Opioid and non-opioid mechanisms of stress analgesia: lack of cross-tolerance between stressors

Restraint stress-induced antinociceptive effects in acute pain: Involvement of orexinergic system in the nucleus accumbens

The complicated relevance between stress and pain has been identified. Neurotransmitters and neuropeptides of various brain areas play a role in this communication. Pain inhibitory response is known as stress-induced analgesia (SIA). The studies demonstrated that the nucleus accumbens (NAc) is critical in modulating pain. As a neuropeptide, orexin is crucially involved in initiating behavioral and physiological responses to threatening and unfeeling stimuli. However, the role of the orexin receptors of the NAc area after exposure to restraint stress (RS) as acute physical stress in the modulation of acute pain is unclear. One hundered twenty adult male albino Wistar rats (230-250 g) were used. Animals were unilaterally implanted with cannulae above the NAc. The SB334867 and TCS OX2 29 were used as antagonists for OX1r and OX2r, respectively. Different doses of the antagonists (1, 3, 10, and 30 nmol/0.5 µl DMSO) were microinjected intra-NAc five minutes before exposure to RS (3 hours). Then, the tail-flick test as a model of acute pain was performed, and the nociceptive threshold (Tail-flick latency; TFL) was measured in 60-minute time set intervals. According to this study's findings, the antinociceptive effects of RS in the tail-flick test were blocked during intra-NAc administration of SB334867 or TCS OX2 29. The RS as acute stress increased TFL and deceased pain-like behavior responses. The 50 % effective dose values of the OX1r and OX2r antagonists were 12.82 and 21.64 nmol, respectively. The result demonstrated contribution of the OX1r into the NAc was more remarkable than that of the OX2r on antinociceptive responses induced by the RS. Besides, in the absence of RS, the TFL was attenuated. The current study's data indicated that OX1r and OX2r into the NAc induced pain modulation responses during RS in acute pain. In conclusion, the findings revealed the involvement of intra-NAc orexin receptors in improving SIA.

Role of orexinergic receptors within the ventral tegmental area in the development of morphine sensitization induced by forced swim stress in the rat

The ventral tegmental area (VTA) has been suggested as part of a common system for reward, stress, and morphine sensitization. Repeated exposure to stress enhances sensitivity to drugs such as morphine. The role of orexin receptor type 1 (OX1R) and type 2 (OX2R) within the VTA in cross-sensitization of morphine with stress was assessed in this study. Various doses of OX1R antagonist (SB334867) and OX2R antagonist (TCS OX2 29) were microinjected into the VTA of 134 adult male albino Wistar rats through cannulae, which had been bilaterally implanted above this region. Five min after microinjection, animals were forced to swim for 6 min, and 10 min after forced swim stress (FSS) termination, a low dose of morphine (i.e., ineffective dose for sensitization) was subcutaneously injected (1 mg/kg; sc). This procedure was repeated for three consecutive days as a sensitization period followed by a 5-day drug/stress-free period. On the 9th day, sensitivity to morphine was examined by measuring antinociceptive responses to the ineffective dose of morphine via tail-flick test. The obtained findings revealed that while concurrent administration of FSS and an ineffective dose of morphine (1 mg/kg; sc) for three consecutive days induced sensitivity to morphine, intra-VTA administration of OX1R- and OX2R antagonists, dose-dependently blocked this sensitization. These results suggested that both orexin receptors located in the VTA have a considerable role in morphine sensitization induced by concurrent administration of FSS and a low dose of morphine. So, there is a contribution of the orexin system partly to stress-induced sensitization to morphine.

Intra-accumbal dopaminergic system modulates the restraint stress-induced antinociceptive behaviours in persistent inflammatory pain

BACKGROUND

Stress activates several neural pathways that inhibit pain sensation. Nucleus accumbens (NAc), as an important component of the mesolimbic dopaminergic system, has a major role in pain modulation and is differentially affected by stress. Based on the nature of stressors, the direction of this effect is controversial. We previously showed that forced swim stress-induced analgesia through activation of NAc dopamine receptors. In this study, we aimed to examine the role of dopamine receptors within the NAc in restraint stress (RS)-induced analgesia.

METHODS

Male Wistar rats weighing 230-250 g were unilaterally implanted with a cannula into the NAc. D1-like dopamine receptor antagonist, SCH-23390 (0.25, 1 and 4 µg/0.5 µL saline), or D2-like dopamine receptor antagonist, Sulpiride (0.25, 1 and 4µg/0.5µl DMSO), were microinjected into NAc in two separate super groups 5 min prior to exposure to RS. Their control groups just received intra-accumbal saline or DMSO (0.5 µl) respectively. The formalin test was performed after animals were subjected to RS using Plexiglas tubes.

RESULTS

The results demonstrated that RS produces analgesia in both phases of the formalin test. Intra-NAc injection of SCH-23390 equally reduced RS-induced analgesia in both early and late phases of the formalin test, while Sulpiride reduced RS-induced analgesia just at the late phase.

CONCLUSIONS

These findings suggest that the dopaminergic system might act as a potential endogenous pain control system in stress conditions. However, the lack of evaluation of the role of the dopaminergic system in RS-induced antinociception in acute pain conditions is considered as a limitation for this study. In addition, a comprehensive evaluation of this endogenous pain control system in animal and clinical studies will guide future efforts for developing more effective medication.

SIGNIFICANCE

Restraint stress (RS) induces the antinociceptive behaviors in both phases of formalin test. Blockade of intra-accumbal dopamine receptors impresses the antinociception induced by RS. Blockade of D1-like dopamine receptor equally reduced RS-induced analgesia in both early and late phases of the formalin test. Blockade of D2-like dopamine receptor reduced RS-induced analgesia just at the late phase.

Endogenous cannabinoid modulation of restraint stress-induced analgesia in thermal nociception

It is thought that endogenous cannabinoids have a role in the analgesia induced by specific forms of stress. We examined if the role of endogenous cannabinoids is also dependent upon the mode of nociception, and whether this could be altered by drugs which block their enzymatic degradation. In C57BL/6 mice, restraint stress produced analgesia in the hot-plate and plantar tests, two thermal pain assays that engage distinct supraspinal and spinal nociceptive pathways. Stress-induced analgesia in the hot-plate test was abolished by pre-treatment with the opioid receptor antagonist naltrexone but was unaffected by the cannabinoid receptor antagonist 1-(2,4-Dichlorophenyl)-5-(4-iodophenyl)-4-methyl-N-4-morpholinyl-1H-pyrazole-3-carboxamide (AM281). By contrast, stress-induced analgesia in the plantar test was abolished by pre-treatment with naltrexone plus AM281, but not by either antagonist individually. Remarkably, inhibiting the breakdown of endocannabinoids, with the dual fatty acid amide hydrolase and monoacylglycerol lipase inhibitor JZL195, rescued stress-induced analgesia in the hotplate test when endogenous opioid signalling was blocked by naltrexone. Furthermore, JZL195 recruited analgesia induced by sub-threshold restraint stress in both thermal pain assays. These findings indicate the role of endocannabinoids in stress-induced analgesia differs with the type of thermal pain behaviour. However, by inhibiting their breakdown, endocannabinoids can be recruited to substitute for endogenous opioid signalling when their activity is blocked, indicating a degree of redundancy between opioid and cannabinoid systems. Together these data suggest targeting endocannabinoid breakdown could provide an alternative, or adjuvant to mainstream analgesics such as opioids.

Involvement of NTS2 receptors in stress-induced analgesia

Stress activates multiple neural systems that suppress pain sensation. This adaptive phenomenon referred as stress-induced analgesia (SIA) is mediated by the activation of endogenous pain inhibitory systems. Both opioid and non-opioid forms of SIA have been elicited in rodents according to stressor parameters and duration. There is accumulating evidence that the endogenous neurotensin (NT) system plays an important role in SIA. Especially, NT-deficient mice were shown to exhibit reduced SIA following water avoidance or restraint stress. Since central NT produces naloxone-insensitive analgesic effects by acting on spinal and supraspinal NTS2 receptors, we hypothesized that NT might mediate non-opioid SIA through NTS2 activation. Here, we evaluated the influence of an opioid-independent severe stress produced by a cold-water swim for 3 min at 15 degrees C on rodent offspring's pain perception. Our results demonstrated that mice lacking NTS2 exhibit significantly reduced SIA following cold-water swim stress. Indeed, NTS2 knockout mice submitted to both acute (plantar test) and tonic (formalin test) pain stimuli show a greater sensitivity to pain in comparison to wild-type littermates. Accordingly, pretreatment with the NT receptor antagonist SR142948A results in a hyperalgesic response to stress induced by cold-water swim. Endogenous NT regulates hypothalamic-pituitary-adrenal axis activity in stress condition by increasing corticosterone plasma levels. Accordingly, the plasma levels of corticosterone measured by radioimmunoassay are significantly reduced in non-stressed and stressed NTS2-deficient mice in comparison with wild-type mice. To further investigate the site of action of NT in mediating SIA, we microinjected NTS2 agonists in lumbar spinal cord and quantified post-stress sensitivity to pain in rats using the plantar test. Exogenously administered NTS2 analogs, JMV-431, beta-lactotensin and NT69L markedly enhance the magnitude and duration of stress antinociception in both 25- and 60-day-old rats. In sum, by using genetic and pharmacological approaches, we demonstrated here that NTS2 receptors mediate non-opioid SIA. Our results also revealed that the release of endogenous NT in response to stress requires the presence of NTS2 to stimulate corticotropin-releasing factor (CRF)-induced elevation of plasma corticosterone, and that NTS2 receptors localized at the lumbar spinal cord participate to the disinhibition of descending pain control pathways. Therefore, these data highlight the significance of NTS2 as a novel target for the treatment of pain and stress-related disorders.

Changes in in vivo [(3)H]-Ro15-4513 binding induced by forced swimming in mice

Mice were forced to swim for 5 min in water at a temperature of 12 degrees C (cold water swim stress) or 32 degrees C (warm water swim stress), and stress-induced analgesia (SIA) was measured using the tail-flick test. The cold water swim stress induced non-opioid SIA as well as hypothermia, whereas the warm water swim stress caused opioid SIA. The in vivo binding of [(3)H]-Ro15-4513 was measured in the stressed mice and compared with that in control mice. The specific binding of [(3)H]-Ro15-4513 in the cerebral cortex, hippocampus, and cerebellum was significantly altered by forced swimming in cold water. Apparent association and dissociation rate of [(3)H]-Ro15-4513 binding were decreased, and the change in the dissociation rate was most pronounced in the hippocampus. In contrast, no significant alterations were observed in in vitro binding. The hypothermia induced by the cold water swim stress seems to be the main reason for alterations in the specific binding of [(3)H]-Ro15-4513. The kinetics of a saturable amount of [(3)H]-Ro15-4513 in the blood and brain were also measured. The relative ratio of the radioactivity concentration in the brain to that in the blood was significantly decreased by forced swimming in cold water, indicating that the cold water swim stress induced changes in the nonspecific binding of [(3)H]-Ro15-4513 in the brain. These results together with previous reports suggested that non-opioid SIA induced by the cold water swim stress might be related to alterations in the rates of general ligand-receptor interactions including GABA(A)/benzodiazepine system. Changes in the nonspecific binding might be also involved in non-opioid SIA.

Emotional stress reactivity in irritable bowel syndrome

OBJECTIVES

Irritable bowel syndrome (IBS) has been proposed to be a stress-related disorder. Research on stress reactivity in IBS has yielded ambiguous results, regarding responses to physical and mental stress. This study aimed to investigate the responses to emotional stress in IBS patients.

METHODS

Twelve IBS patients and 12 healthy individuals underwent public speaking anticipation as an emotional stressor and a control situation. Stress reactivity was quantified by subjective and psychophysiological measures.

RESULTS

Stress responses were elicited in healthy controls and IBS patients. Differential stress responses were observed in measurements of heart rate. There was no change in rectal sensitivity under stress, whereas patients exhibited lower discomfort thresholds than healthy controls in all conditions.

CONCLUSION

This study measured reactivity to an emotional stressor in IBS. It provides evidence that there is a specific alteration of stress responses in IBS patients, but no overall exaggerated stress response. IBS patients showed a broader and less specific response to emotional stress than healthy controls. Rectal sensitivity was unchanged under emotional stress both in IBS patients and healthy controls.

Inhibition of fatty-acid amide hydrolase enhances cannabinoid stress-induced analgesia: sites of action in the dorsolateral periaqueductal gray and rostral ventromedial medulla

Recent research in our laboratory has demonstrated that stress activates an endogenous cannabinoid mechanism that suppresses sensitivity to pain [Nature 435 (2005) 1108]. In this work, CB(1) antagonists administered systemically blocked stress-induced analgesia induced by brief, continuous foot-shock. The present studies were conducted to examine the role of cannabinoid CB(1) receptors in the brainstem rostral ventromedial medulla (RVM) and midbrain dorsolateral periaqueductal gray (PAG) in cannabinoid stress-induced analgesia (SIA). Pharmacological blockade of vanilloid TRPV1 receptors with capsazepine, administered systemically, did not alter cannabinoid SIA, suggesting that cannabinoid SIA was not dependent upon TRPV1. Microinjection of the competitive CB(1) antagonist rimonabant (SR141716A) into either the RVM or dorsolateral PAG suppressed stress antinociception in this model. Rimonabant was maximally effective following microinjection into the dorsolateral PAG. The fatty-acid amide hydrolase (FAAH) inhibitor arachidonoyl serotonin (AA-5-HT) was subsequently used to block hydrolysis of endocannabinoids and enhance SIA. Systemic and site-specific injections of AA-5-HT into either the dorsolateral PAG or RVM induced CB(1)-mediated enhancements of SIA. Palmitoyltrifluoromethylketone, a potent inhibitor of FAAH and phospholipase A2 activity, administered systemically, exerted similar effects. In all conditions, the antinociceptive effects of each FAAH inhibitor were completely blocked by coadministration of the CB(1) antagonist rimonabant. The present results provide evidence that a descending cannabinergic neural system is activated by environmental stressors to modulate pain sensitivity in a CB(1)-dependent manner.

Differential involvement of opioid receptors in stress-induced antinociception caused by repeated exposure to forced walking stress in mice

We examined the effects of repeated exposure to forced walking stress for 6 h once a day for 0, 6 and 9 consecutive days on formalin-induced paw licking in mice. In each observation period, stress-induced antinociception (SIA) was observed only in the late phase (from 10 to 30 min), but not in the early phase (from 0 to 10 min) of formalin-induced paw licking in mice. Moreover, it was hard to develop tolerance even by daily exposure to stress for 6 days, although SIA for 9 days decreased compared with those for 0 and 6 days. Naloxone (10 mg/kg), an opioid-receptor antagonist, was effective in reducing the SIA induced by forced walking stress for 6 days and/or 9 days, but not for 0 days. Furthermore, the experiments with selective opioid-receptor antagonists, beta-funaltrexamine (mu) naltrindol (delta), or nor-binaltorphimine (kappa) demonstrated that SIA induced by forced walking stress for 9 successive days may be mediated through opioid delta- and kappa-receptors. Finally, although SIA seemed to be a unitary phenomenon, the present results strengthened the idea that SIA is induced by exposure to forced walking stress with characteristics dependent on the duration of exposure.

Effects of repeated cold stress on feeding, avoidance behavior, and pain-related nerve fiber activity

The specific alternation of rhythm in temperature (SART), which is defined as rapid and frequent changes in the environmental temperature several times within the course of a day, produces abnormalities in behavior such as hyperphagia and in sensory sensation such as hyperalgesia. As the first step toward understanding the mechanisms of these abnormalities, we studied the effects or SART stress on ingestive behavior. During the light and dark phases, the animals' food intake increased, but their body weight gain decreased. In addition, diurnal variation in body weight also decreased. Next, we examined the behavioral and electrophysiological effects of SART stress on avoidance behavior by studying the rat's avoidance of a noxious stimulus in the form of a footshock. The rats demonstrated hyperreactivity; the delay in escaping the footshock was decreased by SART stress. The excitability of C-fiber activity, which responds to mechanical and thermal stimuli to a single saphenous nerve, was not changed by SART stress. This suggests that the hyperreactivity in footshock avoidance and the hyperalgesia in pain response induced by SART stress are based on excessive emotionality.

Antisense oligodeoxynucleotide to a delta-opioid receptor blocks the antinociception induced by cold water swimming

The type of opioid receptors in the spinal cord involved in antinociception induced by cold water swimming (CWS) was studied in male ICR mice. Mice were submitted to CWS for 3 min and antinociception was measured 7 min after the CWS by the tail-flick test. Intrathecal (i.t.) injection of naltrindole (NTI, 5 micrograms) which blocked i.t. DPDPE ([D-Pen2,D-Pen5]en-kephalin, 5 micrograms)-induced antinociception, blocked the CWS-induced antinociception. On the other hand, i.t. injection of CTOP (D-Phe-Cys-Try-D-Try-Orn-Thr-Pen-Thr-NH2, 50 ng) and norbinaltorphimine (nor-BNI, 5 micrograms) which blocked i.t. DAMGO ([D-Ala2,NHPhe4,Gly-ol]enkephalin, 10 ng)- and U50,488H (trans(+/-)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)- cyclohexyl]benzeneacetamide, 75 micrograms)-induced antinociception, respectively, did not block CWS-induced antinociception. Intrathecal pretreatment with antisense oligodeoxynucleotide to delta-opioid receptor mRNA (delta-AS oligo, 163 pmol) once a day for 1 to 3 days caused a time-dependent attenuation of CWS-induced antinociception. delta-AS at doses from 1.6 to 163 pmol pretreated i.t. for 3 days caused a dose-dependent blockade of CWS-induced antinociception. However, i.t. pretreatment with mismatch oligodeoxynucleotide (MM oligo, 163 pmol) for 3 days did not affect the CWS-induced antinociception. The results indicate that CWS-induced antinociception is mediated by the stimulation of delta-opioid receptors in the spinal cord.

Antinociceptive and hypothermic crosstolerance between continuous and intermittent cold-water swims in rats

Antinociceptive responses induced by continuous (CCWS: 2 degrees C, 3 min) and intermittent (ICWS: 2 degrees C, 18 10-s swims, 18 10-s recoveries) cold-water swims differ in their sensitivity to opioid antagonists and crosstolerance with morphine. The present study examined whether CCWS and ICWS antinociception and hypothermia displayed crosstolerance in rats. Jump thresholds were significantly increased following acute exposure to CCWS (30 min) and ICWS (30-60 min). CCWS antinociception displayed tolerance (90% reduction) to CCWS after 14 days and crosstolerance (100% reduction) to ICWS on the fifteenth day. ICWS antinociception displayed tolerance (74% reduction) to ICWS and crosstolerance (81% reduction) to CCWS. Core body temperatures were significantly decreased following acute exposure to CCWS (30 min) and ICWS (30-90 min). Although CCWS and ICWS hypothermia displayed tolerance to the same stressor and crosstolerance to the other stressor, the changes in the antinociceptive and hypothermic effects failed to correlated significantly with each other.

Cross-tolerance between morphine and swim analgesia in mice selectively bred for high and low stress-induced analgesia

Mice selectively bred for high (HA) and for low analgesia (LA) induced by 3-min swimming at 20 degrees C and unselected controls (C) were injected three times daily for 3 days with 20 mg/kg morphine HCl. The analgesic effect of 10 mg/kg morphine in nontolerant mice differed between the lines in the rank order of HA > C > LA and significantly decreased after repeated treatment with morphine, as revealed by the hotplate test (56 degrees C). The tolerance to morphine analgesia was more pronounced in HA than in C mice but did not develop at all in LA mice. Similarly, the magnitude of swim-induced analgesia in morphine tolerant mice decreased to a greater degree in the HA than the C line but did not change in LA mice. Naloxone HCl (1 and 10 mg/kg) attenuated swim analgesia more in nontolerant HA than C mice but had no effect in morphine-tolerant HA and C and in all LA mice. The differential degree of morphine tolerance and cross-tolerance with swim analgesia suggests that the strategy of selective breeding toward divergent magnitudes of stress-induced analgesia has differentiated opioid involvement in endogenous pain inhibition in the selected lines.

Effects of stress on opioid receptor binding in the rat central nervous system

The endogenous opioid peptides are known to play a significant role in the modulation and/or mediation of numerous environmental or experimental stressors. However, the specific opioid peptide(s) and receptor type(s) involved, under what physiologic conditions they are engaged and within which regions of the CNS is not well understood. We therefore examined the effects of both a chronic and an acute stressor-90-h water deprivation and a single 20-min foot shock on opioid receptor binding in 17 specific rat brain nuclei. [3H]DSTLE (Tyr-D-Ser-Gly-Phe-Leu-Thr) and [3H]DAGO(Tyr-D-Gly-Phe-NMe-Phe-Gly-ol) were used to label delta and mu receptors, respectively. Foot shock induced profound antinociception as measured by tail-flick latency which outlasted the stressor by several minutes. However, only the septum responded with a decrease in [3H]DAGO binding to this type of stress-induced analgesia. No other alterations in either [3H]DAGO or [3H]DSTLE binding were seen in response to foot shock. In contrast, water deprivation induced increases in [3H-DAGO] binding in the septum as well as increases in [3H]DSTLE binding in the caudate and accumbens nuclei. Moreover, the presumptive mild stress of handling in the foot shock control group was sufficient to decrease mu or delta receptor binding in seven out of 17 brain regions investigated (including the frontal cortex and olfactory tubercle where both mu and delta binding were increased) when compared to unhandled deprivation control animals. These changes in opioid receptor binding may have been the result of alterations in treatment-induced peptide release, receptor regulation, or interactions with other released neurotransmitter ligand/receptor complexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Parallel activation of multiple spinal opiate systems appears to mediate 'non-opiate' stress-induced analgesias

Pain is powerfully modulated by circuitries within the CNS. Two major types of pain inhibitory systems are commonly believed to exist: opiate (those that are blocked by systemic opiate antagonists and by systemic morphine tolerance) and non-opiate (those that are not). We used intrathecal delivery of mu, delta, and kappa opiate receptor antagonists to examine 3 well-accepted non-opiate stress-induced analgesias. Combined blockade of all 3 classes of opiate receptors antagonized all of the 'non-opiate' analgesias. Further experiments demonstrated that blocking mu and delta or mu and kappa was sufficient to abolish 'non-opiate' analgesias. Combined blockade of kappa and delta receptors was without effect. The clear conclusion is that all endogenous analgesia systems may in fact be opiate at the level of the spinal cord. Phenomena previously thought to be non-opiate appear to involve parallel activation of multiple spinal opiate processes. These findings suggest the need for a fundamental shift in conceptualizations regarding the organization and function of pain modulatory systems in particular, and opiate systems in general.

Effects of intrathecal antibodies to substance P, calcitonin gene-related peptide and galanin on repeated cold stress-induced hyperalgesia: comparison with carrageenan-induced hyperalgesia

Rats exposed to a cold environment (4 degrees C) for 30 min every 1 h during the day and at night show a gradual decrease in the nociceptive threshold for pressure stimulation. Such hyperalgesia, referred to as repeated cold stress (RCS)-induced hyperalgesia, is stable for at least 4 h and maintained for 3 days only by exposing to cold overnight; thus, no adaptation to RCS is apparent. Hyperalgesia gradually returns over 4 days after cold exposure ceases. To determine whether three neuropeptides, substance P (SP), calcitonin gene-related peptide (CGRP) and galanin (GAL), which are present in the superficial dorsal horn including primary afferent terminals, would be responsible for RCS-induced hyperalgesia, we examined the effects of intrathecal injections of their antibodies (used as inhibitors of neuropeptide-mediated synaptic transmission) on the nociceptive threshold of RCS rats, and compared this with the antibody effect on carrageenan-induced hyperalgesia. An intrathecal injection of anti-SP antibody significantly inhibited the hyperalgesia of RCS rats as well as carrageenan-induced hyperalgesia, and slightly increased the nociceptive threshold of non-RCS rats. Anti-CGRP antibody produced an improvement in the hyperalgesia of RCS rats as well as carrageenan-induced hyperalgesia without having an effect on the nociceptive threshold of non-RCS rats. Although anti-GAL antibody significantly inhibited carrageenan-induced hyperalgesia, it did not affect the nociceptive threshold of RCS and non-RCS rats. The present results suggest that enhancement of synaptic transmission mediated by SP and CGRP, but not GAL, in the spinal dorsal horn is, at least in part, involved in RCS-induced hyperalgesia.

Tolerance and cross-tolerance with morphine in mice selectively bred for high and low stress-induced analgesia

Mice selectively bred for high (HA) and low (LA) swim-induced analgesia were exposed to two different stress paradigms; one consisting of a 3-min swim at 20 degrees C daily for 14 days, and the other consisting of 3-min swims repeated at 2-h intervals for 48 h. Both forms of chronic stress resulted in the development of tolerance to swim-induced antinociception to a greater degree in the HA mice than in control (C) mice, but were both ineffective at inducing tolerance in LA mice. Swimming repeated at 2-h intervals for 48 h resulted in cross-tolerance with morphine in HA and C mice. Naloxone (1 and 10 mg/kg, IP) failed to antagonize swim-induced analgesia in mice that had experienced chronic swimming in the 2-h/48-h paradigm. The daily swimming paradigm failed to produce cross-tolerance with morphine analgesia in any line. Differential degree of tolerance in three lines supports a hypothesis that selective breeding for high and low stress-induced analgesia has modified the degree of opioid involvement in the endogenous analgesia mechanisms.

Stress induced analgesia plays an adaptive role in the organization of behavioral responding

The data on ability of stressful or noxious stimuli to suppress the perception of pain was reviewed. The focus of this review has been the attempt to demonstrate that the emergent "Stress Induced Analgesia" (SIA) plays an adaptive role in the modulation of behavioral responding by organisms during periods of threat or danger to the organism. We have reviewed the experimental paradigms that normally used in these studies which point to the fact that the variables inducing SIA need not be actually aversive or even stressful. We also reviewed the data on the mechanisms of SIA and suggested that both opioid and nonopioid mechanisms are involved in the mediation of SIA and that these mechanisms are at least semiindependent and subject to differential conditioning. Finally, we have described a series of experiments carried out in our laboratory where the induction of SIA interacted with behavioral performance in an inverted U shape function, low levels of stress facilitated responding and learning while high levels disrupted responding. We argued that taken together, the effects of SIA seem to be highly adaptive in that it allowed animals to deal with a dangerous and threatening situation in a manner which increased the organism's chance of survival.

The analgesic effect of peripheral nerve stimulation in various tests of nociception in rats

The present study examines analgesic properties of 2 Hz peripheral nerve stimulation in four different tests of nociception: the tail-flick, hot-plate, jump-response and formalin tests. Radial, sciatic and trigeminal nerve stimulation produced decreased response amplitudes to weak electrical foot shocks in the jump-response test. The fact that all three nerves produced the same effect suggests the involvement of general, non-segmental mechanisms. The nerve stimulation produced a characteristic after-effect, lasting several minutes, suggesting the involvement of supraspinal mechanisms. The radial nerve stimulation resulted in the most pronounced reduction in jump responses. Sciatic nerve stimulation also produced analgesia in the formalin test but had no effect on the responsiveness to a brief stimulus at threshold level in the hot-plate or the tail-flick tests. It is concluded that analgesia by peripheral nerve stimulation in animals is most readily detected by tests allowing a quantitative evaluation of responses to above-threshold noxious stimuli and not only measuring reactions occurring at the threshold for nociception.

Analgesia or hyperalgesia following stress correlates with emotional behavior in rats

Analgesia following exposure to a variety of noxious and non-noxious stressors is well documented and is commonly referred to as stress-induced analgesia. Hyperalgesia following stress has also been reported. The present study shows that a mild stressor (15 min of vibration) produced increased tail-flick latencies (TFL) in some rats, but decreased latencies in other rats. The results of the individual subjects were reproduced in a later session: the rats showing increased TFL on day 1, responded with increased TFL on day 2. Rats showing decreased TFL on day 1 responded with decreased TFL on day 2. Whichever reaction occurred, analgesia or hyperalgesia, this correlated with the animal's behavior during the stress procedure. Analgesia was produced in quiet rats and hyperalgesia in hyperemotional ones. Various peripheral nerve stimulation procedures producing hyperemotional reactions also resulted in lowering of the pain threshold. The results of the present study show behavioral modulation of pain mechanisms.

Noradrenergic mechanisms in mediation of stress-induced hyperalgesia in rats

Exposure to a mild stressor (15 min of vibration) produced analgesia in some rats and hyperalgesia in other rats from the same batch treated in the same way. Rats which responded with decreased tail-flick latencies (TFL) showed signs of hyperemotionality during the stress procedure. Stress-induced hyperalgesia was abolished by the administration of diazepam (2.5 mg/kg i.p.) and clonidine (25 micrograms/kg i.p.). It is suggested that the reversal of hyperalgesia was due to the anxiolytic properties of the drugs. Yohimbine, an alpha 2-adrenoceptor antagonist (5 mg/kg i.p.), antagonized the effect of clonidine. The influence of clonidine on stress-induced hyperalgesia may be mediated by alpha 2-adrenoceptors.

Potent inhibition of non-opioid defeat analgesia in male mice by benzodiazepine antagonist Ro15-3505

In male mice, defeat in social encounters is associated with an acute non-opioid analgesia, a reaction that may also be seen in response to the scent of a territorial conspecific. As this form of pain inhibition is blocked by diazepam and Ro15-1788, benzodiazepine receptor mediation has been proposed. To further test this hypothesis, the effects of a novel benzodiazepine receptor antagonist (Ro15-3505; 0.625-20 mg/kg) on basal nociception and defeat analgesia have been examined. Results show that, although devoid of intrinsic activity on the mouse tail-flick assay, Ro15-3505 totally blocks the analgesic consequences of defeat at doses above 1.25 mg/kg. Despite certain inconsistencies in the literature, present data provide further support for benzodiazepine receptor mediation of this ecologically-relevant form of pain inhibition.

Cold swim stress-induced changes in the levels of opioid peptides in the rat CNS and peripheral tissues

Endogenous opioid peptides have been implicated in stress-induced analgesia and stress-induced feeding behavior. An earlier study from our laboratory showed that rats subjected to cold swim stress consumed significantly more food compared to controls. The present study describes changes in the levels of various opioid peptides in the central nervous system and periphery due to cold swim stress. Male Sprague-Dawley rats were subjected to cold swim stress (1 degree C for 5 min), then sacrificed by decapitation; brain, pituitary, adrenals and plasma were collected. Tissue extracts were assayed for opioid peptides by RIA. Cold swim stress resulted in analgesia which could be blocked by prior administration of naloxone, as observed by a tail-flick latency test. Cold swim stress caused a 42% decrease in pituitary beta-endorphin, but increased the level of this peptide in the hypothalamus and plasma by 36% and 337%, respectively. Dynorphin level decreased by 62% in the hypothalamus, but was not affected in the pituitary. Levels of Leu-enkephalin and Met-enkephalin decreased in the adrenal gland by 37% and 18%, respectively, but were not significantly affected in the CNS. These results indicate that cold swim stress has a differential effect on the level of CNS and peripheral opioid peptides, and that both central and peripheral opioid peptides may be important in stress-induced analgesia and feeding behavior.

Social conflict analgesia: inhibition of early non-opioid component by diazepam or flumazepil fails to affect appearance of late opioid component

Two forms of analgesia (opioid and non-opioid) are associated with social conflict in mice. The non-opioid form is seen in response to the scent of an aggressive conspecific or defeat experience, whilst the opioid form occurs in response to extended conspecific attack. Recently, it has been reported that the non-opioid reaction is dose-dependently blocked by diazepam and by Flumazepil (Ro15-1788; a benzodiazepine receptor antagonist). In view of the temporal relationship between these two reactions, the present study was conducted to determine whether activation of non-opioid substrates is a necessary precursor to the development of opioid analgesia. Results indicate that inhibition of non-opioid analgesia by diazepam (2-4 mg/kg), or by Flumazepil (20-40 mg/kg), does not alter the opioid analgesic reaction to conspecific attack. Findings are discussed in relation to the presumed adaptive significance of these biologically-meaningful forms of pain inhibition.

Pain relief by electrical stimulation of the periaqueductal and periventricular gray matter. Evidence for a non-opioid mechanism

Pain relief following stimulation of the periaqueductal gray matter (PAG) or periventricular gray matter (PVG) in man has been ascribed to stimulation-induced release of endogenous opioid substances. Forty-five patients were studied and followed for at least 1 year after placement of chronic stimulating electrodes in the PAG or PVG to determine if pain relief due to stimulation could be ascribed to an endogenous opioid mechanism. Three criteria were assessed: the development of tolerance to stimulation; the possibility of cross-tolerance to morphine; and reversibility of stimulation-induced pain relief by the opiate antagonist naloxone. Sixteen patients (35.6%) developed tolerance to stimulation, that is, they obtained progressively less effective pain relief. Twelve (44.4%) of 27 patients undergoing stimulation of the thalamic sensory relay nuclei for treatment of chronic pain (a presumably non-opioid mechanism) also developed tolerance. Morphine sulfate was administered in a blind, placebo-controlled protocol to 10 patients who had become tolerant to PAG-PVG stimulation and none showed evidence of cross-tolerance. Fifteen of 19 patients, already tolerant to morphine at the time of PAG-PVG electrode implantation, experienced excellent pain relief by stimulation, also indicating a lack of cross-tolerance. Twenty-two patients who experienced excellent pain relief from chronic PAG-PVG stimulation received intravenous naloxone in a double-blind, placebo-controlled protocol. Pain intensity as assessed by the visual analog scale was increased to the same degree by both placebo and naloxone. Eight patients showed no increase in pain intensity with either placebo or naloxone. Although tolerance to PAG-PVG stimulation developed in these patients, the frequency of tolerance was similar to that seen in patients undergoing thalamic sensory nuclear stimulation. Since the latter technique presumably relieves pain by a non-opioid mechanism, the development of tolerance to PAG-PVG stimulation does not, in itself, confirm an opioid mechanism. Cross-tolerance between PAG-PVG stimulation and morphine was not seen and cross-tolerance to PAG-PVG stimulation in patients already tolerant to morphine was rare. The pain-relieving effect of PAG-PVG stimulation was reversed to an approximately equal degree by naloxone and placebo. The authors do not believe that, in most patients, pain relief elicited by PAG-PVG stimulation depends on an endogenous opioid mechanism. It appears that other, non-opioid mechanisms are primarily responsible for such pain relief.

Effects of centrifugal rotation on analgesia and conditioned flavor aversions

In the first experiment, 48 female Wistar rats were water deprived and given three conditioning days with saccharin-flavored water (1.5 g/liter) followed by 0, 5, 10 or 15 min of centrifugal rotation (150 rpm). Analgesia was measured by the tail flick test immediately after rotation. Over conditioning days, taste aversions developed. In general, taste aversion strength increased with duration of rotation. Analgesia also was in proportion to duration of rotation; however, over days tolerance developed in all rotated groups. In the second experiment 12 female Wistar rats were water deprived and given naloxone (20 mg/kg) or saline prior to 15 min of rotation. Rotation-induced analgesia was not affected by naloxone. It was concluded that somatic and gastrointestinal reactions to rotation are not served by a single mechanism.

Evidence for the involvement of cerebral renin-angiotensin system (RAS) in stress analgesia

Studies concerning variations of the central renin-angiotensin system (RAS) during immobilization stress in rats have shown a significant increase in renin-like activity in the hypothalamus and fronto-parietal cortex, together with a definite decrease in the hypophysis and pineal gland. The resultant stress analgesia is blocked by the previous administration of naloxone and saralasin (angiotensin II antagonist). The intracerebral administration of renin and angiotensin II produces an increase in latencies to thermoalgesic stimuli; this is reduced, as is immobilization stress, by naloxone and saralasin. Both chemical hypophysectomy obtained by dexamethasone pretreatment as well as surgical epiphysectomy block the stress-induced analgesia. The experimental data obtained argue in favour of the participation of the cerebral RAS in stress analgesia through the indirect mechanism of release of opioid peptides.

A new immunization procedure for obtention of anti-leucine-enkephalin antibodies. Part II. Effects of olfactory bulb removal on pro-enkephalin related peptides in rat brain

Bilateral Olfactory Bulb Removal (OBR) induced both complex behavioral alterations and a decrease of many neurotransmitter levels. We studied brain levels of the pro-enkephalin related peptides 45 days after OBR. Opioid levels were studied using three different highly specific antisera exhibiting very high affinities in radioimmunoassays in striatum, hypothalamus, hypophysis, brain stem and cortex. Methionine enkephalin levels increase significantly in striatum (42%), hypophysis (94%) and hypothalamus (25%) and non-significantly in the other areas. Leucine-enkephalin levels tended to increase in all dissected structures but a significant increase only occurred in striatum (42%). Octapeptide levels (Methionine-enkephalin-Arg-Gly-Leu) significantly increase in striatum (22%) and decrease in hypophysis (97%) and in brain stem (76%). All these results are partially consistent with the decrease of opiate binding described previously after OBR and suggest a complex imbalance in neurotransmitters after such a sensorial deprivation. It is suggested that the modifications of enkephalinergic neurotransmission might be related to the stressful state induced by OBR.

Cold-restraint stress reduces [3H]etorphine binding to rat brain membranes: influence of acute and chronic morphine and naloxone

[3H]Etorphine binding was characterized in rat brain homogenates depleted of endogenous opioids from animals acutely and chronically treated with morphine or naloxone and either unstressed or subjected to a 3-h restraint period in the cold. There was significant reduction in the number of high-affinity opiate binding sites in brain tissue from stressed as compared to unstressed animals. Despite the fact that the opiate drug regimens used produce marked behavioral and physiological effects, stress-induced opiate receptor depletion was not influenced by the drugs or by withdrawal. The various drug treatments also failed to produce significant changes in opiate receptor site densities or affinities in either stressed or unstressed animals. We propose that persistent activation of opiate receptors by endogenous opioids released during restraint stress leads to receptor 'down-regulation'.

Two opioid forms of stress analgesia: studies of tolerance and cross-tolerance

We have previously reported that stress analgesia sensitive to and insensitive to opiate antagonists can be differentially produced in rats by varying the severity or temporal pattern of inescapable footshock. In these studies, we give further evidence for the opioid and non-opioid bases of these paradigms of stress analgesia. We find that naloxone-sensitive analgesia demonstrates tolerance with repeated stress and cross-tolerance with morphine, whereas naloxone-insensitive analgesia demonstrates neither of these characteristics. Moreover, different forms of opioid, but not non-opioid, stress analgesia manifest cross-tolerance with each other. These data are discussed in terms of the similarities and differences between two forms of opioid stress analgesia.

Stress-induced analgesia in the mouse: strain comparisons

Inescapable footshock is capable of differentially activating opioid- and non-opioid-mediated mechanisms of stress-induced analgesia in the rat, depending on the temporal and intensive parameters of its administration. In this study we compared the effects of opioid and non-opioid stress analgesia in two strains of mice, one known to be deficient in central opioid binding sites (CXBK) and one normal in this regard (C57BL/6BY). We found that although the C57 strain showed robust opioid and non-opioid stress analgesia, the CXBK strain only showed stress analgesia of the non-opioid type.

Non-opiate analgesia following stressful acoustic stimulation

The change in the nociceptive reactions of rats was characterized after stressful acoustic (115 dB) stimulation. Acoustic loading for five minutes resulted in considerable analgesia in the hot-plate test, whereas a significant analgesic response was not observed in the tail-flick test. The analgesic reaction after acoustic stimulation was resistant to naloxone pretreatment and was also found in morphine-tolerant rats, but the acute thermoregulatory and analgesic effects of morphine were greatly potentiated by simultaneous acoustic loading. Substance P or cholecystokinin treatment likewise failed to prevent the analgesic effect of auditory stimulation. No tolerance developed to the analgesic effect on repeated stressing. Diltiazem, a slow calcium channel blocker, facilitated the analgesia. The data suggest a stress-induced analgesia with obviously non-opiate properties, although an indirect involvement of opiate effects could not be excluded.

Sensitization or tolerance to morphine effects after repeated stresses

Rats were subjected to prolonged footshock, intensive acoustic stress, cold water swim and restraint over a period of 10 days. The analgesic and thermoregulatory properties of morphine (2, 4 and 8 mg/kg, sc.) were tested on the 11th day. Analgesia assessment was performed by means of hot-plate (HP) and tail-flick (TF) tests, and body temperature (Tb) changes was measured. Prolonged footshock and acoustic stress increased the sensitivity to morphine, while repeated restraint lessened morphine's effect. Cold water swim caused ambiguous consequences, facilitated the effect of a small dose of morphine, but reduced that of a large dose. It was concluded that the sensory components of the stressful exposure determine the effects of repeated stress on morphine sensitivity. Whereas painful interventions led to sensitization, and non-painful procedures result in tolerance to morphine's effects. The finding that analgesic and thermoregulatory effects of morphine were simultaneously enhanced supports the contention that the mechanism of sensitization to opiates involves a site where pathways mediating opiate analgesia and thermoregulatory effects converge.

Intrinsic mechanisms of pain inhibition: activation by stress

Portions of the brain stem seem normally to inhibit pain. In man and laboratory animals these brain areas and pathways from them to spinal sensory circuits can be activated by focal stimulation. Endogenous opioids appear to be implicated although separate nonopioid mechanisms are also evident. Stress seems to be a natural stimulus triggering pain suppression. Properties of electric footshock have been shown to determine the opioid or nonopioid basis of stress-induced analgesia. Two different opioid systems can be activated by different footshock paradigms. This dissection of stress analgesia has begun to integrate divergent findings concerning pain inhibition and also to account for some of the variance that has obscured the reliable measurement of the effects of stress on tumor growth and immune function.

Failure to produce a non-opioid foot shock-induced antinociception in rats

Brief continuous foot shock reportedly produces a naloxone-insensitive and thus non-opioid form of antinociception. In the present study, current intensity and duration of foot shock were varied: lower current intensities (0.5 or 1 mA) failed to produce a significant increase in tail flick (TF) latency, while current intensities of 3 mA and 6 mA applied for 2 or 3 min produced significant and long-lasting inhibition of the nociceptive TF reflex. Naloxone pretreatment attenuated significantly the antinociception developed at 3 mA but failed to affect that produced at 6 mA. It was noted, however, that higher current intensities damage the tail and the antinociceptive efficacy of footshock was reevaluated under conditions when the tail of the animal was not allowed to contact the electrified grid during foot shock. A significant short-lasting antinociception was produced only at the 6 mA current intensity. This antinociception could be attenuated by naloxone pretreatment, developed tolerance over time (8 days) and exhibited cross-tolerance with morphine, thus characterizing it as opioid in nature. These results raise the question to what extent damage to the tail contributes to the non-opioid foot shock-induced antinociception assessed using the nociceptive TF reflex.

Endogenous opiates: 1983

This paper is the sixth in an annual series of reviews of research involving the endogenous opiates, each installment being restricted to work published during the previous year. Although the early articles in the series attempted to be comprehensive and cover the complete range of research with the opiate peptides, in the last two years we have limited our coverage to non-analgesic and behavioral work due to the enormous number of articles published in the field. The specific areas discussed here include stress, tolerance and dependence, consummatory responses, other gastrointestinal functions, interactions with alcohol, mental illness, learning and memory, cardiovascular responses, respiratory effects, thermoregulation, neurological disorders, activity, and miscellaneous other topics. As in previous years, we have attempted to present a relatively complete review of the subjects covered only for the previous year and generally have not tried to evaluate their contributions relative to those of past years.