstract:

BACKGROUND:The long-term use of opioids for analgesia carries significant risk for tolerance, addiction, and diversion. These adverse effects are largely mediated by μ-opioid receptors in the central nervous system. Based on the authors' previous observation that morphine and δ-opioid receptor agonists synergize in spinal cord in a protein kinase Cε-dependent manner, they predicted that this μ-opioid receptor-δ-opioid receptor synergy would take place in the central terminals of nociceptive afferent fibers and generalize to their peripheral terminals. Therefore, the authors hypothesized that loperamide, a highly efficacious μ-opioid receptor agonist that is excluded from the central nervous system, and oxymorphindole, a δ-opioid receptor agonist that was shown to synergize with morphine spinally, would synergistically reverse complete Freund's adjuvant-induced hyperalgesia. METHODS:Using the Hargreaves assay for thermal nociception, the von Frey assay for mechanical nociception and the complete Freund's adjuvant-induced model of inflammatory pain, we tested the antinociceptive and antihyperalgesic effect of loperamide, oxymorphindole, or the loperamide-oxymorphindole combination. Animals (Institute for Cancer Research [ICR] CD1 strain mice; n = 511) received drug by systemic injection, intraplantar injection to the injured paw, or a transdermal solution on the injured paw. Dose-response curves for each route of administration and each nociceptive test were generated, and analgesic synergy was assessed by isobolographic analysis. RESULTS:In naïve animals, the loperamide-oxymorphindole combination ED50 value was 10 times lower than the theoretical additive ED50 value whether given systemically or locally. In inflamed animals, the combination was 150 times more potent systemically, and 84 times more potent locally. All combinations showed statistically significant synergy when compared to the theoretical additive values, as verified by isobolographic analysis. The antihyperalgesia was ablated by a peripherally-restricted opioid antagonist. CONCLUSIONS:From these data we conclude that the loperamide-oxymorphindole combination synergistically reverses complete Freund's adjuvant-induced inflammatory hyperalgesia. The authors also conclude that this interaction is mediated by opioid receptors located in the peripheral nervous system.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Bruce DJ,Peterson CD,Kitto KF,Akgün E,Lazzaroni S,Portoghese PS,Fairbanks CA,Wilcox GL

doi

10.1097/ALN.0000000000002840

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

649-663

issue

3

eissn

0003-3022

issn

1528-1175

journal_volume

131

pub_type

杂志文章
  • The use of propofol, nitrous oxide, or isoflurane does not affect the reproductive success rate following gamete intrafallopian transfer (GIFT): a multicenter pilot trial/survey.

    abstract:BACKGROUND:Whether anesthetic agents administered during gamete intrafallopian transfer (GIFT) affect reproductive outcome is controversial. This multicenter pilot trial and survey had two purposes: to evaluate the effect of propofol, nitrous oxide, midazolam, and isoflurane on pregnancy outcome after GIFT, and to dete...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/00000542-199901000-00007

    authors: Beilin Y,Bodian CA,Mukherjee T,Andres LA,Vincent RD Jr,Hock DL,Sparks AE,Munson AK,Minnich ME,Steinkampf MP,Christman GM,McKay RS,Eisenkraft JB

    更新日期:1999-01-01 00:00:00

  • Importance of myocardial loading conditions in determining the effects of enflurane on left ventricular function in the intact and isolated canine heart.

    abstract::The effect of enflurane (2% and 4% inspired) on left ventricular (LV) function were examined in chronically instrumented dogs, both intact and after isolation of their hearts and lungs from the systemic circulation. Enflurane in the intact dogs increased heart rate (32 +/- 5% with 2% and 41 +/- 4% with 4%) and elicite...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198302000-00010

    authors: Zimpfer M,Gilly H,Krösl P,Schlag G,Steinbereithner K

    更新日期:1983-02-01 00:00:00

  • Isoflurane prevents delayed cell death in an organotypic slice culture model of cerebral ischemia.

    abstract:BACKGROUND:General anesthetics reduce neuronal death caused by focal cerebral ischemia in rodents and by in vitro ischemia in cultured neurons and brain slices. However, in intact animals, the protective effect may enhance neuronal survival for only several days after an ischemic injury, possibly because anesthetics pr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200201000-00033

    authors: Sullivan BL,Leu D,Taylor DM,Fahlman CS,Bickler PE

    更新日期:2002-01-01 00:00:00

  • Preoperative and intraoperative predictors of postoperative acute respiratory distress syndrome in a general surgical population.

    abstract:BACKGROUND:Acute respiratory distress syndrome (ARDS) is a devastating condition with an estimated mortality exceeding 30%. There are data suggesting risk factors for ARDS development in high-risk populations, but few data are available in lower incidence populations. Using risk-matched analysis and a combination of cl...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182794975

    authors: Blum JM,Stentz MJ,Dechert R,Jewell E,Engoren M,Rosenberg AL,Park PK

    更新日期:2013-01-01 00:00:00

  • Predictors of pulse oximetry data failure.

    abstract:BACKGROUND:Pulse oximeters have been reported to fail to record data in 1.12-2.50% of cases in which anesthesia records were handwritten. There is reason to believe that these may be underestimates. Computerized anesthesia records may provide insight into the true incidence of pulse oximetry data failures and factors t...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199604000-00013

    authors: Reich DL,Timcenko A,Bodian CA,Kraidin J,Hofman J,DePerio M,Konstadt SN,Kurki T,Eisenkraft JB

    更新日期:1996-04-01 00:00:00

  • Midazolam: effects on amnesia and anxiety in children.

    abstract:BACKGROUND:The minimum time interval between administration of oral midazolam and separation of children from their parents that ensures good anterograde amnesia has not been previously determined. This is of particular importance in a busy operating room setting where schedule delays secondary to midazolam administrat...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200009000-00016

    authors: Kain ZN,Hofstadter MB,Mayes LC,Krivutza DM,Alexander G,Wang SM,Reznick JS

    更新日期:2000-09-01 00:00:00

  • Lung volumes, mechanics, and oxygenation during spontaneous positive-pressure ventilation: the advantage of CPAP over EPAP.

    abstract::To determine if continuous positive airway pressure (CPAP) or expiratory positive airway pressure (EPAP) is superior for achieving or maintaining effective lung volume in spontaneously breathing critically ill patients in acute respiratory failure, the authors measured functional residual capacity (FRC), airway and es...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198110000-00013

    authors: Schlobohm RM,Falltrick RT,Quan SF,Katz JA

    更新日期:1981-10-01 00:00:00

  • The invention and development of enflurane, isoflurane, sevoflurane, and desflurane.

    abstract::Thirty-six halogenated Me Et ethers have been synthesized for evaluation as volatile anesthetics. Eleven of the ethers were too unstable to test, and, of the remaining 25, 13 had promising anesthetic properties in mice and are suitable for study in larger animals. Those ethers having one H with at least 2 halogens oth...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/ALN.0b013e31816499cc

    authors: Terrell RC

    更新日期:2008-03-01 00:00:00

  • Newborn blood levels of lidocaine and mepivacaine in the first postnatal day following maternal epidural anesthesia.

    abstract::Distribution and elimination of lidocaine and mepivacaine were studies in 114 subjects after obstetric epidural anesthesia, Epinephrine significantly lowered the concentrations of lidocaine in the mothers' circulations by about 33 per cent, and the concentrations of mepivacaine by about 22 per cent. It also significan...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197506000-00014

    authors: Brown WU,Bell GC,Lurie AO,Weiss B,Scanlon JW,Alper MH

    更新日期:1975-06-01 00:00:00

  • Subjective, psychomotor, cognitive, and analgesic effects of subanesthetic concentrations of sevoflurane and nitrous oxide.

    abstract:BACKGROUND:Sevoflurane is a volatile general anesthetic that differs in chemical nature from the gaseous anesthetic nitrous oxide. In a controlled laboratory setting, the authors characterized the subjective, psychomotor, and analgesic effects of sevoflurane and nitrous oxide at two equal minimum alveolar subanesthetic...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-199711000-00012

    authors: Galinkin JL,Janiszewski D,Young CJ,Klafta JM,Klock PA,Coalson DW,Apfelbaum JL,Zacny JP

    更新日期:1997-11-01 00:00:00

  • Postoperative nausea and vomiting. Its etiology, treatment, and prevention.

    abstract::In a recent editorial, Kapur described perioperative nausea and vomiting as "the big 'little problem' following ambulatory surgery."257 Although the actual morbidity associated with nausea is relatively low in health outpatients, it should not be considered an unavoidable part of the perioperative experience. The avai...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/00000542-199207000-00023

    authors: Watcha MF,White PF

    更新日期:1992-07-01 00:00:00

  • Isoflurane differentially modulates inhibitory and excitatory synaptic transmission to the solitary tract nucleus.

    abstract:BACKGROUND:Isoflurane anesthesia produces cardiovascular and respiratory depression, although the specific mechanisms are not fully understood. Cranial visceral afferents, which innervate the heart and lungs, synapse centrally onto neurons within the medial portion of the nucleus tractus solitarius (NTS). Isoflurane mo...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318167af9a

    authors: Peters JH,McDougall SJ,Mendelowitz D,Koop DR,Andresen MC

    更新日期:2008-04-01 00:00:00

  • Effect of Exogenous Albumin on the Incidence of Postoperative Acute Kidney Injury in Patients Undergoing Off-pump Coronary Artery Bypass Surgery with a Preoperative Albumin Level of Less Than 4.0 g/dl.

    abstract:BACKGROUND:Hypoalbuminemia may increase the risk of acute kidney injury (AKI). The authors investigated whether the immediate preoperative administration of 20% albumin solution affects the incidence of AKI after off-pump coronary artery bypass surgery. METHODS:In this prospective, single-center, randomized, parallel-...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0000000000001051

    authors: Lee EH,Kim WJ,Kim JY,Chin JH,Choi DK,Sim JY,Choo SJ,Chung CH,Lee JW,Choi IC

    更新日期:2016-05-01 00:00:00

  • Monitoring of pulmonary endothelial enzyme function: an animal model for a simplified clinically applicable procedure.

    abstract::The authors present a simple and clinically applicable method for the serial monitoring of pulmonary microvascular enzyme function in vivo. This method requires the intravenous injection of trace amounts of a radiolabelled substrate and the collection of a single arterial blood sample. Simultaneous measurement of pulm...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198801000-00008

    authors: Toivonen HJ,Makari N,Catravas JD

    更新日期:1988-01-01 00:00:00

  • Dexamethasone Dose and Early Postoperative Recovery after Mastectomy: A Double-blind, Randomized Trial.

    abstract:BACKGROUND:Pain and nausea are the most common challenges in postoperative recovery after mastectomy. Preventive measures include multimodal analgesia with preoperative glucocorticoid. The aim of this study was to investigate whether 24 mg of preoperative dexamethasone was superior to 8 mg on early recovery after maste...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0000000000003112

    authors: Steinthorsdottir KJ,Awada HN,Abildstrøm H,Kroman N,Kehlet H,Kvanner Aasvang E

    更新日期:2020-04-01 00:00:00

  • Selective metabolic activation of the hippocampus during lidocaine-induced pre-seizure activity.

    abstract::Neurophysiologic studies indicate that local anesthetic-induced seizures are generated in subcortical brain structures. The authors utilized a quantitative autoradiographic technique to measure cerebral metabolism during lidocaine-induced seizure activity in rats anesthetized with nitrous oxide. Local cerebral metabol...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198101000-00007

    authors: Ingvar M,Shapiro HM

    更新日期:1981-01-01 00:00:00

  • High-efficiency delivery of salbutamol with a metered-dose inhaler in narrow tracheal tubes and catheters.

    abstract::We sought to determine the percent delivery by metered-dose inhaler (MDI) of a preparation of salbutamol (albuterol) to the distal end of either pediatric-size tracheal tubes or a narrow-gauge catheter. A bench model consisting of a swivel actuator; 3.0-6.0-mm ID tracheal tubes all 16 cm in length or a 19-G (standard ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199102000-00024

    authors: Taylor RH,Lerman J

    更新日期:1991-02-01 00:00:00

  • Alteration by halothane of glucose and glycogen metabolism in rat skeletal muscle.

    abstract::Exposure of resting rat diaphragm for one hour in vitro to halothane (1-1.5, 2-2.5 and 4-4.5 per cent in oxygen) produced significant alterations of intracellular glucose disposition. Glycolysis (as measured by lactate production) increased, while glycogen formation was inhibited in a dose-related fashion. Net glucose...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197705000-00001

    authors: Rosenberg H,Haugaard N,Haugaard ES

    更新日期:1977-05-01 00:00:00

  • Effect of hydroxyethyl starch on postoperative kidney function in patients having noncardiac surgery.

    abstract:BACKGROUND:Whether intraoperative use of hydroxyethyl starch impairs kidney function remains unknown. The authors thus tested the primary hypothesis that Hextend promotes renal injury in surgical patients. Secondarily, the authors evaluated the dose-outcome relationship, in-hospital and 90-day mortality, and whether th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000375

    authors: Kashy BK,Podolyak A,Makarova N,Dalton JE,Sessler DI,Kurz A

    更新日期:2014-10-01 00:00:00

  • Mechanism of myocardial protection by isoflurane. Role of adenosine triphosphate-regulated potassium (KATP) channels.

    abstract:BACKGROUND:The mechanism of the protective actions of volatile anesthetics in ischemic myocardium has not been clearly elucidated. The role of myocardial adenosine triphosphate-regulated potassium (KATP) channels in isoflurane-induced enhancement of recovery of regional contractile function after multiple brief occlusi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199610000-00015

    authors: Kersten JR,Schmeling TJ,Hettrick DA,Pagel PS,Gross GJ,Warltier DC

    更新日期:1996-10-01 00:00:00

  • Variations in pancuronium requirement, plasma concentration, and urinary excretion induced by cardiopulmonary bypass with hypothermia.

    abstract::To determine the effects of cardiopulmonary bypass (CPB) and hypothermia on the neuromuscular blockade produced by pancuronium, this relaxant was infused intravenously into 10 anesthetized patients to produce and maintain 90% depression of the twitch tension of the adductor pollicis muscle following supramaximal ulnar...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198306000-00004

    authors: d'Hollander AA,Duvaldestin P,Henzel D,Nevelsteen M,Bomblet JP

    更新日期:1983-06-01 00:00:00

  • Propofol decreases myofilament Ca2+ sensitivity via a protein kinase C-, nitric oxide synthase-dependent pathway in diabetic cardiomyocytes.

    abstract:BACKGROUND:The authors' objective was to assess the role of protein kinase C (PKC) and nitric oxide synthase (NOS) in mediating the effects of propofol on diabetic cardiomyocyte contractility, intracellular free Ca2+ concentration ([Ca2+]i), and myofilament Ca2+ sensitivity. METHODS:Freshly isolated ventricular myocyt...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200605000-00014

    authors: Wickley PJ,Shiga T,Murray PA,Damron DS

    更新日期:2006-05-01 00:00:00

  • Pulmonary shunt and cardiovascular responses to CPAP during nitroprusside-induced hypotension.

    abstract::The effects of continuous positive airway pressure (CPAP) on cardiovascular dynamics and pulmonary shunt (QS/QT) were investigated in 12 dogs before and during sodium nitroprusside infusion that decreased mean arterial blood pressure 40-50 per cent. Before nitroprusside infusion, 5 cm H2O CPAP significantly, P less th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197705000-00008

    authors: Hodges MR,Stanley TH,Johansen RK

    更新日期:1977-05-01 00:00:00

  • Buprenorphine disrupts sleep and decreases adenosine concentrations in sleep-regulating brain regions of Sprague Dawley rat.

    abstract:BACKGROUND:Buprenorphine, a partial μ-opioid receptor agonist and κ-opioid receptor antagonist, is an effective analgesic. The effects of buprenorphine on sleep have not been well characterized. This study tested the hypothesis that an antinociceptive dose of buprenorphine decreases sleep and decreases adenosine concen...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31822e9f85

    authors: Gauthier EA,Guzick SE,Brummett CM,Baghdoyan HA,Lydic R

    更新日期:2011-10-01 00:00:00

  • Of Penguins, Pinnipeds, and Poisons: Anesthesia on Elephant Island.

    abstract::Although Ernest Shackleton's Endurance Antarctic expedition of 1914 to 1916 is a famous epic of survival, the medical achievements of the two expedition doctors have received little formal examination. Marooned on Elephant Island after the expedition ship sank, Drs. Macklin and McIlroy administered a chloroform anesth...

    journal_title:Anesthesiology

    pub_type: 历史文章,杂志文章

    doi:10.1097/ALN.0000000000001151

    authors: Firth PG

    更新日期:2016-07-01 00:00:00

  • Are all preterm infants younger than 60 weeks postconceptual age at risk for postanesthetic apnea?

    abstract:BACKGROUND:Preterm and ex-preterm infants are at risk for life-threatening apnea after general anesthesia. The authors attempted to define the postconceptual age beyond which apnea is less likely to occur and to identify the factors that predispose to postanesthetic apnea. METHODS:Ninety-one infants younger than 60 we...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199306000-00009

    authors: Malviya S,Swartz J,Lerman J

    更新日期:1993-06-01 00:00:00

  • Platelet function and adrenoceptors during and after induced hypotension using nitroprusside.

    abstract:BACKGROUND:Hypotension induced by sodium nitroprusside can minimize intraoperative blood loss. The release of endogenous catecholamines can influence adrenoceptors of platelets and thus might change the ability of platelets to aggregate. METHODS:Forty patients undergoing nasal septum, tympanoplastic, or sphenoid sinus...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199612000-00014

    authors: Dietrich GV,Heesen M,Boldt J,Hempelmann G

    更新日期:1996-12-01 00:00:00

  • Xenon does not alter cardiac function or major cation currents in isolated guinea pig hearts or myocytes.

    abstract:BACKGROUND:The noble gas xenon (Xe) has been used as an inhalational anesthetic agent in clinical trials with little or no physiologic side effects. Like nitrous oxide, Xe is believed to exert minimal unwanted cardiovascular effects, and like nitrous oxide, the vapor concentration to achieve 1 minimum alveolar concentr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200002000-00035

    authors: Stowe DF,Rehmert GC,Kwok WM,Weigt HU,Georgieff M,Bosnjak ZJ

    更新日期:2000-02-01 00:00:00

  • Thiopental alters contraction, intracellular Ca2+, and pH in rat ventricular myocytes.

    abstract:BACKGROUND:Myocardial contractility is regulated by intracellular concentration of free Ca2+ ([Ca2'],) and myofilament Ca2+ sensitivity. The objective of this study was to elucidate the direct effects of thiopental on cardiac excitation-contraction coupling using individual, field-stimulated ventricular myocytes. METH...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199807000-00027

    authors: Kanaya N,Zakhary DR,Murray PA,Damron DS

    更新日期:1998-07-01 00:00:00

  • Thoracic epidural anesthesia increases mucosal perfusion in ileum of rats.

    abstract:BACKGROUND:Previous studies reported that thoracic epidural anesthesia (TEA) protected against a decrease in gastric intramucosal pH, suggesting that TEA increased gut mucosal perfusion. The current study examines the effects of TEA on ileal mucosa using intravital microscopy in anesthetized rats. METHODS:Nineteen rat...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200009000-00036

    authors: Sielenkämper AW,Eicker K,Van Aken H

    更新日期:2000-09-01 00:00:00