kappa-Opioid receptor agonist protects against ischemic reduction of 2-deoxyglucose uptake in morphine-tolerant rats

The Kappa Opioid Receptor: A Promising Therapeutic Target for Multiple Pathologies

Kappa-opioid receptors (KOR) are widely expressed throughout the central nervous system, where they modulate a range of physiological processes depending on their location, including stress, mood, reward, pain, inflammation, and remyelination. However, clinical use of KOR agonists is limited by adverse effects such as dysphoria, aversion, and sedation. Within the drug-development field KOR agonists have been extensively investigated for the treatment of many centrally mediated nociceptive disorders including pruritis and pain. KOR agonists are potential alternatives to mu-opioid receptor (MOR) agonists for the treatment of pain due to their anti-nociceptive effects, lack of abuse potential, and reduced respiratory depressive effects, however, dysphoric side-effects have limited their widespread clinical use. Other diseases for which KOR agonists hold promising therapeutic potential include pruritis, multiple sclerosis, Alzheimer's disease, inflammatory diseases, gastrointestinal diseases, cancer, and ischemia. This review highlights recent drug-development efforts targeting KOR, including the development of G-protein-biased ligands, mixed opioid agonists, and peripherally restricted ligands to reduce side-effects. We also highlight the current KOR agonists that are in preclinical development or undergoing clinical trials.

Synergistic Effect and Mechanism of Apoptosis Induction by Morphine and the HIV-1gp120V3 Loop in Hippocampal Neurons

HIV-associated neurocognitive disorders (HAND) are a collective name for neurological disorders associated with HIV-1 infection. The incidence and severity of HAND are increased by concomitant opioid use disorder, such as heroin and morphine abuse. Our previous study showed that the HIV-1 envelope protein gp120 and morphine synergistically induce apoptosis in rat hippocampal neurons. However, the underlying mechanism remains unclear. We hypothesized that morphine and gp120 activated the neuronal apoptosis signaling pathway via their typical membrane receptors. If they shared key signaling molecules, their induction of neuronal apoptosis could be inhibited by blocking these targets. We found that morphine and gp120V3 loop synergistically induced hippocampal neuron apoptosis, mediated by activating the extracellular signal-regulated kinase (ERK) pathway, increasing the intracellular Ca2 + concentration and expression of caspase-, and reducing the mitochondrial membrane potential. The ERK inhibitor PD98509 and the phosphatidylinositol 3-kinase activator IGF-1 blocked this effect. These results indicate that ERK plays a crucial role in the apoptosis of hippocampal neurons in HAND.

Perinatal neuroprotection by muscle relaxants against hypoxic-ischemic lesions: Is it a possible hypothesis?

The incidence of neurological disabilities ascribable to hypoxia-ischemia in the perinatal period (HIPP) is rising. Glutamate plays a key role in the development of cerebral damage related to HIPP: it triggers the excitotoxic cascade by overactivating N-methyl-D-aspartate receptors (NMDA), implicated as important mediators of both learning and neuronal development. Laudanosine is the metabolite of the neuromuscular blocking drugs, atracurium and cisatracurium, administered as part of obstetric general anesthesia. In elective cesarean section, laudanosine may be found in the fetus with a mean umbilical vein concentration of 26 (range 6-60) ng ml(-1). At nM concentrations, laudanosine can activate alpha4beta2 nACh subtype receptors. Activation of alpha4beta2 nAChRs provided neuroprotection against NMDA excitotoxic cascade in a neonatal model. Taken together, experimental and clinical data widely indicate a potential neuroprotective role for laudanosine against perinatal brain lesions of hypoxic-ischemic origin. The clinical relevance is that administration of the neuromuscular blocking drugs atracurium and cisatracurium, administered as part of general anesthesia for cesarean section, could be potentially therapeutic in obstetric anesthesia. Therefore, we find laudanosine to be an attractive proposal for further studies in the prevention of neurological disabilities ascribable to perinatal injury related to hypoxia and ischemia.

Hibernation-like state induced by an opioid peptide protects against experimental stroke

BACKGROUND

Delta opioid peptide [D-ala2,D-leU5]enkephalin (DADLE) induces hibernation in summer ground squirrels, and enhances preservation and survival of isolated or transplanted lungs and hearts. In the present study, we investigated the protective effect of DADLE in the central nervous system.

RESULTS

Adult Sprague-Dawley rats were pretreated with DADLE (4 mg/kg every 2 h x 4 injections, i.p.) or saline prior to unilateral occlusion of the middle cerebral artery (MCA). Daily behavioral tests revealed that ischemic animals treated with DADLE did not show any significant behavioral dysfunctions compared with saline-treated ischemic animals. Opioid antagonists only transiently inhibited the protective effect of DADLE, indicating the participation of non-opioid mechanisms in DADLE neuroprotection. Histological examination using triphenyltetrazolium chloride (TTC) revealed that brains from ischemic animals treated with DADLE, either alone or with adjuvant opioid blockers, exhibited almost completely intact striata. In contrast, brains from ischemic animals that received saline showed significant infarction in the lateral striatum. Analyses of apoptotic cell death revealed a significant increase in the p-53 mRNA expression in the striatum of ischemic animals that received saline, while those that received DADLE exhibited near normal striatal p-53 expression. This protective effect was accompanied by significant increments in protein levels of glial cell line-derived neurotrophic factor in the striatum of DADLE-treated ischemic animals.

CONCLUSION

These results indicate that DADLE protected against necrotic and apoptotic cell death processes associated with ischemia-reperfusion injury. The present study demonstrates that delta opioids are crucially involved in stroke, suggesting that the opioid system is important in the study of brain injury and protection.

A review of the properties of spiradoline: a potent and selective kappa-opioid receptor agonist

The selective kappa-opioid receptor agonist spiradoline mesylate (U62,066E), an arylacetamide, was synthesized with the intention of creating an analgesic that, while still retaining its analgesic properties, would be devoid of the, mainly mu receptor mediated, side effects such as physical dependence and respiratory depression associated with morphine. Spiradoline is highly selective for the kappa receptor with K(i) of 8.6 nM in guinea pig. Examination of the enantiomers of spiradoline, showed the (-)enantiomer to be responsible for the kappa agonist properties. Spiradoline easily penetrates the blood brain barrier, and does not seem to have any significant active metabolites. In preclinical studies, spiradoline has a short duration of action with a peak at around 30 min after administration. The analgesic properties of spiradoline are well documented in mice and rats. Antitussive properties have also been reported in rats. Furthermore, spiradoline was reported to display effects suggestive of neuroprotective properties in animal models of ischemia. In humans, spiradoline is a potent diuretic. It also produces significant sedation presumably due to its antihistamine properties. Preclinical studies have shown that spiradoline reduces blood pressure and heart rate, and has possible antiarrhythmic properties. Clinical studies did not confirm these findings. kappa Receptors inhibit dopaminergic neurotransmission. Spiradoline, given systematically to rats, produces a significant and long lasting decrease in dopamine release, and in locomotor activity. It has also antipsychotic-like effect in animal behavioral tests. At low doses spiradoline was reported to decrease tics in patients with Tourette's syndrome. Although spiradoline had promising effects in animal tests of analgesia, and a reasonably good safety profile in preliminary studies, it did not replace morphine as an analgesic. The available clinical data suggest that spiradoline produces disturbing adverse effects such as diuresis, sedation, and dysphoria at doses lower than those needed for analgesic effects. Thus, future development of spiradoline-like analgesic compounds should preferably focus on reduction of unwanted effects on the central nervous system. Spiradoline, which currently is commercially available for preclinical research, might prove useful in some psychiatric conditions and possibly as a neuroprotective agent.

Kappa opioid receptor is expressed by somatostatin- and neuropeptide Y-containing interneurons in the rat hippocampus

In our previous studies (J. Chem. Neuroanat. 2000;19:233-241), kappa opioid receptors were immunocytochemically identified in inhibitory interneurons of the dentate hilus and CA1 area of the rat hippocampus. From among the known interneuron subtypes, somatostatin- (SOM) and neuropeptide Y- (NPY) immunoreactive (IR) hippocampal interneurons show morphology and distribution similar to the kappa opioid receptor (KOR) immunopositive cells. In the present study, with the help of double immunocytochemical labelling, we provide direct evidence that the majority of the interneurons immunoreactive for SOM and/or NPY also express the kappa opioid receptor. The receptor was localized on the perikaryal and proximal dendritic region of the SOM- and NPY-immunopositive neurons in the dentate hilus and the CA1 region. From among the SOM-immunoreactive cells, 77% in the dentate hilus and 51% in the CA1 stratum oriens was double labelled. In the case of NPY-immunoreactive neurons this proportion was 56 and 65%, respectively. The co-expression of KOR and SOM/NPY suggests that hippocampal interneurons can selectively be activated by the different opioids under different physiological circumstances.

Treatment with delta opioid peptide enhances in vitro and in vivo survival of rat dopaminergic neurons

A major problem in neural transplantation therapy is poor survival of grafted cells, which may be due to low cell viability prior to transplantation or scarce trophic factors available to the cells following transplantation. Recently, the delta enkephalin analogue [D-Ala(2),D-Leu(5)]-enkephalin (DADLE) has been demonstrated to protect against, as well as to reverse methamphetamine-induced loss of dopamine transporters. Here, we show that pretreatment with DADLE (0.0025, 0.005, 0.01 g/ml) dose-dependently enhanced cell viability of cultured primary rat fetal mesencephalic cells. In addition, DADLE administration in adult rats (4 mg/kg every 2 h, 4 injections, i.p.) prior to 6-hydroxydopamine lesions of the medial forebrain bundle, significantly reduced the severity of loss of tyrosine hydroxylase-immunoreactive neurons in the substantia nigra 1 month post-lesion. This is the first report suggesting that DADLE can be used as a supplement factor for improving the cell viability of fetal mesencephalic cells and as a protective agent against neurotoxicity in a Parkinson's disease model.

Effects of naloxone and morphine on acute hypoxic survival in mice

OBJECTIVE

To investigate a role of the opiate system during acute hypoxic hypoxia, the effects of naloxone and morphine on hypoxic survival rate were investigated in awake adult mice.

DESIGN

Prospective, randomized, animal trial.

SETTING

University research laboratory.

SUBJECTS

Male dd-Y mice (n = 864 in experiment I, n = 144 in experiment II, n = 30 in experiment III).

INTERVENTIONS

The animals were placed in an airtight plastic chamber into which a continuous flow of 8 L/min 5% oxygen-95% nitrogen was passed.

MEASUREMENTS AND MAIN RESULTS

One and 5 mg/kg naloxone had no significant effect on the survival rate of mice subjected to acute hypoxic hypoxia, whereas 10 mg/kg naloxone decreased the survival rate. On the other hand, 2 and 5 mg/kg morphine was shown to have a protective action against acute hypoxic hypoxia. The protective effects of 5 mg/kg morphine against hypoxia was even antagonized by 5 mg/kg naloxone, which did not itself show any significant effect on the survival rate. The oxygen consumption in the morphine-treated (5 mg/kg) mice was significantly (p < .05) lower (87.0% +/- 4.6%; mean +/- SE) than that in the saline-treated animals.

CONCLUSIONS

The present study suggests that the endogenous opiate system does not play a significant role on the pathophysiology caused by acute hypoxic hypoxia and that the improved survival of the hypoxic animals by morphine is at least partly attributable to its depressant effect on oxygen consumption.

The effect of fentanyl on electrophysiologic recovery of CA 1 pyramidal cells from anoxia in the rat hippocampal slice

Fentanyl is widely used in conditions in which the brain is at risk of ischemic or anoxic injury. We evaluated the effect of fentanyl on anoxic injury to CA 1 pyramidal cells in the rat hippocampus. These neurons are extremely sensitive to anoxic injury and are densely populated with opioid receptors. We prepared hippocampal slices from adult Sprague-Dawley rats and evoked a postsynaptic population spike in the CA 1 pyramidal cell region by stimulating the Schaffer collateral pathway. The amplitude of this response was used to evaluate the effect of fentanyl on anoxic injury. Pretreatment with fentanyl (50 or 500 ng/mL) did not alter the amplitude of the CA 1 population spike before anoxia, nor did it alter the recovery of this response after 5,6, or 7 min of anoxia. After 5 min of anoxia, the population spike recovered to 76% of its preanoxic level in the control group and to 87% in the group treated with 500 ng/mL of fentanyl. After 6 min of anoxia, recovery was 45% in the control group, 57% in the group treated with 50 ng/mL of fentanyl, and 58% in the group treated with 500 ng/mL of fentanyl. After 7 min of anoxia, recovery was 5% in the control group and 4% in the group treated with 50 ng/mL of fentanyl. We conclude that fentanyl does not affect the recovery of the electrophysiological response in rat hippocampal neurons subjected to an anoxic insult.

IMPLICATIONS

Because fentanyl is used in large doses during surgical procedures in which the brain is at increased risk of ischemic or anoxic injury, it is important to determine its effect on such injury. Using the rat hippocampal slice model, we found fentanyl to be neither neurotoxic nor protective against anoxic injury to neurons when used in concentrations comparable to those produced in clinical practice.

Prolonged antagonism of morphine-induced locomotor stimulation by kappa opioid agonists: enhancement by prior morphine exposure

The selective kappa agonists U50488 (10 mg/kg, i.p.) and spiradoline (1 mg/kg, i.p.) attenuated the locomotor activating effects of a morphine challenge (5 mg/kg, i.p.) administered 19 h later in rats. This antagonism of morphine by a kappa agonist was reversed by the selective kappa antagonist, norbinaltorphimine (10 mg/kg, s.c.). Furthermore, the kappa opioid antagonism of morphine was enhanced by prior morphine exposure (2 doses of 30 mg/kg, i.p. administered once a day for 2 days). The present data suggest that kappa-micro opioid interactions may occur over time periods that exceed the acute durations of drug actions.