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

Physiological and anatomical bases for sex differences in pain and nausea as presenting symptoms of acute coronary syndromes

Acute coronary syndromes (ACS) are common in both men and women. Studies show that women have longer times before diagnosis and treatment in the Emergency Department and worse outcomes than men, which may be related to the differing symptom presentations of men and women. Men are more likely to have chest pain, whereas women are more likely to have dyspnea or nausea. However, women tend to be older and more likely to have diabetes mellitus, hypertension, and peripheral neuropathies. Men and women also exhibit differences in the neural receptors and pathways involved in pain and noxious-stimuli perception. Moreover, men and women may have subtle differences in the locations and sites of their atherosclerotic lesions, all of which may affect symptom presentation. The purposes of this review are to present: (1) the physiology of two common symptoms associated with ACS, ie, pain and nausea; (2) how these symptoms differ between men and women; and (3) how different comorbidities may affect the presentation of these symptoms.

Hypertensive state, independent of hypertrophy, exhibits an attenuated decrease in systolic function on cardiac kappa-opioid receptor stimulation

Opioids/opiates are commonly administered to alleviate pain, unload the heart, or decrease breathlessness in patients with advanced heart failure. As such, it is important to evaluate whether the myocardial opioidergic system is altered in cardiac disease. A hamster model of spontaneous hypertension was investigated before the development of hypertension (1 mo of age) and in the hypertensive state (10 mo of age) to evaluate the effect of prolonged hypertension on myocardial opioidergic activity. Plasma beta-endorphin was decreased before the development of hypertension and in the hypertensive state (P < 0.05). There was no change in cardiac beta-endorphin content at either time point. No differences were detected in cardiac or plasma dynorphin A, Met-enkephalin, or Leu-enkephalin, or in cardiac peptide expression of kappa- or delta-opioid receptors. mu-Opioid receptor was not detected in either model. To determine how hypertension affects myocardial opioid signaling, the ex vivo work-performing heart was used to assess the cardiac response to opioid administration in healthy hearts and those subjected to chronic hypertension. Agonists selective for the kappa- and delta-opioid receptors, but not mu-opioid receptors, induced a concentration-dependent decrease in cardiac function. The decrease in left ventricular systolic pressure on administration of the kappa-opioid receptor-selective agonist, U50488H, was attenuated in hearts from hamsters subjected to chronic, untreated hypertension (P < 0.05) compared with control. These results show that peripheral and myocardial opioid expression and signaling are altered in hypertension.

Immunocytochemical distribution of Met-enkephalin-Arg6-Gly7-Leu8 (Met-8) in the auditory system of the rat

Methionine-enkephalin-Arg(6)-Gly(7)-Leu(8) (Met(8)) is known to act as a neurotransmitter or neuromodulator and it has been implicated in pain, cardiovascular and motor mechanisms, but its role in audition is currently unknown. In the present study we have applied an immunocytochemical technique and describe the distribution of cell bodies and fibers containing Met(8) in the auditory pathway of the rat. The main finding is that we found either Met(8)-immunoreactive fibers or cell bodies or both in virtually all nuclei of the rat auditory system except for the medial superior olive and the ventral division of the medial geniculate body in which we did not find any immunoreactivity for Met(8). This suggests that the neuropeptide Met(8) is widely distributed throughout the auditory system of the rat. Our results suggest that Met(8) could play at least two roles in hearing. It seems to be involved in the processing of the descending auditory pathway, and it may be implicated in the multisensory integration of auditory information that takes place in the non-lemniscal auditory pathway.

An immunocytochemical mapping of methionine-enkephalin-arg6-gly7-leu8 in the human brainstem

Using an indirect immunoperoxidase technique, we studied the distribution of immunoreactive fibers and cell bodies containing methionine-enkephalin-Arg(6)-Gly(7)-Leu(8) in the adult human brainstem. Immunoreactive cell bodies were found in the reticular formation of the medulla oblongata (in which we observed the highest density of immunoreactive cell bodies) and the pons, the solitary nucleus, the hypoglossal nucleus, the medial and spinal vestibular nuclei, the lateral cuneate nucleus, the nucleus prepositus, the central gray of the pons and mesencephalon, the central and pericentral nuclei of the inferior colliculus, the superior colliculus, ventral to the superior olive and in the midline region of the pons and mesencephalon. The highest density of immunoreactive fibers containing methionine-enkephalin-Arg(6)-Gly(7)-Leu(8) was found in the spinal trigeminal nucleus, the central gray and the reticular formation of the medulla oblongata, pons and mesencephalon, the solitary nucleus, the spinal vestibular nucleus, the dorsal accessory olivary nucleus, the raphe obscurus, the substantia nigra and in the interpeduncular nucleus. The widespread distribution of immunoreactive structures containing methionine-enkephalin-Arg(6)-Gly(7)-Leu(8) in the human brainstem indicates that this neuropeptide might be involved in several physiological mechanisms, acting as a neurotransmitter and/or neuromodulator.

Synthesis and binding characteristics of a novel enkephalin analogue, [3H]Tyr-D-Ala-Gly-Phe-D-Nle-Arg-Phe

The endogenous opioid heptapeptide (Tyr-Gly-Gly-Phe-Met-Arg-Phe; MERF) has been shown to interact with multiple opioid as well as non-opioid sites in mammalian brain membranes. To increase the stability and bioavailability of MERF, new synthetic derivatives with D-amino acid substitutions were prepared and studied. One of the new compounds in this series, Tyr-D-Ala-Gly-Phe-D-Nle-Arg-Phe (DADN), had only moderate affinity in competing with [3H]MERF, whereas it displayed the highest potency in producing antinociception following intrathecal administration. DADN was radiolabeled with 41Ci/mmol specific activity. Specific binding of [3H]DADN was saturable, stereoselective and of high affinity. Chemical stability, increased micro-receptor selectivity, and hydrophobicity of the peptide all contribute to the effectiveness observed in biochemical and pharmacological studies.

An immunocytochemical mapping of methionine-enkephalin-Arg6-Gly7-Leu8 in the cat brainstem

The distribution of methionine-enkephalin-Arg6-Gly7-Leu8-immunoreactive cell bodies and fibres was studied in the brainstem of the cat using an indirect immunoperoxidase technique. In the mesencephalon, immunoreactive cell bodies were observed in the periaqueductal grey, the dorsal raphe nucleus, the central and pericentral nuclei of the inferior colliculus and the pericentral division of the dorsal tegmental nucleus. In the pons, immunoreactive cell bodies were observed in the dorsolateral division of the pontine nucleus; below the central division of the dorsal tegmental nucleus; above the dorsolateral division of the pontine nucleus, and close to the superior cerebellar peduncle. In the medulla oblongata, immunoreactive cell bodies were observed in the laminar spinal trigeminal nucleus and in the lateral tegmental field; the dorsal motor nucleus of the vagus; the prepositus hypoglossal nucleus; the medial nucleus of the solitary tract; the rostral division of the cuneate nucleus, and close to the parvocellular division of the alaminar spinal trigeminal nucleus. The highest (moderate) density of immunoreactive fibres was observed in the periaqueductal grey; the parvocellular and magnocellular divisions of the alaminar spinal trigeminal nucleus; the laminar spinal trigeminal nucleus; the rostral division of the cuneate nucleus; the dorsal motor nucleus of the vagus; the lateral nucleus of the solitary tract, and in the midline between the central divisions of the reticulotegmental pontine nucleus. The widespread distribution of methionine-enkephalin-Arg6-Gly7-Leu8 in the cat brainstem indicates that the peptide might be involved in several physiological functions.

Dexamethasone modulates hypotension induced by opioids in anaesthetised rats

The effect of dexamethasone on hypotension induced by mu-, kappa- and delta-opioid receptor agonists was investigated in pentobarbital-anaesthetised rats. Morphine (nonselective opioid receptor agonist), DAGO (D-Ala2-N-methyl-[Phe4-Gly5-ol]enkephalin; mu-opioid receptor-selective agonist), U50-488H (trans(+/-)-3,4-dichloro-N-methyl-N-(2[1pyrrolidynyl]cyclohexyl)-benzeneacetamide; kappa-opioid receptor-selective agonist) and deltorphin II (delta-opioid receptor-selective agonist), given intravenously, 5 micromol/kg, induced hypotension in rats. This hypotension was characterised by a fall in mean arterial blood pressure in 1-2 min that recovered in 30 min for morphine and U50-488H and in 5 or 20 min for DAGO and deltorphin II, respectively. Dexamethasone per se at a dose of 7.5 micromol/kg, i.v. did not significantly modify the mean arterial blood pressure of animals. Dexamethasone administration 90 min, but not 30 or 60 min, before the opioid agonists injection, prevented the hypotension induced by morphine or U50-488H, but not that induced by DAGO or deltorphin II. Pretreatment with RU-38486 (mifepristone; 7.5 micromol/kg, i.v.), a glucocorticoid receptor antagonist, 15 min before the steroid, prevented dexamethasone inhibition of hypotension induced by morphine and U50-488H. Furthermore, pretreatment with cycloheximide, a protein synthesis inhibitor (3.5 micromol/kg, i.v.), was also able to abolish the effects of dexamethasone on morphine- and U50-488H-induced hypotension. Results of the present study indicate that dexamethasone inhibited kappa-opioid receptor-mediated hypotension in rats, indicating a further important functional interaction between corticosteroids and the opioid system at kappa receptors. The ability of cycloheximide and RU-38486 to block dexamethasone effects indicates that steroid interference with kappa-opioid receptor-mediated hypotension involves a protein synthesis-dependent mechanism via glucocorticoid receptors.

Relevance of the C-terminal Arg-Phe sequence in gamma(2)-melanocyte-stimulating hormone (gamma(2)-MSH) for inducing cardiovascular effects in conscious rats

1. The cardiovascular effects by gamma(2)-melanocyte-stimulating hormone (gamma(2)-MSH) are probably not due to any of the well-known melanocortin subtype receptors. We hypothesize that the receptor for Phe-Met-Arg-Phe-amide (FMRFa) or Phe-Leu-Phe-Gln-Pro-Gln-Arg-Phe-amide (neuropeptide FF; NPFFa), other Arg-Phe containing peptides, is the candidate receptor. Therefore, we studied various Arg-Phe containing peptides to compare their haemodynamic profile with that of gamma(2)-MSH(6 - 12), the most potent fragment of gamma(2)-MSH. 2. Mean arterial pressure (MAP) and heart rate (HR) changes were measured in conscious rats after intravenous administration of gamma(2)-MSH related peptides. 3. Phe-Arg-Trp-Asp-Arg-Phe-Gly (gamma(2)-MSH(6 - 12)), FMRFa, NPFFa, Met-enkephalin-Arg-Phe-amide (MERFa), Arg-Phe-amide (RFa), acetyl-Phe-norLeu-Arg-Phe-amide (acFnLRFa) and desamino-Tyr-Phe-norLeu-Arg-Phe-amide (daYFnLRFa) caused a dose-dependent increase in MAP and HR. gamma(2)-MSH(6 - 12) showed the most potent cardiovascular effects (ED(50)=12 nmol kg(-1) for delta MAP; 7 nmol kg(-1) for delta HR), as compared to the other Arg-Phe containing peptides (ED(50)=177 - 292 nmol kg(-1) for delta MAP; 130 - 260 nmol kg(-1) for delta HR). 4. Peptides, which lack the C-terminal Arg-Phe sequence (Lys-Tyr-Val-Met-Gly-His-Phe-Arg-Trp-Asp-Arg-Pro-Gly (gamma(2)-pro(11)-MSH), desamino-Tyr-Phe-norLeu-Arg-[L-1,2,3,4 tetrahydroisoquinoline-3-carboxylic acid]-amide (daYFnLR[TIC]a) and Met-enkephalin (ME)), were devoid of cardiovascular actions. 5. The results indicate that the baroreceptor reflex-mediated reduction of tonic sympathetic activity due to pressor effects is inhibited by gamma(2)-MSH(6 - 12) and that its cardiovascular effects are dependent on the presence of a C-terminal Arg-Phe sequence. 6. It is suggested that the FMRFa/NPFFa receptor is the likely candidate receptor, involved in these cardiovascular effects.

Cardiac opioids

Opioid peptides have long been considered as neuropeptides or neurotransmitters. The more recent discovery of these same peptides in non-neuronal tissue suggests that the peptides may have autocrine, paracrine, or endocrine functions as well. The opioid peptides, enkephalins, dynorphins, and endorphins, have been found in isolated cardiac myocytes and heart tissue. This review will cover the recent literature on opioid peptides in respect to cardiac distribution, biochemistry, and function.

beta-Endorphin and blood pressure in multiple trauma victims

In addition to pain and stress, endogenous opiates and in particular beta-endorphin could be involved in the modulation of cardiovascular parameters. Several studies have thus shown increases in plasma beta-endorphin levels in the course of septic or hypovolemic shock. Our study involving 44 multiple trauma patients indicates that even in the absence of any hemodynamic disorders, there is a correlation between systolic blood pressure and plasma beta-endorphins. These results argue in favor of the existence of feedback between systolic blood pressure and plasma beta-endorphins.

Effects of mu-, delta- and kappa-agonists on isolated right atria of the rat

The present study examined the effects of morphine, DAMGO, DPDPE and U-50, 488H on auricular rate on isolated right atria of the rat. All the opioid agonists tested induced a decrease of auricular rate. The maximal effect obtained with U-50,488H (75 +/- 8.3%) was significantly (p < 0.001) higher than that obtained with morphine (12 +/- 2.7%), DAMGO (8 +/- 0.6%) or DPDPE (11 +/- 1.8%). The inhibitory effects of U-50,488H were not antagonized by the presence of naloxone (10(-7) or 5 x 10(-7) M) or MR-2266 (10(-7) or 5 x 10 (-7) M). Moreover, U-50,488H did not change the auricular chronotropism in the presence of atropine (5 x 10(-7) M). In this case the maximal inhibitory effect was 79 +/- 6.7%, similar to that obtained with the kappa-agonist alone (75 +/- 8.3%). Propranolol (10(-8) or 5 x 10(-8) M) modified the inhibitory effect of U-50,488H. The maximal effect obtained by the kappa-agonist in presence of propranolol was 100 +/- 0 significantly (p < 0.01) higher than that obtained with U-50,488H alone. These results demonstrated that the depressant action of U-50,488H was not blocked in the presence of opioid receptor antagonists and probably does not involve opioid receptors. Furthermore, propranolol caused a dose-dependent potentiation of the effects of the kappa-agonist supporting the conclusion that it is not mediated by opioid receptors.

Endogenous opiates: 1992

This paper is the fifteenth installment of our annual review of research concerning the opiate system. It includes papers published during 1992 involving the behavioral, non-analgesic, effects of the endogenous opiate peptides. The specific topics this year include stress; tolerance and dependence; eating; drinking; gastrointestinal and renal function; mental illness and mood; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical-related activity; general activity and locomotion; sex, pregnancy, and development; immunological responses; and other behaviors.

Involvement of catecholamines in the effect of U-50,488H on isolated left atria of the rat

1. The present study examined the effect of U-50,488H on auricular contraction of isolated left atria of the rat. 2. The negative inotropic action induced by the kappa-agonist was antagonized in the presence of propranolol (10(-8) or 5 x 10(-8) M), yohimbine (5 x 10(-7) or 10(-6) M) or in reserpinized rats (5 mg/kg i.p. 24 hr before the experiments). 3. These results suggest that catecholaminergic mechanisms are involved in the cardiac depressant effect induced by U-50,488H.