Cardiovascular effects of peptides related to the enkephalins and beta-casomorphin

A1- and A2 beta-casein on health-related outcomes: a scoping review of animal studies

PURPOSE

Food-derived bioactive peptides may influence important physiological functions. An important example is beta-casomorphins, which are opioid peptides derived from A1 beta-casein in bovine milk and have been associated to be risk factors for non-communicable diseases in humans. A1 and A2 beta-casein are different with respect to the release of bioactive peptides, in particular BCM-7. However, evidence from human studies is limited and could be complemented with evidence derived from animal studies. We conducted a scoping review to identify animal studies investigating the effects of A1 beta-casein or BCM-7 compared to A2 beta-casein or any other intervention on health-related outcomes.

METHODS

We systematically searched for relevant studies in two electronic databases (Medline, Embase; last search performed March 2020). Two reviewers independently undertook study selection and data extraction of included references. Results were summarized tabularly and narratively.

RESULTS

We included 42 studies investigating various animal models, including rats, mice, rabbits, and dogs. Six studies investigated health-related outcomes of A1- vs. A2 milk, while most studies (n = 36) reported on physiological properties (e.g., analgesic effect) of BCM-7 as an opioid peptide. Included studies were extremely heterogeneous in terms of the study population, type of intervention and dose, and type of outcome measures.

CONCLUSIONS

Only a few studies comparing the effects of A1- and A2 milk were identified. More studies addressing this research question in animal models are needed to provide essential information to inform research gaps. Results from future studies could eventually complement research for humans, particularly when the body of evidence remains uncertain as is the case in the A1- and A2 milk debate.

Structure-activity relationships of naturally occurring and synthetic opioid tetrapeptides acting on locus coeruleus neurons

Intracellular recording was used to study the effects of eight opioid tetrapeptides with similar amino acid sequences, namely endomorphin-1 (Tyr-Pro-Trp-Phe-NH2), endomorphin-2 (Tyr-Pro-Phe-Phe-NH2), morphiceptin (Tyr-Pro-Phe-Pro-NH2), hemorphin-4 (Tyr-Pro-Trp-Thr), Tyr-MIF-1 (Tyr-Pro-Leu-Gly-NH2), Tyr-W-MIF-1 (Tyr-Pro-Trp-Gly-NH2), TAPS (Tyr-D-Arg-Phe-Sar) and DALDA (Tyr-D-Arg-Phe-Lys-NH2), on neurons of the rat locus coeruleus, using a submerged brain slice preparation. All the tetrapeptides inhibited the spontaneous firing of all neurons of the locus coeruleus tested. Higher concentrations also caused hyperpolarization of the neurons and a reduction in input resistance. These inhibitory effects were rapidly and completely reversed by CTAP (D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2, a selective micro-opioid receptor antagonist). The IC50 of the opioid tetrapeptides, in terms of inhibition of spontaneous firing of locus coeruleus neurons, as compared to the concentrations which produced a 5-mV hyperpolarization (HC5 mV) were calculated, giving the same rank order of potency: TAPS (IC50 = 1.9 nM, HC5 mV = 3.4 nM) > endomorphin-1 (IC50 = 8.8 nM, HC5 mV = 22.1 nM) and endomorphin-2 (IC50 = 5.3 nM, HC5 mV = 16.1 nM)> DALDA (IC50 = 20 nM, HC5 mV = 143 nM) > morphiceptin (IC50 = 65 nM, HC5 mV = 335 nM) > Tyr-W-MIF-I (IC50 = 3.8 microM, HC5 mV = 6.7 microM) > hemorphin-4 (IC50 = 6.7 microM, HC5 mV = 36.9 microM) > Tyr-MIF-1 (IC50 = 37.5 microM, HC5 mV = 76.2 microM). Comparison of the ability of endomorphin-1 and endomorphin-2 to inhibit spontaneous firing based on single-cell recordings (n = 5) showed these two peptides to be equipotent. Based on these results, the structure-activity relationships of these opioid tetrapeptides are discussed herein.

Endomorphins decrease heart rate and blood pressure possibly by activating vagal afferents in anesthetized rats

Endomorphin 1 (10, 30, 100 nmol/kg) administered intravenously (i.v. ) to urethane-anesthetized rats consistently and dose-dependently lowered heart rate (HR) and mean arterial pressure (MAP); the decrease in blood pressure recovered faster as compared to the HR. The effects of endomorphin 2 were qualitatively similar. Naloxone (2 mg/kg, i.v.) completely antagonized the bradycardia and hypotension caused by endomorphin 1. Pretreatment of the rats with atropine methylnitrate, atropine sulfate (2 mg/kg, i.v.) or bilateral vagotomy nearly abolished the bradycardia and attenuated the hypotensive effect of endomorphin 1. Our studies suggest that the bradycardia effect following systemic administration of the new opioid peptide may be explained by activation of vagal afferents and the hypotensive effect may be secondary to a reduction of cardiac output and/or a direct vasodilation.

Naloxone inhibits renal hemodynamic effect of head-out water immersion in humans

Head-out water immersion (HOI) is followed by renal vasodilation and natriuresis, in association with a fall in blood pressure. The latter suggests an exaggerated sympathetic suppression. We studied the role of endogenous opioids on the renal response to HOI. Six healthy subjects underwent four- hour clearance studies during: (1) time control; (2) naloxone 0.1 mg/kg i.v. bolus, followed by 0.1 mg/kg/hr; (3) HOI; and (4) concomitant HOI and naloxone administration. Compared to the time control study, naloxone had no effects on mean arterial pressure (MAP), plasma renin activity (PRA), aldosterone, catecholamines, atrial natriuretic peptide (ANP), glomerular filtration rate (GFR), estimated renal plasma flow (ERPF), and sodium excretion. HOI caused significant decrements of MAP, PRA, aldosterone, and catecholamines, and increased ANP, GFR, from 94 +/- 5 to 102 +/- 5 ml/min (P < 0.01), ERPF, from 529 +/- 30 to 616 +/- 35 ml/min (P < 0.01), and sodium excretion. Renal blood flow increased as well, and calculated renal vascular resistance decreased from 99 +/- 6 to 77 +/- 5 mm Hg.min.liter-1 (P < 0.01). HOI during concomitant naloxone administration had similar effects on MAP and humoral factors, however, caused no change in GFR, ERPF and renal blood flow, and the fall in renal vascular resistance, from 98 +/- 6 to 83 +/- 5 mm Hg.min.liter-1 (P < 0.05) was significantly less than found in the absence of naloxone (P < 0.05). The natriuretic effect was undisturbed. These data suggest that endogenous opioids play a role in the response to HOI, in particular, potentiate the renal vasodilatory response.

Mechanisms involved in the cardiovascular responses to opioid products of proenkephalin in the anaesthetised rat

1. Cardiovascular effects of opioid peptide products of proenkephalin, [Met] enkephalin (ME), [Leu] enkephalin (LE), [Met] enkephalyl Arg6-Phe7 (MEAP) and [Met] enkephalyl Arg6-Gly7-Leu8 (MEAGL) have been studied in urethane-anaesthetised rats. 2. ME, LE, MEAP and MEAGL produced vasodepression and bradycardia mediated by mu-opioid receptors. 3. Atypical responses to MEAP were observed in a quarter of the animals studied showing tachycardia and pressor effects. This response was probably due to the release of the dipeptide Arg-Phe which exerted its effects at sympathetic ganglia. 4. Studies with the peptidase inhibitors captopril and bestatin showed a differential potentiation of the cardiovascular effects of the proenkephalin products by inhibition of angiotensin converting enzyme and aminopeptidase. 5. The effects of vagotomy, pithing and studies with atropine, and N-methyl levallorphan were used to demonstrate that, for all four proenkephalin peptides, cardiovascular effects were mediated by peripheral opioid receptors and transmission to the CNS via vagal afferents.

Effects of selective opioid receptor agonists and antagonists during myocardial ischaemia

The antiarrhythmic activities of 16-methylcyprenorphine (M8008), nor-binaltorphimine (NBT) and naltrexone, which are relatively specific opioid receptor antagonists for delta, kappa and mu receptors, respectively, were examined during the 30 min following coronary artery occlusion in anaesthetised rats. The haemodynamic and electrocardiographic effects of the opioid receptor agonists [D-Ala2,D-Leu5]enkephalin (DADLE) (relatively selective for delta receptors), ICI-204448 (kappa) and glyol (mu) were also investigated over the 30-90 min post ligation period. When administered intravenously 5 min before ligation, M8008 (0.5 mg kg-1 and 2.5 mg kg-1) reduced the number of ventricular ectopic beats but had no effect on the incidence or duration of ventricular fibrillation. NBT and naltrexone were not antiarrhythmic at a dose of 0.5 mg kg-1 but at 2.5 mg kg-1 (a concentration at which both drugs block kappa receptors) the number of ventricular ectopic beats, the incidence of ventricular fibrillation and mortality were all reduced. All of the opioid receptor agonists caused a transient decrease in heart rate and in arterial blood pressure but none exhibited an arrhythmogenic effect. These studies suggest that the delta and kappa opioid receptor antagonists used may be antiarrhythmic as a result of blockade of the action of endogenously released peptides acting on these receptors or that they have a non-specific 'direct' antiarrhythmic action.

Normotensive Wistar rats differ from spontaneously hypertensive and renal hypertensive rats in their cardiovascular responses to opioid agonists

1. The effects of three opioid receptor agonists on the blood pressure and heart rate of anaesthetized normotensive, spontaneously hypertensive and renal hypertensive rats were measured. 2. Mu agonist morphiceptin i.c.v. induced a pressor response and increase in heart rate in hypertensive rats, but hypotension in normotensive rats. After intravenous (i.v.) injection, morphiceptin produced a hypotensive response in all three groups of rats. 3. In contrast, the delta agonist DTLET i.c.v. decreased blood pressure and heart rate in hypertensive rats, but increased both pressure and beat rate in normotensive rats. After i.v. injections DTLET produced a hypertensive response and increase in heart rate in all groups of rats. 4. Kappa agonist U-50, 488H given i.c.v. induced effects similar to morphiceptin: an increase in blood pressure and heart rate in hypertensive and a decrease in normotensive rats. After i.v. injections U-50, 488H produced decreases in blood pressure and heart rate in all treated groups of rats. 5. Pretreatment with naloxone antagonized the activity of morphiceptin but prevented only the stimulating effect of DTLET in normotensive rats. Cardiovascular actions of U-50, 488H were not blocked by naloxone. 6. The results suggest that opioid agonists exert similar changes in cardiovascular function at central and peripheral sites in both models of experimental hypertension and these effects are different in normotensive rats.

D-Ala-2-Me-Phe-4-Met-(O)-ol-enkephalin in the nucleus tractus solitarius of the rat produces cardiorespiratory depression

1. The synthetic Met-enkephalin, D-Ala-2-Me-Phe-4-Met-(O)-ol-enkephalin (FK 33-824). 1 or 2 micrograms, after its injection into the nucleus tractus solitarius (NTS) of Wistar rats, anesthetized with pentobarbital and breathing spontaneously, produced a transient increase in blood pressure followed by sustained and significant (P less than 0.05) hypotension and bradycardia. This occurred in a dose dependent manner. 2. FK 33-824 in the NTS, 1 or 2 micrograms, also produced a marked respiratory depression. 3. In anesthetized rats, in which hypoventilation was prevented by mechanical ventilation, there was a definite reduction in blood pressure and heart rate that was considerably and significantly (P less than 0.05) less than that observed in spontaneously breathing rats. 4. Blood pressure fluctuations occurred after NTS injection that were more marked in spontaneously breathing animals but still occurred in animals that were ventilated mechanically. 5. FK 33-824, 1 and 2 micrograms in the NTS was fatal within 100 min for all animals but was prevented by mechanical ventilation. Higher doses of FK 33-824, 10 micrograms in the NTS, however, induced fatal ventricular arrhythmias even in the mechanically ventilated rat. 6. Thus, FK 33-824 in the NTS decreases blood pressure and heat rate in spontaneously breathing as well as mechanically ventilated rats, but much of the effect on blood pressure and heart rate is due to the profound respiratory depression in the spontaneously breathing rat.

Intrathecal administration of delta receptor agonists in the urethane anesthetized rat provokes an increase in arterial pressure via a non-opioid mechanism

Intrathecal administration of the delta receptor specific agonists Leu5-enkephalin (Leu-Enk; 300 nmol), Met5-enkephalin (Met-Enk; 300 nmol) and [D-Pen2,D-Pen5]enkephalin (DPDPE; 100 nmol) to the T2 or the T9 segment of the rat spinal cord provoked a transient (less than 5 min) increase (15-20 mm Hg) in arterial pressure. DPDPE, but not Leu-Enk or Met-Enk, also significantly increased heart rate by 30-35 bpm. Intravenous administration of 300 nmol of Leu-Enk mimicked the effects observed following intrathecal administration. The hypertensive effect of intrathecal and intravenous Leu-Enk administration was blocked by prior systemic administration (10 mg/kg) of the nicotinic ganglion blocker hexamethonium, suggesting that the effect was mediated via sympathetic activation. The increase in arterial pressure observed following intrathecal Leu-Enk administration was not blocked by either intrathecal (305 nmol) or intravenous (10 mg/kg) administration of the opiate receptor blocker naloxone, although naloxone did block the hypertension provoked by intravenous Leu-Enk administration. Moreover, intrathecal administration of Des-Tyr1-Leu-Enk (300 nmol), an enkephalin fragment devoid of opiate receptor activity, also increased arterial pressure. These results suggest that the hypertension elicited by intrathecal delta agonist administration was not mediated via an opioid mechanism.

Intravenous beta-endorphin: behavioral and physiological effects in conscious monkeys

Beta-endorphin (0.7 and 2.8 mg/kg) and morphine (0.15 and 0.60 mg/kg) were administered intravenously to rhesus monkeys responding on an operant schedule. Beta-endorphin injections resulted in dose-dependent effects which included marked, but relatively brief disruptions in behavioral responding, decreases in systolic blood pressure, and more protracted increases in heart rate. Morphine injections were followed by much longer duration decreases in response rates and systolic blood pressure, and an irregular but largely deceleratory heart rate response. On a molar basis, beta-endorphin was approximately twice as potent as morphine. It was concluded that intravenously administered beta-endorphin exerts behavioral and physiological effects in the unanesthetized primate.

Physiologic role of the peripheral enkephalinergic system in regulating cardiovascular homeostasis: evidence of interactions with the renin-angiotensin and kallikrein-kinin systems

On isolated heart preparation, it was found that Leu5-Enkephalin (Leu5-ENK) did not influence the cardiac function. On the other hand, Leu5-ENK induced a specific dose-related inhibition, in the cardiac perfusate, of the activities of kininase II (KII) and angiotensin converting enzyme (ACE) (but not of kininase I-KI). Instead no detectable alterations of the above enzymatic activities with the used concentrations of Leu5-ENK were observed in vitro. This opioid also increased specifically the effects induced by some of the autacoids, related to both renin-angiotensin and kallikrein-kinin systems, on the KII and ACE activities. A specific correlation between these Leu5-ENK-induced modifications and the functional responses of the heart to the same autacoids was observed. Naloxone (NAL) and more significantly ICI 174864 (ICI) opposed or reversed the inhibitory effect of the used opioid whereas they had neither inhibitory nor synergic effect on both KII and ACE activity by themselves. The possible physiologic role of the enkephalins in regulating cardiovascular function by acting peripherally on some humoral systems through modulatory mechanism was discussed.

Opioid peptides from milk as a possible cause of sudden infant death syndrome

Milk from breast or baby formula is the exclusive source of nutrition for newborn infants. Short chain opioid peptides such as beta-casomorphins have been isolated from breast milk as well as baby formula. These biologically active peptides are absorbed from the gastrointestinal tract. In infants predisposed to respiratory apnea because of abnormal autonomic nervous system development and respiratory control mechanisms, opioid peptides derived from milk might be one of the etiological factors for sudden infant death syndrome and near miss sudden infant death syndrome.

The effect of D-Ala-2-Me-Phe-4-Met-(0)-Ol enkephalin on blood pressure, heart rate and digoxin-induced arrhythmias in the guinea pig

The cardiovascular effects of D-Ala-2-Me-Phe-4-Met-(0)-Ol enkephalin were investigated after its administration into the fourth cerebroventricle of the guinea pig. This enkephalin is a synthetic Met-enkephalin analog that is more resistant to degradation and has a high affinity for opioid receptors. It produced a significant increase in blood pressure and decline in heart rate. At high concentrations, 100 micrograms/kg plus 100 micrograms/kg/hr in the fourth ventricle, it produced bradyarrhythmias that were sometimes fatal. At doses that did not alter survival or produce arrhythmia, namely 30 micrograms/kg plus 25 micrograms/kg/hr in the fourth ventricle, the response to digitalis was assessed. Significant leftward shifts in the relationships between digoxin and arrhythmia occurrence and development of fatal arrhythmias were observed. Thus, D-Ala-2-Me-Phe-4-Met-(0)-Ol enkephalin has definite cardiovascular effects that include potentiation of digoxin arrhythmias.

Circulating [Met]enkephalin and catecholamine responses to acute hypotension and hypertension in anaesthetized greyhounds

The effects of either hypotension induced by sodium nitroprusside or hexamethonium or hypertension produced by angiotensin II or noradrenaline on the circulating levels of methionine enkephalin ([Met]enkephalin)-like immunoreactivity (MLI), adrenaline and noradrenaline in anaesthetized greyhounds were examined. Nitroprusside infusions (200 and 400 micrograms min-1) induced a fall in blood pressure accompanied by significant rises in plasma MLI and catecholamine concentrations. Concomitant administration of a high dose of naloxone did not alter the fall in blood pressure produced by nitroprusside but was associated with greater rises in circulating MLI and catecholamines when compared to nitroprusside alone, suggesting that [Met]enkephalin is not involved in the hypotensive action of nitroprusside. Intravenous hexamethonium (2.5 mg kg-1) provoked a fall in blood pressure which was not associated with any changes in plasma MLI. However, it produced a fall in plasma noradrenaline and a rise in plasma adrenaline. Thus it appears that neural mechanisms are required, at least in part, for the release of MLI. Angiotensin II (1.25 micrograms kg-1 min-1) and noradrenaline (8 micrograms kg-1 min-1) infusions produced an elevation in blood pressure without altering the circulating MLI levels. Study of the molecular forms of circulating MLI, before and during hypotension, revealed that the large molecular weight enkephalin-containing peptides with approximate molecular sizes of 18kD and 8kD were the predominant forms both in the basal and stimulated states. It is concluded that circulating [Met]enkephalin is not involved in the tonic control of blood pressure but it may modulate catecholamine release following hypotension as part of the stress response.

Alpha-MSH and other ACTH fragments improve cardiovascular function and survival in experimental hemorrhagic shock

Hypovolemic shock was produced in rats by withdrawing about 50% of the estimated total blood volume. Following mean arterial pressure stabilization in the range of 15-25 mm Hg, with a pulse pressure of 7-12 mm Hg, the rats were given intravenous bolus injections either of ACTH fragments or of saline. The following ACTH fragments or analogs were used: ACTH-(4-10), alpha-MSH, ACTH-(1-16), ACTH-(1-17), ACTH-(1-18), [Nle4,D-Phe7]alpha-MSH, [beta-Ala1,Lys17]ACTH-(1-17)-4-amino-n-butilamide (alsactide). ACTH-(1-24) and human synthetic ACTH-(1-39) were used for comparison. All animals treated with saline died in 22.51 +/- 3.62 min. Treatment with ACTH fragments (160 micrograms/kg i.v.) increased blood pressure and pulse amplitude, the effect starting within a few minutes, gradually increasing, and reaching a maximum in 15-30 min. The blood and pulse pressure increases were sustained, remaining almost stable until the end of the 2 h recording. Two out of nine rats treated with alsactide, which was the least active, died within 2 h after treatment, while all rats treated with the other ACTH fragments or analogs were still surviving at that time. Both on a weight and on a molar basis, the most active was ACTH-(1-24), followed by ACTH-(1-16), by the alpha-MSH analog [Nle4,D-Phe7]ACTH-(1-13), by ACTH-(1-18) and by ACTH-(1-17). The present results show that melanocortins reverse otherwise fatal hypovolemic shock, and suggest a new therapeutic approach for shock treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Some species differences in cardiovascular responses to intravenously injected leucine-enkephalin

Studies were conducted to determine the cardiovascular responses to leucine-enkephalin (L-enk) in three different species of animals; rabbit, dog and monkey. All animals were anesthetized with pentobarbital sodium after sedation with ketamine. Mean blood pressure (MBP) and heart rate (HR) were simultaneously monitored. The pressor and HR responses to bilateral carotid occlusion (BCO) were determined before injection of L-enk. Increased MBP and HR due to BCO in monkey were significantly greater than in the other two animal groups. Following i.v. injection of L-enk (5-30 micrograms/kg), a significant fall in MBP occurred in all groups in a dose-dependent manner; however, the time course of changes in MBP in rabbits was significantly shorter than that in the other animal groups. Significant decreases in HR after the injection of L-enk occurred in rabbits and dogs, whereas increases in HR occurred in monkeys. These results show that some cardiovascular responses to L-enk may be species dependent. These different cardiovascular responses to L-enk may be at least partly related to species differences in baroreceptor reflex sensitivity.

Interactions between the antiopiate Tyr-MIF-1 and the mu opiate morphiceptin at their respective binding sites in brain

The interactions between Tyr-MIF-1, a brain peptide with antiopiate activity, and the beta-casomorphins, a family of peptides derived from milk protein with opiate activity, were investigated by in vitro binding assays. Specific binding of 125I-Tyr-MIF-1 to rat brain membranes was displaced with high potency by beta-casomorphin, morphiceptin, and the morphiceptin analog PL017 but not by the analgesically inactive analog D-Pro2-morphiceptin or by several other ligands for classical delta, kappa, or sigma opiate receptors. In addition, Tyr-MIF-1 displaced 125I-morphiceptin from its binding sites in brain with affinities similar to those of unlabeled morphiceptin and PL017. These results, which include the first demonstration of a binding site in brain for labeled morphiceptin, indicate that brain antiopiate Tyr-MIF-1 and the beta-casomorphin derived peptides with opiate activity may share a common binding site or cross-react at each other's site. This suggests a possible mechanism of action for endogenous antiopiate-opiate interactions.

The opioid system and central cardiovascular control: analysis of controversies

Opiates, like morphine, were long known to produce changes in blood pressure and cardiac functions. However, the nature of these changes are a subject of continuous controversy. The substantial differences in the opiate effects on the cardiovascular system is also apparent in more recent studies using enkephalins, beta-endorphin and dynorphins. The present review is aimed to indicate the source of the variations in the experimental data and analyze the relative contribution of different experimental factors to the observed effects of opiates and opioid peptides on the cardiovascular system. The major factors which contribute to the nature of the opioid effect on the cardiovascular system are: anesthesia, species, dose, site of action in the brain, respiratory changes and receptor specificity. However, the cardiovascular status per se is an important determinant of the opiates and opioid peptide effects on hemodynamic functions as indicated in states of hypertension and shock. A newly described factor is the plasticity of the opioid receptor system which changes its level and distribution pattern in different physiological and pathophysiological states. This review emphasizes the importance of utilization of highly specific ligands to opiate receptors administered to discrete brain areas in the conscious animal.

Release of catecholamines and [Met5]enkephalin immunoreactive material from perfused bovine adrenal glands

Retrogradely perfused bovine adrenal glands were stimulated by acetylcholine (ACh) and 1,1-dimethyl-4-phenyl-piperazinium (DMPP), with or without hexamethonium. Stimulation by either agent resulted in an increased release of both [Met5]enkephalin immunoreactive material (ME-IRM) and catecholamines as measured by radioimmunoassay and high performance liquid chromatography with electrochemical detection, respectively. ACh (5 X 10(-5) M) and DMPP (5 X 10(-5) M) stimulated the release of norepinephrine greater than the release of epinephrine. The action of these agents was antagonized by hexamethonium (5 X 10(-4) M). DMPP produced the same percentage increase in the release of ME-IRM and norepinephrine but produced a greater percentage increase in the release of ME-IRM compared to the release of epinephrine. There was no apparent correlation between the percentage increase in the release of ME-IRM and either norepinephrine or epinephrine after ACh.

Reduction by phentolamine of the hypotensive effect of methionine enkephalin in anaesthetized rabbits

In intact rabbits anaesthetized with pentobarbitone, methionine enkephalin (Met enkephalin, 1-1,000 micrograms kg-1 i.v.) produced a dose-dependent bradycardia and hypotension. The bradycardia and hypotension were antagonized by naloxone hydrochloride (1 mg kg-1), but not by naloxone methobromide (1.3 mg kg-1). Phentolamine (1 and 4 mg kg-1 i.v.) blocked both the hypotension and bradycardia produced by Met enkephalin. The inhibitory effect of phentolamine was not due to a simple hypotensive action of this drug per se because a similar degree of hypotension induced by nitroprusside (15 micrograms kg-1, i.v.) caused a further reduction of pressure when Met enkephalin was added. Atropine (2 mg kg-1) reduced the bradycardia but not the hypotensive response to Met enkephalin. Met enkephalin did not antagonize the vasopressor effect of exogenous noradrenaline (2-8 micrograms kg-1, i.v.). Met enkephalin had no significant effects in superfused thoracic aortic strips and in isolated perfused hearts of rabbits. It is concluded that the cardiovascular effects of Met enkephalin are more probably due to an action on the central nervous system, although a peripheral site of action cannot be completely excluded.

Peripheral opioid receptors influencing heart rate in rats: evidence for endogenous tolerance

Opioid peptides injected into the circulation of rats evoke a vagally mediated bradycardia. The intravenous ED50 of morphine for producing a greater than or equal to 10% fall in heart rate was determined in urethane-anesthetized rats. Hypophysectomy, or adrenalectomy plus treatment with dexamethasone (0.5 microgram/h, s.c., 1 day), procedures that remove endogenous sources of opioid peptides, increased the sensitivity of the animal to morphine bradycardia by 6-10-fold. Conversely, stressing the animals by exposure to cold (4-6 degrees C for two days) elevated the ED50 for morphine sulfate and for beta h-endorphin by about 5-fold. Dexamethasone infusions prevented the cold-induced desensitization to morphine. Intravenous administration of rat corticotropin-releasing factor (CRF) also desensitized the animals to morphine. CRF alone produced a fall in blood pressure and heart rate. The bradycardia was prevented by pretreatment with naloxone. These results indicate that the sensitivity of vagal opioid chemoreceptors is influenced by endogenous sources of opioid peptides. This phenomenon can be called 'endogenous tolerance'.

Depressor and bradycardic effect following intrathecal injection of [NMePhe3,D-Pro4]morphiceptin in rats

The intrathecal injection of 1.25, 2.5 and 5 micrograms of [ NMePhe3 ,D-Pro4] morphiceptin (MC), a highly selective mu receptor agonist, in pentobarbital-anesthetized rats resulted in a dose-dependent decrease of mean arterial pressure, reaching a maximal effect 1 h after its administration. A marked bradycardic effect paralleled the depressor effect. These effects were totally reversed by prior intrathecal injection of 10 micrograms of naloxone. The effect of MC was fully present in bilaterally vagotomized rats and in rats under artificial respiration. These results provide evidence for the opioid control of blood pressure and heart rate via mu receptors in the spinal cord.

Captopril potentiates the vasodepressor action of Met-enkephalin in the anaesthetized rat

The transient vasodepressor action of Met-enkephalin (10-80 micrograms kg-1, i.v.) in anaesthetized rats was significantly potentiated by the angiotensin-converting enzyme inhibitor, captopril (2 mg kg-1, i.v.); at this dose, it failed to modify the transient vasodepressor action of the non-specific vasodilator, nitroprusside (2.5, 5.0, 10 micrograms kg-1, i.v.). Captopril (2 mg kg-1, i.v.) caused a slow, progressive fall in the blood pressure of anaesthetized spontaneously hypertensive (SH) rats when compared to vehicle-treated controls. Pretreatment with naloxone (1.5 mg kg-1, i.v.) 30 min earlier failed to alter significantly the hypotensive action of captopril in anaesthetized SH rats. It was concluded that although captopril potentiated the vasodepressor action of Met-enkephalin in anaesthetized normotensive rats, potentiation of endogenous opioids does not appear to be involved in the hypotensive action of captopril in anaesthetized SH rats.

Abdominal vagotomy does not modify endotoxic shock in rats

Bilateral subdiaphragmatic vagotomy does not improve the clinical course nor the survival of Sprague-Dawley rats injected intravenously with E. coli lipopolysaccharide. These results show that whatever peripheral signals are elicited by endotoxin to generate the centrally mediated hypotensive response, they are not conveyed to the central nervous system by abdominal vagal afferent fibers.

Inhibition of an opioid-evoked vagal reflex in rats by naloxone, SMS 201-995 and ICI 154, 129

Intravenous injection of opioid agonists in rats evokes a vagal reflex resulting in a fall in heart rate, and blood pressure. Three opioid antagonists, naloxone, SMS 201-995, and ICI 154,129 were used to assess the nature of the opioid receptors that mediate the vagal reflex. The agonists used were morphine, Tyr-Pro-NMePhe-D-Pro-NH2 (PLO17), and D-Ala2-Leu5-enkephalin (DADL). At challenge doses of morphine, PLO17, and DADL at five times the ED50 for bradycardia, the naloxone ED50 for DADL was nine times greater than that for morphine and PLO17. The pA2 value of naloxone against DADL was significantly less than that for morphine and PLO17. The antagonist properties of SMS 201-995 were similar to those of naloxone. ICI 154,129, a putative delta receptor antagonist, was not, however, selective in its antagonism of opioid bradycardia. Both SMS 201-995 and ICI 154,129, when injected alone, produced changes in heart rate and blood pressure. The cardiovascular actions of the peptide antagonists were not affected by naloxone hydrochloride at doses up to 4 mg/kg i.v.

Vasoactive peptides. State-of-the-art review

At least 16 naturally occurring peptides either constrict or dilate blood vessels. Many of these peptides are present in nerve cells and nerve terminals supplying systemic and pulmonary blood vessels and the heart. Such neuropeptides are released locally as neurotransmitters, and can influence vascular tone, local and regional blood flow, arterial blood pressure, and cardiac function. There is evidence for the participation of at least some vasoactive peptides in the regulation of these functions and in the mediation or modulation of systemic shock and arterial hypertension. The investigation of vasoactive peptides in relation to cardiovascular function and dysfunction is at a promising threshold.

Mechanism of the cardiovascular response to systemic intravenous administration of leucine-enkephalin in the conscious dog

Leucine-enkephalin (Leu5-ENK) (35 micrograms/kg) increased heart rate and mean systemic arterial blood pressure following intravenous injection into chronically-instrumented, conscious dogs. Repeated injections at five-minute intervals were not associated with a diminished response. Naloxone (1 mg/kg) pre-treatment inhibited both heart rate and blood pressure increases. Prazosin (1 mg/kg) attenuated the increase in blood pressure but did not influence the heart rate response. Propranolol (1 mg/kg) attenuated the heart rate response but not the pressor response. Clonidine (30 micrograms/kg) attenuated the positive chronotropic effect of Leu5-ENK. Atropine (1 mg/kg) plus propranolol (1 mg/kg) blocked the heart rate response but the pressor effect was still present. The attenuation of the heart rate response by propranolol and the pressor response by prazosin suggests an adrenergic component to the enkephalin response; the reduction in the heart rate response by clonidine and atropine-propranolol indicates a role for cholinergic mechanisms in the chronotropic response. Hexamethonium (10 mg/kg) blocked the heart rate response and markedly inhibited the pressor response. Vagal interruption attenuated both heart rate and blood pressure responses. It is concluded that intravenous Leu5-ENK stimulates afferent pathways located in fibers which are contained in the vagosympathetic trunk to reflexly increase heart rate and blood pressure.

Blood pressure elevation in rats by peripheral administration of Tyr-Gly-Gly-Phe-Met-Arg-Phe and the invertebrate neuropeptide, Phe-Met-Arg-Phe-NH2

Phe-Met-Arg-Phe-NH2 (FMRFamide), injected at less than 1 mumol/kg intravenously in the anesthetized rat, produces sharp elevations of blood pressure and changes in respiration. The effects were dependent on the carboxyterminal Arg-Phe (RF) configuration and were stereospecific for these two amino acids. A related peptide with RF carboxyterminus, gamma 1-melanotropic stimulating hormone, also had potent blood pressure stimulating activity. The mechanisms underlying the pressor effect of FMRFamide have not yet been established but this pressor action was not significantly attenuated by standard pharmacologic antagonists or prevented by removal of the adrenal or pituitary gland.

Cardiorespiratory effects of mu and delta opiate agonists following third or fourth ventricular injections

The cardiorespiratory effects of prototype mu (morphine and beta-casomorphine 1-4) and delta (D-Ala2-D-Leu5Enkephalin-DADLE) opioid ligands were compared following microinjection into third and fourth ventricular spaces in conscious and anesthetized rats. The direction of change in arterial pressure produced by ventricular opioid injections varied according to ligand, site of administration, and state of consciousness of the animal. In general, pentobarbital anesthesia blocked or reversed the pressor response to these opiate agonists; depressor responses became magnified following pentobarbital. Qualitatively, the predominant effect of third ventricular DADLE in anesthetized rats was to produce a depression of arterial pressure and pulse pressure, suggesting an involvement of hypothalamic delta opioid receptors in decreasing sympathetic outflow. By contrast, morphine exerted pronounced bradycardic effects following fourth ventricular administration, suggesting an action at mu opioid receptors which influence vagal parasympathetic activity. Both ligands lowered respiratory rates upon fourth ventricular injection, indicating a possible involvement of either opioid receptor subtype in the depression of brainstem respiratory centers. These depressant effects of opioids upon cardiorespiratory function were readily reversed by naloxone. The qualitative similarity between the cardiovascular effects of third ventricular DADLE administration and various forms of circulatory shock may indicate that both phenomena involve delta opioid receptors at hypothalamic sites.

Effects of enkephalins on perfusion pressure in isolated hindlimb preparations

A series of studies were conducted to determine the effects of leucine-(leu-) enkephalin and methionine-(met-) enkephalin on perfusion pressure. These experiments utilized isolated perfused femoral arterial preparations in pentobarbital-anesthetized cats. The enkephalins were administered intraarterially into the femoral artery and changes in perfusion pressure recorded. Leu-enkephalin in doses of 1 microgram to 320 micrograms produced significant dose-dependent decreases in perfusion pressure (4.0 +/- 1.3% with 1 microgram to 19.1 +/- 2.1% with 320 microgram). Similar declines in perfusion pressure (5.2 +/- 2.4% with 1 microgram to 21.7 +/- 4.1% with 320 micrograms) were observed following the administration of met-enkephalin. Pretreatment with naloxone (3 mg/kg) antagonized the effects of both enkephalins. Diphenhydramine (2 mg/kg) effectively antagonized the leu-enkephalin elicited decline in perfusion pressure but blocked the effects of met-enkephalin only at lower agonist doses. Propranolol treatment (4 mg/kg) did not alter the pressure responses to either enkephalin. The results of the study show that intraarterially administered enkephalins exert a vasodilatory effect on vasculature in skeletal muscle which may be direct, indirect or both. The differential antagonism of the effects of the two enkephalins suggest that the two opioids act through different receptors or multiple receptors.

Antinociceptive potencies of beta-casomorphin analogs as compared to their affinities towards mu and delta opiate receptor sites in brain and periphery

beta-Casomorphins and their analogs were tested for their opioid activities in the myenteric plexus longitudinal muscle preparation of the guinea pig ileum (GPI), the isolated mouse vas deferens (MVD), and for their affinities to mu- delta- and kappa- binding sites in rat brain membranes. C-terminal amidation of beta-casomorphin-4 and (-5) increased opioid potency in both organ preparations (GPI, MVD) and affinity to mu-binding sites in brain whereas binding to delta-sites was diminished. These beta-casomorphin-amides displayed a 2-3 times greater naloxone reversible antinociceptive effect than natural beta-casomorphins. Introduction of D-alanine at position 2 in the beta-casomorphin-amides increased potency in the GPI whereas activity in the MVD was only slightly changed. These compounds, however, showed a remarkable increase in binding to delta-sites in brain with an unaffected or slightly increased binding to mu-sites and decreased binding to kappa-sites. D-Ala2-beta-casomorphin-4 and (-5) amides were 10 times more potent antinociceptive agents than corresponding beta-casomorphin-amides. These results suggest firstly, that peripheral delta-receptors in the MVD are not as closely related to delta-binding sites at rat brain membranes as is the case with mu-receptors in the GPI and mu-binding sites, and secondly, in addition to mu-receptors, delta-receptors may be of importance in mediating antinociception.

Naloxone attenuates the hypotension induced by Hageman factor

The hypotension induced in the pentobarbital anesthesized rat by the i.v. administration of an active Hageman factor fragment (Hff) is significantly attenuated by naloxone. This effect is specific because the opiate antagonist does not modify the hypotension elicited by rat urinary kallikrein, bradykinin or nitroglycerin. These results suggest that the contact activation of endogenous Hageman factor could result in the generation of vasoactive opioid peptides derived from circulating large molecular weight precursors.

Analgesic activity of intracerebroventricular administration of morphiceptin and beta-casomorphins: correlation with the morphine (micro) receptor binding affinity

Analgesic activities of morphiceptin, beta-casomorphins, [D-Ala2, D-Leu5]enkephalin and Sandoz peptide, FK 33-824, were examined by intracerebroventricular administration in rats. Their relative potencies in vivo were compared with their receptors binding activities. The receptors binding affinities were determined from the competition curves against [3H]naloxone binding in the absence and presence of sodium ions for morphine (micro) receptors and against 125I-[D-A1A2, D-Leu]enkephalin binding for enkephalin (delta) receptors. A good correlation between analgesic activity and morphine (micro) receptor but not enkephalin (delta) receptor binding affinity was obtained. These data extend the hypothesis that morphine (micro) receptors mediate the major portion of the analgesic activity of opioids.

[Met5]-enkephalin-like peptides of the adrenal medulla: release by nerve stimulation and functional implications

In adrenal chromaffin cells, various molecular forms of polypeptides cross-reacting with [met5]-enkephalin antisera are stored in granules together with catecholamines and soluble proteins. Splanchnic nerve stimulation increases the release of enkephalin-like peptides from the adrenal gland into the adrenal vein. The release of these peptides appears to be mediated by a cholinergic nicotinic receptor. Fractionation of plasma extracts on Bio-gel P-2 shows the presence of only low molecular weight peptides in the resting condition. The low molecular weight fraction contains mainly [met5]-enkephalin and [leu5]-enkephalin. When the splanchnic nerve is stimulated high and low molecular weight peptides are released and the amount of low molecular weight peptides in plasma is increased. The content of enkephalin-like peptides in adrenal venous plasma was similar in control and reserpinized dogs. Splanchnic nerve stimulation increased the peptide content but not the epinephrine content of plasma in reserpinized dogs. This also caused a fall of arterial blood pressure which could be prevented by pretreatment with naloxone. A decrease in blood pressure was also directly elicited by the injection of [met5]-enkephalin-[arg6-phe7]. The duration of the hypotensive effect of this peptide was prolonged by prior injection of captopril.

Leucine-enkephalin: reversal of intrinsic cardiovascular stimulation by pentobarbital

In the conscious, chronically instrumented dog, leucine-enkephalin ([Leu5]ENK), 35 micrograms/kg injected intravenously, increased heart rate, respiratory rate, systolic and diastolic systemic arterial pressures, mean pulmonary arterial pressure, and cardiac output. After pentobarbital-induced anesthesia, the same dose of [Leu5]ENK decreased heart rate, systemic and pulmonary arterial pressures, and cardiac output. Responses both before and after pentobarbital were blocked by naloxone. These results indicate that barbiturate anesthesia can reverse the cardiovascular stimulatory activity of intravenously administered [Leu5]ENK.

Opioid peptides and blood pressure regulation

Immunohistochemical and functional studies suggest that opioid peptides are involved in blood pressure regulation. Endorphin and enkephalins contained in the brain seem to exert their effects by mediation of cardiovascular centers in the brain stem. Additional effects on blood pressure may be exhibited by circulating opioid peptides released from the pituitary and adrenal gland which may act at both central and peripheral sites. It is expected that further studies will complete our knowledge about the interaction of opioid peptides and blood pressure regulation and will result in therapeutic applications.

Effects of [D-Ala2]-methionine-enkephalin on blood pressure, heart rate, and baroreceptor reflex sensitivity in conscious cats

Effects of intracerebroventricular (i.c.v) injection of [D-Ala2]-methionine-enkephalinamide (DAME) on blood pressure (BP), heart rate, and baroreceptor reflex sensitivity were studied in conscious cats. DAME was administered at doses between 5 and 100 nmoles. Blood pressure and heart rate increased dose dependently. The sensitivity of the baroreceptor reflex was attenuated for 15 to 60 minutes after DAME administration; this was independent of the BP changes. The effects of enkephalin on BP and baroreceptor reflex were abolished by i.c.v. naloxone. DAME caused pathological changes in the electroencephalogram (EEG) characterized by sharp waves in the hippocampus recordings and a loss of theta activity in the electrocorticogram. Behavioral changes were characterized by decreased physical mobility and anxiousness. These behavioral and EEG changes lasted for a longer period of time than the cardiovascular changes; they were also counteracted by naloxone. It is concluded that DAME produces a centrally mediated vasopressor response and a baroreceptor reflex attenuation and that, with respect to the time course, the effects on the baroreceptor reflex are separated from those on BP behavior and EEG, but not on heart rate. The fact that all effects of enkephalin on the parameters tested in the present experiment were completely antagonized by naloxone suggests that they are mediated by naloxone-sensitive enkephalin brain receptors.