Morphine and met-enkephalin effects on sural Adelta afferent terminal excitability

Spinally applied ketamine or morphine attenuate peripheral inflammation and hyperalgesia in acute and chronic phases of experimental arthritis

Inflammation causes sensitization of peripheral and central nociceptive neurons. Pharmacological modulation of the latter has successfully been used for clinical pain relief. In particular, inhibitors of the NMDA glutamate receptor such as ketamine and agonists at the mu-opioid receptor such as morphine are broadly used. Besides driving the propagation of pain signals, spinal mechanisms are also discussed to modulate inflammation in the periphery. Here, we tested the hypothesis that intrathecally applied ketamine or morphine not only reduce pain-related behavior, but also attenuate induction and maintenance of the inflammatory response in a model of chronic antigen-induced arthritis (AIA). Ketamine, morphine or vehicle was applied to the spinal cords of anesthesized animals with AIA. Swelling and histopathological changes were assessed after 6h (acute phase). Intrathecal catheters were implanted in another set of animals with AIA and substances were applied continuously. During the observation period of 21 days, inflammation and pain-related behavior were assessed. Ketamine and morphine significantly reduced arthritis severity as indicated by reduced joint swelling, but even more intriguingly by reduced infiltration with inflammatory cells and joint destruction in the acute and the chronic phase of arthritis. Morphine showed strong antinociceptive effects in the acute phase only, while the newly established effective dose for ketamine in a continuous application design reduced hyperalgesia in the acute and the chronic stage. In conclusion, both compounds exhibit anti-inflammatory effects during induction and maintenance of arthritis when applied intrathecally. These data thus propose a role of spinal NMDA- and opioid-receptors in the neuronal control of immune-mediated inflammation.

Opioid inhibition of Ih via adenylyl cyclase

Opioids are coupled through G proteins to both ion channels and adenylyl cyclase. This study describes opioid modulation of the voltage-dependent cation channel, Ih, in cultured guinea pig nodose ganglion neurons. Forskolin, PGE2, and cAMP analogs shifted the voltage dependence of activation of Ih to more depolarized potentials and increased the inward current at -60 mV. Opioids had no effect on Ih alone, but reversed the effect of forskolin on Ih. This action of opioids was blocked by naloxone. Opioids had no effect on Ih in the presence of cAMP analogs, suggesting that modulation occurs at the level of adenylyl cyclase. The shift in the voltage dependence of Ih by agents that induce inflammation (i.e., PGE2) is one potential mechanism to mediate an increased excitability. Opioid inhibition of adenylyl cyclase and subsequent inhibition of Ih may be a mechanism by which opioids inhibit primary afferent excitability and relieve pain.

Modulation by opioids and by afferent sensory neurones of prostanoid protection of the rat gastric mucosa

1. Pretreatment with capsaicin, to deplete sensory neuropeptides from primary afferent neurones or the administration of morphine (9 mg kg-1, i.v.), which can inhibit neuropeptide release, augmented gastric mucosal injury induced by a 5 min challenge with intragastric ethanol in the rat, as assessed by macroscopic and histological evaluation. 2. Morphine administration substantially attenuated the protective actions of the prostaglandin analogue 16,16 dimethyl prostaglandin E2 (dm PGE2; 0.5-20 micrograms kg-1, p.o.) against ethanol-induced damage. This reduced degree of protection by dmPGE2 was not however, the consequence of the enhanced level of damage. 3. These actions of morphine in reducing prostaglandin protection against mucosal injury were abolished by pretreatment (5 min) with naloxone (1 mg kg-1, i.v.) or the peripherally acting opioid antagonist, N-methyl nalorphine (6 mg kg-1, i.v.). 4. Capsaicin pretreatment (2 weeks before study), likewise attenuated the protective actions of dmPGE2, although to a lesser degree than did morphine. 5. These findings, thus implicate the involvement of capsaicin- and opioid-sensitive afferent neurones in the processes by which exogenous prostanoids can protect the gastric mucosa from damage.

Presynaptic inhibition of muscle spindle and tendon organ afferents in the mammalian spinal cord

More than 30 years ago, Frank and Fuortes proposed that the synaptic effectiveness of muscle spindle afferents associated with spinal motoneurones could be diminished by the activation of nerves from flexor muscles. Since that time, research has focused on disclosing the mode of operation and the spinal pathways involved in this presynaptic inhibitory control. Initially, it was assumed that the same last-order interneurones mediated presynaptic inhibition of both muscle spindle and tendon organ afferent fibres. More recent evidence indicates that the synaptic effectiveness of these two groups of afferents is controlled by separate sets of GABAergic interneurones synapsing directly with the intraspinal terminals of the afferent fibres. This unique arrangement allows for selective control of the information on muscle length or muscle tension, despite the convergence of muscle spindle and tendon organ afferents on second-order interneurones.

Analgesic synergy and improved motor function produced by combinations of mu-delta- and mu-kappa-opioids

This study evaluated the effects of intrathecal administration of a low-analgesic dose of the selective mu-agonist DAMGO co-administered with sequentially increasing doses of either the selective delta-agonist DPDPE or the selective kappa-agonist, U50,488H on mechanical nociceptive thresholds in the rat. Potent analgesic synergy was observed with both combinations. Since an elevation in nociceptive threshold can result from motor deficits, as well as true analgesia, we also evaluated the effects of the combination regimens on motor coordination using a rotarod apparatus. The combination regimens produced significantly less motor deficits than those observed when DPDPE and U50,488H were administered as single agents. These findings of enhanced analgesia with decreased motor side-effects associated with administration of fixed mu/delta or mu/kappa combinations suggest that co-administration of opiates that act at different receptors may constitute a superior approach to the treatment of pain.

Morphine and substance P release in the spinal cord

In anaesthetised cats, antibody microprobes were used to measure the release of immunoreactive substance P (irSP) in the lumbar dorsal horn during noxious cutaneous stimulation or high-intensity electrical stimulation of a hind limb nerve. The major region of irSP release detected was centered on the substantia gelatinosa, with lesser release at the dorsal cord surface. Release at these sites was unchanged by systemic administration of morphine, or of morphine followed by naloxone. During superfusion of the dorsal cord surface with high concentrations of morphine, irSP release in the substantia gelatinosa region was slightly reduced and surface release was not observed, effects not reversed by systemic naloxone administration. The results suggest that the analgesic action of morphine does not involve reduced release of SP in the spinal cord.

Kappa- and delta-opioid agonists synergize to produce potent analgesia

This study evaluated the interaction of the analgesic effects of a selective kappa- (U50, 488H) and a selective delta- ([D-Pen2,5]enkephalin, DPDPE) opioid agonist, co-injected intrathecally, using the Randall-Selitto paw-withdrawal test, in the rat. Intrathecal administration of both U50, 488H and DPDPE, as single agents, produced dose-dependent increases in mechanical nociceptive threshold. However, when the dose-response curves for both U50, 488H and DPDPE in the presence of a low-analgesic dose of the other agent were compared with the dose-response curves for the respective agonist administered alone, the curves for the combination regimens were shifted to the left. A statistically significant deviation from parallelism between the dose-response curves of the single versus the combined agents, as well as isobolographic analysis, demonstrates that the simultaneous administration of opioid agonists, the act at kappa- and delta-opioid receptor sites, can produce analgesic synergy.

gamma-Aminobutyric acid inhibits the potassium-stimulated release of somatostatin from rat spinal cord slices

Evidence supports the idea that somatostatin (SO) is a neurotransmitter or neuromodulator of primary afferent neurons involved in nociception. Since gamma-aminobutyric acid (GABA), norepinephrine, and morphine alter nociception at the level of the spinal cord, we examined whether these agents could alter the potassium-stimulated release of somatostatin from rat spinal cord slices. Male Sprague-Dawley rats were decapitated and a 2 cm segment of the lumbar spinal cord removed and chopped into 0.5 x 0.5 mm pieces and perfused at 37 degrees C in individual perfusion chambers with a modified Krebs-bicarbonate buffer at a flow rate of 0.5 ml/min. Perfusates were collected at 2 min intervals and assayed for SO using radioimmunoassay. Exposure of spinal cord tissue to 50 mM KCl resulted in a 3-fold increase in release of SO from a basal level of approximately 0.2 to 0.6 pg/mg tissue/min. This evoked release was calcium dependent. Pre-exposure of tissue to GABA at 10(-4) and 10(-5) M significantly inhibited the potassium-stimulated release of SO, but did not alter basal release. The GABA receptor antagonist, bicuculline methiodide, at 10(-5) but not 10(-6) M attenuated the GABA-induced inhibition of somatostatin release. Bicuculline methiodide alone did not significantly alter either basal or stimulated release. Neither baclofen (10(-5) M, 5 x 10(-5) M), norepinephrine (10(-5) M), nor morphine (10(-5) M) had any significant effect on basal or stimulated release of SO from spinal cord tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrical stimulation of primary afferent A fibres does not reduce substance P release in the dorsal horn of the cat

Antibody microprobes were used to measure the release of immunoreactive substance P in the dorsal horn of anaesthetised cats during noxious mechanical or thermal stimulation of the hind limb. Concomitant electrical stimulation of the ipsilateral tibial or sural nerve at intensities sufficient to excite only A alpha beta or additionally A delta primary afferent fibres did not reduce the release of substance P evoked by noxious stimuli. The results suggest that segmental inhibition produced in the dorsal horn by electrical stimulation of peripheral nerves is not mediated by presynaptic inhibition of substance P release from nociceptive primary afferent fibres.

Enkephalins modulate excitatory synaptic transmission in the superficial dorsal horn by acting at mu-opioid receptor sites

The effect of opioids on synaptic potentials of dorsal horn (DH) neurons has been investigated in a rat spinal cord DH slice-dorsal root ganglion (DRG) in vitro preparation. Conventional intracellular recording from DH and DRG neurons using 3 M potassium acetate-filled electrodes was employed. Dorsal roots were electrically isolated from the spinal cord slice and stimulated with pulses of different intensity and duration to evoke afferent action potentials monitored intracellularly from DRG neurons. Low-intensity single-shock stimulation of the dorsal roots (8-20 V pulses of 0.02-0.05 ms duration) activated large primary afferents and elicited excitatory postsynaptic potentials (EPSP) in all of the neurons tested. High-intensity stimulation of the dorsal roots (over 35 V pulses of 0.5 ms duration), sufficient to excite small myelinated and unmyelinated primary afferents resulted in a large and prolonged depolarization of DH neurons associated with firing of action potentials. Bath application (D-Ala2,N-Me-Phe4,Gly5-ol)-enkephalin (DAGO), (D-Ala2,D-Leu5)-enkephalinamide (DADLEA), or (D-Ala2,D-Met5)-enkephalinamide (DADMEA) produced dose-dependent, reversible hyperpolarization in about 75% of the neurons tested. The hyperpolarization was associated with a fall in neuronal input resistance. In addition, opioids depressed the synaptic transmission in all of the neurons examined. This depressant effect of opioids was independent from their effects on resting membrane potential. Delta specific receptor opioid agonists (D-Pen2.5)-enkephalin (DPDPE) and (D-Pen2,L-Pen5)-enkephalin (DPLPE), were completely ineffective in producing an effect on neuronal membrane or synaptic transmission. All opioid effects were antagonized by naloxone.

Mechanisms involved in the depolarization of cutaneous afferents produced by segmental and descending inputs in the cat spinal cord

The relative contribution of specific and unspecific (potassium) components involved in the generation of primary afferent depolarization (PAD) of cutaneous fibres was analyzed in the spinal cord of the anesthetized cat. To this end we examined the correlation between the intraspinal threshold changes of single afferent fibres in the sural nerve produced by segmental and descending inputs and the negative DC potential shifts produced by these same stimuli at the site of excitability testing, the latter taken as indicators of the changes in extracellular concentration of potassium ions. Stimulation of the ipsilateral brain-stem reticular formation and of the contralateral red nucleus with 100-200 Hz trains reduced very effectively the intraspinal threshold of sural nerve fibres ending in the dorsal horn practically without producing any negative DC potential shifts at the site of excitability testing. However, negative DC potential shifts were produced more ventrally, in the intermediate nucleus and/or motor nucleus. Stimulation of the sural and superficial peroneus nerves with pulses at 2 Hz and strengths below 2 xT, also reduced the intraspinal threshold of single SU fibres without producing significant DC potential changes at the site of excitability testing. On the other hand, 100 Hz trains with strengths above 2 xT produced negative DC potential shifts and a proportional reduction of the intraspinal threshold of the SU fibres. The PAD of sural fibres produced by stimulation of rubro-spinal and reticulo-spinal fibres as well as by stimulation of sensory nerves with low frequency trains was unaffected or slightly increased, by i.v. injection of strychnine (0.2 mg/kg), but was readily abolished 5-10 min after the i.v. injection of picrotoxin (2 mg/kg). The results suggest that activation of reticulo-spinal and rubro-spinal fibres, as well as stimulation of cutaneous nerves with low frequencies and low strengths, produce PAD of cutaneous fibres involving activation of specific interneuronal pathways with interposed last-order GABAergic interneurons. The potassium component of the PAD produced by cutaneous fibres becomes dominant with high stimulus frequencies and strengths.

Effects of midbrain stimulation and iontophoretic application of serotonin, noradrenaline, morphine and GABA on electrical thresholds of afferent C- and A-fibre terminals in cat spinal cord

We have used the single-fibre excitability testing method to investigate whether electrical stimulation in midbrain periaqueductal gray or lateral reticular formation, as well as intraspinal iontophoretic application of the suspected inhibitory neurotransmitters serotonin (5-hydroxytryptamine), noradrenaline, the opiate morphine, or gamma-aminobutyric acid (GABA), exert presynaptic actions at the central terminals of cutaneous afferent unmyelinated or myelinated fibres. Thresholds to antidromically excited 42 single unmyelinated and 18 myelinated fibres in the sural nerve by intraspinal microstimulation were determined before and during periaqueductal gray or lateral reticular formation stimulation (3 100 ms trains/s at 100 Hz; 100-900 microA) or intraspinal iontophoretic application (40-300 nA) of 5-hydroxytryptamine, noradrenaline, morphine or GABA from a multibarrel micropipette. Periaqueductal gray or lateral reticular formation stimulation had mixed effects on unmyelinated and myelinated fibre thresholds, with most threshold measurements within +/- 10% of control. There was a tendency for thresholds to increase more during periaqueductal gray than lateral reticular formation stimulation. Thresholds of unmyelinated fibres were predominantly raised during iontophoretic application of 5-hydroxytryptamine (20/29 fibres), noradrenaline (10/13) and morphine (15/21), while GABA had mixed effects; thresholds of nearly all myelinated fibres were raised by each drug. Both periaqueductal gray or lateral reticular formation stimulation and application of 5-hydroxytryptamine, noradrenaline or morphine tended to raise thresholds in the majority of the 53 unmyelinated and myelinated fibres tested. Methodological problems in interpreting the physiological significance of these results for presynaptic modulation are discussed.

Neurochemical identification of afferents onto spinomedullary neurons in the rat spinal cord central gray matter

The synaptic relationship between spinal cord central gray projection neurons and immunocytochemically identified afferents in the rat were examined at the light microscopic level using the combined techniques of retrogradely transported True blue and serotonin (5-HT), enkephalin (ENK), and substance P (SP) immunocytochemistry. At L4-L6, numerous retrogradely labeled neurons could be identified around the central canal after large bulbar injections of True blue. Of these projection neurons, 75% were apposted by 5-HT varicosities, 57% by ENK varicosities and 58% by SP varicosities. Hemisection of the spinal cord produced a marked reduction in the amount of 5-HT immunoreactivity and the number of putative 5-HT contacts observed on neurons of the spinal cord central gray. A small decrease in SP immunoreactivity and putative contacts was seen after dorsal rhizotomy. Neither rhizotomy nor hemisection produced discernable changes in ENK immunofluorescence. Based on the distributions of 5-HT, ENK and SP in the spinal cord, we suggest that a more precise delineation of lamina X in the rat can be made according to immunocytochemical rather than strictly morphological criteria.

Prolonged C-fibre mediated facilitation of the flexion reflex in the rat is not due to changes in afferent terminal or motoneurone excitability

A standard suprathreshold mechanical stimulus applied to the hindpaw of decerebrate-spinal rats produces a discharge in hamstring flexor alpha-motoneurones which is stable for hours, provided no tissue injury is produced. Tissue injury results, however, in a decrease of threshold and an increase in the responsiveness of the reflex. This reflex hypersensitivity can be mimicked by brief (20 s) low frequency (1 Hz) conditioning stimuli to muscle or cutaneous nerves, if C-fibres are recruited. The prolonged post-conditioning facilitation of the flexion reflex by C-afferent volleys is now shown to be independent of changes in the excitability of the test afferent terminals in the dorsal horn and of the motoneurones. The hypersensitivity is therefore due to changes in the interneurones that link cutaneous nociceptive afferents with flexor motoneurones.

Epinephrine- and norepinephrine-evoked potential changes of frog primary afferent terminals: pharmacological characterization of alpha and beta components

The effects of superfused epinephrine (E) and norepinephrine (NE) on the membrane potential of primary afferent fibers of the isolated frog spinal cord were studied by sucrose gap recordings from the dorsal root. In all preparations both E and NE, applied in concentrations ranging from 0.1 microM to 1.0 mM, produced a hyperpolarization of afferent terminals. In many instances this was followed by a slow depolarization and, in a small number of cords, a small depolarization preceded the increase in membrane potential. E- and NE-induced hyperpolarizations were blocked by the selective alpha 2-antagonists yohimbine and piperoxan, but not by the selective alpha 1-antagonists prazosin and corynanthine or by the beta-blockers propranolol and sotalol. The alpha 2-agonists clonidine, alpha-methylnorepinephrine and guanabenz also hyperpolarized terminals, causing a change in potential that was reduced by yohimbine and piperoxan. Taken together, these results suggest that alpha 2-receptors mediate the hyperpolarizing effects of E and NE. The beta-agonist isoproterenol evoked a slow depolarization similar to that produced by E and NE. The isoproterenol-depolarization was antagonized by propranolol. Sometimes, application of E and NE after superfusion with yohimbine produced only a depolarization of the dorsal root and this depolarization was sensitive to propranolol. It would appear therefore that the late depolarization seen after the application of E and NE is produced by activation of beta-receptors. In contrast, the alpha 1-agonist phenylephrine elicited a short latency, short duration depolarization similar to those seen preceding approximately 10% of the E- and NE-hyperpolarizations. Such short-latency depolarizations were blocked by prazosin and corynanthine. The major component of the response to both E and NE is indirectly mediated through a synaptic process: application of Mn2+, Mg2+, procaine or tetrodotoxin in concentrations sufficient to block synaptic transmission substantially reduced, but never eliminated, the actions of the catecholamines. Interneurons are probably involved because mephenesin, which reduces interneuronal transmission, significantly decreased the E and NE effects. Furthermore, interneurons which secrete excitatory amino acids and/or GABA may mediate the indirect effects of the catecholamines on afferent terminals because (-)baclofen and D.L-alpha-aminoadipate decrease, and picrotoxin and bicuculline increase, the dorsal root (DR) effects of E and NE.(ABSTRACT TRUNCATED AT 400 WORDS)

Mass fragmentographic analysis of monoamine metabolites in the spinal cord of rat after the administration of morphine

A mass fragmentographic method was used in which homovanillic acid (HVA), methoxyhydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were measured from a single sample. The results describe the effect of morphine on the metabolism of the major monoamines, dopamine (DA), noradrenaline (NA), and 5-hydroxytryptamine (5-HT) in the spinal cord. Morphine has very little effect on the metabolism of DA and NA in the spinal cord. However, morphine causes a significant increase in the metabolism of spinal 5-HT. The increase in 5-HIAA induced by morphine is not restricted to the dorsal horn. The three main functional regions of the cord--dorsal horn (sensory), zona intermedia (autonomic), and ventral horn (somatic motor)--are affected to the same degree. The results indicate that morphine causes a generalized activation of serotonin neurons in the spinal cord. There appears to be little or no selectivity for those serotonergic neurons that innervate the dorsal horn. The results are discussed with reference to current data, which indicate a fairly strong link between descending serotonergic nerves and the mechanism of action of morphine-induced analgesia.

Opioid neurons and pain modulation: an ultrastructural analysis of enkephalin in cat superficial dorsal horn

To clarify the circuitry through which opioid compounds modulate spinal and trigeminal nociceptive transmission, we have examined the synaptic associations formed by leucine-enkephalin-containing (enkephalin) neurons in the superficial dorsal horn of the cat. As described previously, punctate enkephalin immunoreactivity is concentrated in the marginal layer (lamina I) and in both the outer and inner layers of the substantia gelatinosa (lamina IIo and IIi). In colchicine treated cats, enkephalin perikarya are most numerous in lamina I and at the border between laminae I and II. Ultrastructural analysis reveals that enkephalin cells receive a diverse afferent input. The majority of afferent inputs are presynaptic to the enkephalin dendrites; few axosomatic synapses are seen. Among these presynaptic axonal profiles are unlabeled axons which resemble primary afferent terminals, including the characteristic central axonal varicosity. Enkephalin dendrites are also postsynaptic to enkephalin immunoreactive axons. Two types of enkephalin axonal profiles appear in the superficial dorsal horn. Class I profiles are only found in lamina I. These are large profiles which form few synapses; those synapses made are axodendritic. Class II enkephalin axons are smaller and are distributed in both layers I and II. While Class II axons most commonly form axo-dendritic synapses, they also form axo-axonic synapses with flat vesicle-containing profiles; the latter are generally presynaptic to the enkephalin terminals. Serial analysis further revealed that both the enkephalin and the flat vesicle-containing profile synapse onto a common dendrite. Although enkephalin axons frequently lie adjacent to round vesicle-containing profiles, anatomical evidence that opioid axons form synapses with this type of ending was not found. An additional type of enkephalin vesicle containing-profile is found in layer IIi; its morphological features do not clearly distinguish its axonal or dendritic origin. These endings are typically postsynaptic to unlabelled central endings, and provide minimal presynaptic input to other elements in the neuropil. Like some class II axons, these labelled profiles contain vesicles which cluster at the membrane immediately adjacent to unlabelled central axons. These results indicate that spinal enkephalin neurons receive a variety of synaptic inputs. These include inputs which may derive from primary afferent axons. Enkephalin neurons, in turn, influence nociceptive transmission predominantly through postsynaptic mechanisms. Finally, while we did not observe enkephalin terminals presynaptic in an axoaxonic relationship, the possibility that enkephalin neurons modulate the excitability of fine fiber nociceptive and nonnociceptive afferents via "nonsynaptic interactions" is discussed.

Actions of morphine and met-enkephalin-amide on nociceptor driven neurones in substantia gelatinosa and deeper dorsal horn

Simultaneous recordings of responses of substantia gelatinosa and deep dorsal horn neurones to thermal noxious cutaneous stimulation were made in spinalized cats anaesthetized with urethane/chloralose. Morphine, whether applied iontophoretically in the substantia gelatinosa (50-200 nA) or injected intravenously (1.0-1.5 mg/kg), enhanced the responses of the substantia gelatinosa cells while depressing those of deep cells. Met-enkephalin-amide (50-200 nA) also had similar reciprocal actions. Naloxone counteracted these effects of the agonists. The results support our previous proposal that the opiates facilitate the activity of a substantia gelatinosa system that controls the responses of deep dorsal horn neurones to pain.

Involvement of spinal opioid systems in footshock-induced analgesia: antagonism by naloxone is possible only before induction of analgesia

Footshock reliably produces analgesia in rats which is mediated either by opiate or non-opiate systems. It has recently been demonstrated that a critical factor determining the involvement of endogenous opioids is the body region shocked; front paw shock produces a naloxone-reversible analgesia and hind paw shock produces an analgesia which fails to be attenuated by this opiate antagonist. The present study demonstrated that a crucial opiate site for the production of front paw footshock-induced analgesia (FSIA) exists within the spinal cord. One microgram of naloxone delivered directly to the lumbosacral cord immediately prior to shock significantly attenuated this analgesia. However, the efficacy of naloxone antagonism was order-dependent in that naloxone failed to antagonize fron paw FSIA if delivered immediately after shock; naloxone could prevent but could not reverse the analgesic state. The body region shocked was again observed to be a critical factor determining the involvement of endogenous opioids since 1 microgram of spinal naloxone failed to antagonize hind paw FSIA. These results were discussed in light of recent evidence proposing a neuromodulatory role of opioids within the spinal cord.

The actions of neuropeptides on dorsal horn neurons in the rat spinal cord slice preparation: an intracellular study

Responses of dorsal horn neurons to bath application of substance P, somatostatin and enkephalin were studied by intracellular recording in the neonatal spinal cord slice preparation. Substance P depolarized dorsal horn neurons and increased their excitability. The depolarization was most commonly associated with an increase in neuronal input resistance. Somatostatin and enkephalin hyperpolarized dorsal horn neurons and caused reduction or abolition of spontaneous firing. While the hyperpolarization produced by enkephalin was always associated with a fall in neuronal input resistance, in the case of somatostatin the similar effect was less consistently observed.

Differing distributions of receptors for morphine and Met5-enkephalinamide in the dorsal horn of the cat

In the dorsal horn of barbiturate-anaesthetized cats evidence was obtained for a different distribution of enkephalin-preferring and morphine-preferring receptors. When ejected electrophoretically from micropipettes, morphine reduced the nociceptive responses of neurones of laminae IV and V when administered in the substantia gelatinosa but not at more ventral sites including sites near cell bodies. By contrast, Met5-enkephalinamide reduced nociceptive responses at all of these sites of administration often with increased potency near cell bodies. It is proposed that morphine-preferring receptors are located mainly near the terminals of primary afferent fibres whereas those for enkephalin are present on these fibres and also on the dendrites and somata of dorsal horn neurones. These dendritic receptors may be located adjacent to sites of termination of nociceptive afferents, a mechanism which would inhibit nociceptive but not other inputs to these neurones.

Effect of iontophoretically applied 5-hydroxytryptamine on the excitability of single primary afferent C- and A-fibers in the cat spinal cord

Excitability testing of single sural afferent C- and A-fibers was employed to study possible presynaptic effects of 5-hydroxytryptamine (5-HT) applied iontophoretically at the intraspinal point of lowest threshold for their antidromic activation in anesthetized or decerebrate spinalized cats. Threshold for single fibers recorded in the sural nerve was measured prior to and during iontophoretic application of 5-HT through a micropipette positioned in close proximity to the intraspinal stimulating electrode. 5-HT produced dose-related increases in threshold for antidromic activation in 21 or 30 C-fibers. Six of 9 A delta, and 4 of 7 A beta-fibers were similarly affected.

The stereospecific effect of naloxone on rat dorsal horn neurones; inhibition in superficial laminae and excitation in deeper laminae

The effect of systemic naloxone on the activity evoked by C-fibre stimulation in dorsal horn neurones of the rat spinal cord has been investigated. Recordings were made in unanaesthetized, decerebrate spinalized rats. Fifteen units were recorded from laminae 4 and 5 of the dorsal horn, 11 of these units were excited by naloxone (0.2--1.0 mg/kg). The onset of this excitation was after 20 sec to 5 min and recovery to control levels occurred within 15--40 min. Of 17 units recorded in substantia gelatinosa of the dorsal horn, 13 were inhibited by the naloxone. The latency of onset of this inhibition was short (2--10 sec) and the effect persisted for 5--10 min. The effects were largely restricted to C-fibre evoked activity although sometimes A delta responses were similarly altered. Neurones stimulated by A beta-fibre threshold, or whose sole afferent input were A beta-fibres, were unaffected by the naloxone. The stereoisomer of naloxone, (+)naloxone which is inactive in opiate receptor binding tests, failed to produce the same changes found with (-)naloxone in 17 units. These results show a differential effect of naloxone on neurones in the dorsal horn which respond to C-fibre input. Units in the substantia gelatinosa are inhibited while units in deeper laminae are excited by naloxone. These effects are likely to be mediated by the blockade of endogenous opioids in the spinal cord.

Epidural opiate and perioperative analgesia

Epidural injections of 5 mg nicomorphine in 20 ml 5% glucose wee given to 10 gynaecological patients to provide intra-operative and post-operative analgesia. Signs of changed nociception appeared within 5 min. The maximum change occurred within 20 min. Effectiveness was at least 3 1/2 h. After an observation period of 30 min, light general anaesthesia is supplemented to give excellent operating conditions. It is suggested that opiates produce these effects by a direct action on the endorphin "pain" modulatory system of human beings at spinal level.

Effects of enkephalin analogue and naloxone on cat spinal cord dorsal root potentials

A systemically active enkephalin analogue, FK33824, given intravenously depressed dorsal root potentials in cat spinal cord. The negative DR V and positive DR VI, measured by computer, were both decreased; this effect was reversed by small doses of intravenous naloxone. Naloxone, given alone, with no previous analogue produced no changes in dorsal root potentials suggesting the absence of a basal enkephalin tone. A second injection of FK33824 was much less effective that the first dose. The results were discussed in relation to presynaptic mechanisms for analgesia: we proposed that FK33824 causes presynaptic inhibition by modulation rather than by depolarization of primary afferent fibers.

Indirect evidence for presynaptic location of opiate receptors on chemosensitive primary sensory neurones

1. Rats were pretreated with 50 mg/kg s.c. capsaicin or solvent on the second day of life; 5 months later 3H-diprenorphine binding to homogenates of the whole spinal cord or of the upper dorsal horn of the spinal cord was investigated. 2. Capsaicin pretreatment resulted in a 17% decrease of opiate binding sites in the whole spinal cord and a 37% decrease in the upper dorsal horn with no change in their affinity. 3. Since neonatal capsaicin pretreatment causes degeneration of chemosensitive primary sensory neurones it is concluded that some opiate receptors are located presynaptically on the central terminals of these neurones.

Presynaptic excitability changes induced by morphine in single cutaneous afferent C- and A-fibers

Intraspinal microstimulation was used to test the excitability of single cutaneous (sural) A- and C-fibers at their central terminals in the cat. Systemic morphine (1.0-2.6 mg/kg) increased the antidromic threshold to 110% (mean value) of control in C-fibers. In some of the C-fibers this effect was reversed by naloxone. A-fibers were not consistently affected by mophine.