Morphine-related metabolites differentially activate adenylyl cyclase isozymes after acute and chronic administration

Morphine-3- and morphine-6-glucuronide are morphine’s major metabolites. As morphine-6-glucuronide produces stronger analgesia than morphine, we investigated the effects of acute and chronic morphine glucuronides on adenylyl cyclase (AC) activity. Using COS-7 cells cotransfected with representatives of the nine cloned AC isozymes, we show that AC-I and V are inhibited by acute morphine and morphine-6-glucuronide, and undergo superactivation upon chronic exposure, while AC-II is stimulated by acute and inhibited by chronic treatment. Morphine-3-glucuronide had no effect. The weak opiate agonists codeine and dihydrocodeine are also addictive. These opiates, in contrast to their 3-O-demethylated metabolites morphine and dihydromorphine (formed by cytochrome P450 2D6), demonstrated neither acute inhibition nor chronic-induced superactivation. These results suggest that metabolites of morphine (morphine-6-glucuronide) and codeine/dihydrocodeine (morphine/dihydromorphine) may contribute to the development of opiate addiction.     

Chronic morphine exposure increases the proportion of on-cells in the rostral ventromedial medulla in rats

Chronic opiate exposure produces tolerance and hypersensitivity to mechanical and thermal stimulation that involves increased pain facilitation from the rostral ventromedial medulla (RVM). The aim of the present study was to determine the effect of sustained systemic morphine exposure on RVM neurons. Three cell types in the RVM have been described: on-cells, off-cells and neutral cells. The activity of on-cells increases in response to noxious stimulation, whereas the activity of off-cells decreases following noxious stimulation. Neutral cells remain relatively unaffected. In lightly anesthetized rats, systematic exploration throughout the RVM using single-unit extracellular recordings was used to examine both the relative proportion and the neuronal properties of the different cell classes in chronic morphine and placebo treated animals. Seven days after implanting either morphine (150 mg, s.c.) or placebo pellets a total of four electrode penetrations through the RVM were made in each animal at identical coordinates along midline. Neuronal responses related to radiant heat-evoked paw withdrawals were recorded. When compared to placebo treated rats, chronic morphine increased the number of on-cells and decreased the number of neutral cells, while the number of off-cells remained unchanged. Chronic morphine exposure had no effect on the spontaneous or heat-evoked discharges in on-, off-, or neutral cells. These results indicate that chronic morphine may sensitize a subpopulation of RVM neurons to noxious stimulation, which would be expected to increase descending facilitation and promote tolerance and chronic morphine-induced paradoxical pain.     

曲马多、吗啡术后自控镇痛对食管癌患者细胞免疫功能的影响

目的：比较曲马多、吗啡对食管癌术后患者的镇痛疗效以及对机体免疫功能的影响。方法：将本院50 例行食管癌手术患者随 机分成对A 组和B 组,A 组接受硬膜外吗啡镇痛,B 组接受硬膜外曲马多镇痛,常规监测心电图（ECG）、无创血压（BP）、心率 （HR）、血氧饱和度（SPO2）、呼气末二氧化碳分压(PETCO2）。记录两组患者不同时间点视觉模拟疼痛（VAS）评分、不良反应发生 率、外周血T 淋巴细胞亚群(CD3+、CD4+、CD8+)、NK 细胞的变化。结果：两组患者均得到满意的术后镇痛效果,术后1d,A、B两组 患者外周血T淋巴细胞亚群、NK 细胞的水平较术前降低（P<0.05）,且A 组降低幅度明显大于B 组（P<0.05）;术后2d,A 组外周 血T 淋巴细胞亚群、NK 细胞的水平虽有所升高,但仍较术前降低（P<0.05）,B 组CD3+、CD4+、CD8+及NK细胞水平恢复至术前水 平;术后3d,A 组上述指标恢复至麻醉前水平。结论：曲马多在镇痛的同时对机体外周血T 淋巴细胞亚群和NK细胞水平影响较 小,减轻了麻醉对细胞免疫功能的抑制效应。     

Simultaneous assay of morphine, morphine-3-glucuronide and morphine-6-glucuronide in human plasma using normal-phase liquid chromatography–tandem mass spectrometry with a silica column and an aqueous organic mobile phase

Morphine (MOR) is an opioid analgesic used for the treatment of moderate to severe pain. MOR is extensively metabolized to morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G). A rapid and sensitive method that was able to reliably detect at least 0.5 ng/ml of MOR and 1.0 ng/ml of M6G was required to define their pharmacokinetic profiles. An LC–MS–MS method was developed in our laboratory to quantify all three analytes with the required sensitivity and a rapid turnaround time. A solid-phase extraction (SPE) was used to isolate MOR, M3G, M6G, and their corresponding deuterated internal standards from heparinized plasma. The extract was injected on a LC tandem mass spectrometer with a turbo ion-spray interface. Baseline chromatographic separation among MOR, M3G, and M6G peaks was achieved on a silica column with an aqueous organic mobile phase consisting of formic acid, water, and acetonitrile. The total chromatographic run time was 3 min per injection, with retention times of 1.5, 1.9 and 2.4 min for MOR, M6G, and M3G, respectively. Chromatographic separation of M3G and M6G from MOR was paramount in establishing the LC–MS–MS method selectivity because of fragmentation of M3G and M6G to MOR at the LC–MS interface. The standard curve range in plasma was 0.5–50 ng/ml for MOR, 1.0–100 ng/ml for M6G, and 10–1000 ng/ml for M3G. The inter-day precision and accuracy of the quality control (QC) samples were <7% relative standard deviation (RSD) and <6% relative error (R.E.) for MOR, <9% RSD and <5% R.E. for M6G, and <3% RSD and <6% R.E. for M3G. Analyte stability during sample processing and storage were established. Method ruggedness was demonstrated by the reproducible performance from multiple analysts using several LC–MS–MS systems to analyze over one thousand samples from clinical trials.     

阿片类物质对猴免疫缺陷病毒感染的CEM×174细胞内p53合成的调节作用(英文)

已经证明阿片类物质如吗啡能够刺激猴免疫缺陷病毒 ( SIV)的复制 ,并最终加速细胞死亡 ,但是其机理却研究很少 .为探讨吗啡和甲硫氨酸脑啡肽对细胞内 p53合成的作用 ,用 SIV感染CEM× 1 74细胞 ,同时分析 SIV感染时病理过程的机理 .在 CEM× 1 74细胞感染 SIV后不同时间 ,p53含量逐渐增加 ,但 1 0 -7mol/L的吗啡仅在起始阶段对其有促进作用 .在 SIV感染组加入吗啡或甲硫氨酸脑啡肽进行时间曲线实验时 ,p53含量较低 .加入 1 0 -8～ 1 0 -6mol/L吗啡 8h,正常细胞 p53含量仅有轻微改变 .但在 SIV感染情况下 ,则呈现剂量依赖性的大量增加 .相反 ,1 0 -8- 1 0 -6mol/L甲硫氨酸脑啡肽在 8h时能增加正常细胞 p53合成达 60 % .在 SIV感染时 ,SIV本身能够促进 p53的含量 .尽管各组 p53仍然高于对照组 ,但甲硫氨酸脑啡肽对其不再起作用 .结果提示甲硫氨酸脑啡肽对正常细胞 p53含量有明显影响 ,而吗啡 8h增加 SIV感染细胞的 p53含量可能是其加速爱滋病病理过程的机理之一 .     

The role of glutamate in the locus coeruleus during opioid withdrawal and effects of H-7, a protein kinase inhibitor, on the action of glutamate in rats

To investigate the role of glutamate in the locus coeruleus (LC) during opioid withdrawal, rats were continuously infused with morphine (a -opioid receptor agonist, 26 nmol/µl/h) or butorphanol (a //-mixed opioid receptor agonist, 26 nmol/µl/h) intracerebroventricularly (i.c.v.) via osmotic minipumps for 3 days. A direct LC injection of glutamate (1 or 10 nmol/5 µl) or naloxone (an opioid receptor antagonist, 24 nmol/5 µl) induced withdrawal signs in morphine- or butorphanol-dependent animals. However, these agents failed to precipitate any withdrawal signs in saline-treated control animals. On the other hand, the expression of withdrawal signs precipitated by the administration of glutamate or naloxone in opioid-dependent animals was completely blocked by concomitant infusion with 1 or 10 nmol/µl/h of an inhibitor of adenosine 3,5-cyclic monophosphate (cAMP)-dependent protein kinase and protein kinase C, H-7 [1-(5-isoquinolinesulfonyl)-2-methylpiperazine]. In animals that had been infused with opioids in the same manner, i.c.v. injection of naloxone (48 nmol/5 µl) precipitated withdrawal signs and increased extracellular fluid levels of glutamate in the LC of morphine- or butorphanol-dependent rats measured by in vivo microdialysis method. However, concomitant infusion with H-7 inhibited the increases of glutamate levels in the LC. These results strongly suggest that an expeditious release of glutamate in the LC region plays an important role in the expression of physical dependence on opioids. Furthermore, the action on glutamate release might be increased by the enhancement of cAMP-dependent protein kinase and/or protein kinase C activity.     

下行疼痛易化系统在吗啡耐受机制中的作用

吗啡是临床上常用的一种阿片类镇痛药物,广泛用于治疗各种类型疼痛,但是长期应用吗啡会造成吗啡耐受,从而限制了吗啡的临床应用。吗啡耐受的机制十分复杂,近年来的研究表明下行疼痛易化系统参与了吗啡耐受,本文拟对近年来此方面的研究进行综述。     

米非司酮(RU486)对吗啡成瘾后新颖环境探究活动量的影响

精神成瘾性药物急性戒断后行为活动量增加是一个突出表现,本实验以米非司酮(RU486)为干涉药物,抑制糖皮质激素与受体结合,间接抑制戒断期间DA递质升高所引起活动量的增加。结果表明,米非司酮可以明显降低成瘾后急性戒断期间的活动量,但是对腹腔注射生理盐水动物活动量影响不显著。结论:进一步验证糖皮质激素在吗啡成瘾戒断期间的易化作用,同时也表明RU486可以在一定程度上缓解戒断后药物敏感化行为     

Morphine metabolism revisited: I. Metabolic activation of morphine to a reactive species in rats

Treatment of fasted rats with relatively high doses of morphine rapidly results in depletion of hepatic glutathione (GSH) content and marked elevation of serum transaminase activity. Such morphine-induced response has been generally attributed to central nervous system mediated effects of the drug. We now report that this response might be due to a direct effect of the drug in the liver. That is, its metabolic activation to reactive electrophilic metabolite(s), by the hepatic cytochrome P-450-dependent mixed function oxidase system. Structure-activity relationships of morphine and its congeners indicate that the (-)-3-hydroxy-N- methylmorphinan moiety is linked with the potential of these opioids to deplete hepatic GSH and to raise serum transaminases in rats.