Effects of morphine on ionic currents in frog node of Ranvier

Inhibition of Fast Nerve Conduction Produced by Analgesics and Analgesic Adjuvants-Possible Involvement in Pain Alleviation

Nociceptive information is transmitted from the periphery to the cerebral cortex mainly by action potential (AP) conduction in nerve fibers and chemical transmission at synapses. Although this nociceptive transmission is largely inhibited at synapses by analgesics and their adjuvants, it is possible that the antinociceptive drugs inhibit nerve AP conduction, contributing to their antinociceptive effects. Many of the drugs are reported to inhibit the nerve conduction of AP and voltage-gated Na⁺ and K⁺ channels involved in its production. Compound action potential (CAP) is a useful measure to know whether drugs act on nerve AP conduction. Clinically-used analgesics and analgesic adjuvants (opioids, non-steroidal anti-inflammatory drugs, ₂-adrenoceptor agonists, antiepileptics, antidepressants and local anesthetics) were found to inhibit fast-conducting CAPs recorded from the frog sciatic nerve by using the air-gap method. Similar actions were produced by antinociceptive plant-derived chemicals. Their inhibitory actions depended on the concentrations and chemical structures of the drugs. This review article will mention the inhibitory actions of the antinociceptive compounds on CAPs in frog and mammalian peripheral (particularly, sciatic) nerves and on voltage-gated Na⁺ and K⁺ channels involved in AP production. Nerve AP conduction inhibition produced by analgesics and analgesic adjuvants is suggested to contribute to at least a part of their antinociceptive effects.

Local loperamide injection reduces mechanosensitivity of rat cutaneous, nociceptive C-fibers

Loperamide reverses signs of mechanical hypersensitivity in an animal model of neuropathic pain suggesting that peripheral opioid receptors may be suitable targets for the treatment of neuropathic pain. Since little is known about loperamide effects on the responsiveness of primary afferent nerve fibers, in vivo electrophysiological recordings from unmyelinated afferents innervating the glabrous skin of the hind paw were performed in rats with an L5 spinal nerve lesion or sham surgery. Mechanical threshold and responsiveness to suprathreshold stimulation were tested before and after loperamide (1.25, 2.5 and 5 µg in 10 µl) or vehicle injection into the cutaneous receptive field. Loperamide dose-dependently decreased mechanosensitivity in unmyelinated afferents of nerve-injured and sham animals, and this effect was not blocked by naloxone pretreatment. We then investigated loperamide effects on nerve conduction by recording compound action potentials in vitro during incubation of the sciatic nerve with increasing loperamide concentrations. Loperamide dose-dependently decreased compound action potentials of myelinated and unmyelinated fibers (ED50 = 8 and 4 µg/10 µl, respectively). This blockade was not prevented by pre-incubation with naloxone. These results suggest that loperamide reversal of behavioral signs of neuropathic pain may be mediated, at least in part, by mechanisms independent of opioid receptors, most probably by local anesthetic actions.

Inhibitory effects of opioids on compound action potentials in frog sciatic nerves and their chemical structures

An opioid tramadol more effectively inhibits compound action potentials (CAPs) than its metabolite mono-O-demethyl-tramadol (M1). To address further this issue, we examined the effects of opioids (morphine, codeine, ethylmorphine and dihydrocodeine) and cocaine on CAPs by applying the air-gap method to the frog sciatic nerve. All of the opioids at concentrations less than 10 mM reduced the peak amplitude of the CAP in a reversible and dose-dependent manner. The sequence of the CAP peak amplitude reductions was ethylmorphine>codeine>dihydrocodeine> or = morphine; the effective concentration for half-maximal inhibition (IC(50)) of ethylmorphine was 4.6 mM. All of the CAP inhibitions by opioids were resistant to a non-specific opioid-receptor antagonist naloxone. The CAP peak amplitude reductions produced by morphine, codeine and ethylmorphine were related to their chemical structures in such that this extent enhanced with an increase in the number of -CH(2) in a benzene ring, as seen in the inhibitory actions of tramadol and M1. Cocaine reduced CAP peak amplitudes with an IC(50) value of 0.80 mM. It is concluded that opioids reduce CAP peak amplitudes in a manner being independent of opioid-receptor activation and with an efficacy being much less than that of cocaine. It is suggested that the substituted groups of -OH bound to the benzene ring of morphine, codeine and ethylmorphine as well as of tramadol and M1, the structures of which are quite different from those of the opioids, may play an important role in producing nerve conduction block.

Punctate midline myelotomy: a minimally invasive procedure for the treatment of pain in inextirpable abdominal and pelvic cancer

The midline of the dorsal column contains a pathway that may be more important for transmitting visceral nociceptive signals than the spinothalamic tract. Punctate midline myelotomy, a neuroablative operation with the intent of interrupting the midline of the dorsal column, has demonstrated efficacy in the treatment of otherwise intractable abdominal and pelvic cancer pain. The indications, technical procedure, outcomes, and complications of all published clinical studies of punctate midline myelotomy are reviewed. The lesion level of the spinal cord and the depth of the incision are discussed, with the focus on the feasibility of this technique.

Do nociceptive signals from the pancreas travel in the dorsal column?

A midline dorsal column lesion has been shown to be an effective surgical treatment for the relief of pelvic visceral pain in patients. The aim of this study was to examine the effectiveness of a dorsal column lesion upon: (i) increased electrophysiological responses of neurons in the ventral posterolateral thalamic nucleus in anesthetized rats evoked by the application of bradykinin to the surface of the pancreas, and (ii) pain-related behaviors observed after pancreatic infusion with bradykinin. In rats anesthetized with pentobarbital, recordings from individual thalamic neurons were made using tungsten electrodes. Brief application of bradykinin (10 microg/ml) to the surface of the pancreas resulted in an increased firing rate in approximately 20% of neurons recorded. A dorsal column lesion or intrathecal administration of morphine greatly reduced the excitatory effects of pancreatic bradykinin application on thalamic neurons. In a separate group of rats, bradykinin was infused into the pancreas through a previously implanted catheter resulting in a decrease in exploratory behavior and an increase in other pain-related behaviors, e.g. licking of the abdomen. A dorsal column lesion made prior (1 week) to the bradykinin infusion reduced the decrease in exploratory behavior but did not return exploratory behavior to control levels. In conclusion, nociceptive information relayed to the thalamus about the pancreas is transmitted from the spinal cord through the dorsal columns, possibly by the post-synaptic dorsal column pathway. However, the dorsal column pathway may not be the sole route for relaying information about noxious stimulation of the pancreas, particularly that impacting complex behavioral responses.

Selectivity and gating of the type L potassium channel in mouse lymphocytes

Type l voltage-gated K+ channels in murine lymphocytes were studied under voltage clamp in cell-attached patches and in the whole-cell configuration. The kinetics of activation of whole-cell currents during depolarizing pulses could be fit by a single exponential after an initial delay. Deactivation upon repolarization of both macroscopic and microscopic currents was mono-exponential, except in Rb-Ringer or Cs-Ringer solution in which tail currents often displayed "hooks," wherein the current first increased or remained constant before decaying. In some cells type l currents were contaminated by a small component due to type n K+ channels, which deactivate approximately 10 times slower than type l channels. Both macroscopic and single channel currents could be dissected either kinetically or pharmacologically into these two K+ channel types. The ionic selectivity and conductance of type l channels were studied by varying the internal and external permeant ion. With 160 mM K+ in the cell, the relative permeability calculated from the reversal potential with the Goldman-Hodgkin-Katz equation was K+ (identical to 1.0) greater than Rb+ (0.76) greater than NH4+ = Cs+ (0.12) much greater than Na+ (less than 0.004). Measured 30 mV negative to the reversal potential, the relative conductance sequence was quite different: NH4+ (1.5) greater than K+ (identical to 1.0) greater than Rb+ (0.5) greater than Cs+ (0.06) much greater than Na+, Li+, TMA+ (unmeasurable). Single channel current rectification resembled that of the whole-cell instantaneous I-V relation. Anomalous mole-fraction dependence of the relative permeability PNH4/PK was observed in NH4(+)-K+ mixtures, indicating that the type l K+ channel is a multi-ion pore. Compared with other K+ channels, lymphocyte type l K+ channels are most similar to "g12" channels in myelinated nerve.

Facilitatory effects of opioids on the discharges of visceral nociceptors

Effects of opioids on the activity of visceral nociceptors were tested using the in vitro testis-spermatic nerve preparations excised from deeply anesthetized dogs. Morphine, DADLE and dynorphin (10 microM) elicited discharges of polymodal receptors in approximately 1/3 of the tested cases. The incidence of the excitatory response of morphine increased at higher concentrations. The excitatory responses were quite variable among preparations and showed a strong tendency for tachyphylaxis. Similar increases in discharges were elicited when morphine was applied during the steady state of the response evoked by bradykinin (BK) or BK mixed with prostaglandin E2. Pretreatment of morphine for 5 min significantly augmented the subsequent BK responses for 30 min or more. Naloxone per se induced neither excitation nor augmentation of the subsequent BK response, however it reversed the augmenting effect of morphine on BK response. In contrast with previous reports proposing peripheral analgesic effects of opioids, suppressive effects on nociceptors were never observed in the present experiment. Peripheral effects of opioids were discussed.

Effects of enkephalin, applied intracellularly, on action potentials in vertebrate A and C nerve fibre axons

The effects of leucine enkephalin and D-Ala2, Met5 enkephalinamide (DAMA) were tested on the excitability of sciatic nerves in the frog and guinea-pig and vagus nerves in the guinea pig and rabbit. Both enkephalins depressed the amplitude of the compound action potential of A and C fibres. This depression was blocked by small concentrations of naloxone. In the type of experiment carried out, the drugs were added to the cut end of the nerve and the drugs had to reach their site of action in the central bath by diffusion through the axoplasm. This method of application of drug was necessary because enkephalins had no effect on the action potential when applied extracellularly by perfusion. These results demonstrate the presence of stereospecific opioid receptors located on the inner surface of the cell membranes of peripheral vertebrate nerve axons, sensitive to block by some endogenous opioid peptides. A possible physiological role for these intracellular receptors is suggested.

The mechanism of action of ketamine on the myelinated nerve membrane

Ketamine is an intravenous anaesthetic that has been reported to react with a number of synaptic and non-synaptic receptors at both the spinal and supraspinal level. The present investigation was undertaken to analyse the effects of ketamine on the myelinated axon under voltage clamp conditions. Both sodium and potassium channels were affected. The effect may be described as mainly a reduction of the permeability constants. No effect on inactivation was observed. The effects were described by a first order binding to receptors within the ion channels that may be identical with the receptors for other anaesthetics. It was concluded from experiments with naloxone that no opiate receptors were involved in the axonal ketamine effects.

Sensitivity of pulmonary chemo reflexes and lung inflation reflexes to repetitive stimulation and to inhibition with lidocaine and morphine

To study reflex responses caused by stimulation of pulmonary C-fibers and lung inflation, we used a preparation in which the left pulmonary artery and veins were ligated and cannulated and the right and left bronchi were cannulated separately in open-chest dogs. These experiments were performed to establish whether the reflex responses to injections of 150 micrograms of capsaicin through the left pulmonary circulation and inflations of this left lung to 30 cm H2O would be diminished if repeated frequently. Furthermore, the sensitivities of the reflex responses evoked by these capsaicin injections and by left lung inflations (LLI) to blockade with lidocaine or with morphine were studied. Both repeated injections of capsaicin into the left pulmonary circulation and repeated inflations of the left lung for up to 100 min produced a persistent triad of reflex responses: bradycardia, hypotension, and cessation of diaphragmatic contractions. Lidocaine injections (50 mg) into the pulmonary artery of the vascularly isolated lung abolished all reflex responses to subsequent injections of capsaicin, but only attenuated the triad of responses to subsequent left lung inflations by half. Morphine sulfate (60 mg) administered to the pulmonary vascular bed of the isolated lung reduced, but did not eliminate, the triad of reflex responses to subsequent capsaicin injections and lung inflations. The influences of morphine upon capsaicin and lung inflation responses were not abolished by naloxone.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of morphine and morphine-related compounds on the rate of afferent discharges from the pulmonary receptors in bullfrog

We examined the effects of morphine and morphine-related compounds on the rate of afferent discharges from the pulmonary receptors in bullfrog. Morphine (1 X 10(-5) - 1 X 10(-3) M) decreased the rate of spontaneous afferent discharges in a concentration-dependent manner, but hardly affected the rate of afferent discharges synchronized with lung inflation. Dihydrocodeine, naloxone and dextrorphan had the same effects as morphine. Levallophan (1 X 10(-4) M), pentazocine (1 X 10(-4) M) and pethidine (1 X 10(-3) M) clearly decreased both rates of the spontaneous afferent discharges and the afferent discharges synchronized with lung inflation. In the presence of naloxone or levallorphan at the concentration of 1 X 10(-5) M, morphine (1 X 10(-5) and 1 X 10(-4) M) caused an additive decrease in the rate of afferent discharges. Dextromethorphan and apomorphine at the concentration of 1 X 10(-4) M caused an increase in the rate of spontaneous afferent discharges followed by decrease in both rates of the spontaneous afferent discharges and the afferent discharges synchronized with lung inflation. When dextromethorphan or apomorphine was washed out and the rates of afferent discharges were almost restored to the levels before application of each drug, reapplication of these drugs caused no increase in the rate of spontaneous afferent discharges, but the drugs inhibited the generation of afferent discharges. All of these drugs did not affect the flow rate of perfusion solution from the pulmonary vein.