1
|
Didik S, Golosova D, Xu B, Staruschenko A. Opioids and the Kidney: A Compendium. KIDNEY360 2023; 4:1816-1823. [PMID: 37927032 PMCID: PMC10758516 DOI: 10.34067/kid.0000000000000291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
Opioids are a class of medications used in pain management. Unfortunately, long-term use, overprescription, and illicit opioid use have led to one of the greatest threats to mankind: the opioid crisis. Accompanying the classical analgesic properties of opioids, opioids produce a myriad of effects including euphoria, immunosuppression, respiratory depression, and organ damage. It is essential to ascertain the physiological role of the opioid/opioid receptor axis to gain an in-depth understanding of the effects of opioid use. This knowledge will aid in the development of novel therapeutic interventions to combat the increasing mortality rate because of opioid misuse. This review describes the current knowledge of opioids, including the opioid epidemic and opioid/opioid receptor physiology. Furthermore, this review intricately relates opioid use to kidney damage, navigates kidney structure and physiology, and proposes potential ways to prevent opioid-induced kidney damage.
Collapse
Affiliation(s)
- Steven Didik
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
- James A. Haley Veteran's Hospital, Tampa, Florida
| | - Daria Golosova
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Biyang Xu
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Alexander Staruschenko
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
- James A. Haley Veteran's Hospital, Tampa, Florida
- Hypertension and Kidney Research Center, University of South Florida, Tampa, Florida
| |
Collapse
|
2
|
López-Cano M, Font J, Aso E, Sahlholm K, Cabré G, Giraldo J, De Koninck Y, Hernando J, Llebaria A, Fernández-Dueñas V, Ciruela F. Remote local photoactivation of morphine produces analgesia without opioid-related adverse effects. Br J Pharmacol 2023; 180:958-974. [PMID: 34363210 DOI: 10.1111/bph.15645] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Opioid-based drugs are the gold standard medicines for pain relief. However, tolerance and several side effects (i.e. constipation and dependence) may occur upon chronic opioid administration. Photopharmacology is a promising approach to improve the benefit/risk profiles of these drugs. Thus, opioids can be locally activated with high spatiotemporal resolution, potentially minimizing systemic-mediated adverse effects. Here, we aimed at developing a morphine photo-derivative (photocaged morphine), which can be activated upon light irradiation both in vitro and in vivo. EXPERIMENTAL APPROACH Light-dependent activity of pc-morphine was assessed in cell-based assays (intracellular calcium accumulation and electrophysiology) and in mice (formalin animal model of pain). In addition, tolerance, constipation and dependence were investigated in vivo using experimental paradigms. KEY RESULTS In mice, pc-morphine was able to elicit antinociceptive effects, both using external light-irradiation (hind paw) and spinal cord implanted fibre-optics. In addition, remote morphine photoactivation was devoid of common systemic opioid-related undesired effects, namely, constipation, tolerance to the analgesic effects, rewarding effects and naloxone-induced withdrawal. CONCLUSION AND IMPLICATIONS Light-dependent opioid-based drugs may allow effective analgesia without the occurrence of tolerance or the associated and severe opioid-related undesired effects. LINKED ARTICLES This article is part of a themed issue on Advances in Opioid Pharmacology at the Time of the Opioid Epidemic. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v180.7/issuetoc.
Collapse
Affiliation(s)
- Marc López-Cano
- Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Neuropharmacology & Pain Group, Neuroscience Program, Bellvitge Institute for Biomedical Research, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Font
- MCS, Laboratory of Medicinal Chemistry, Institute for Advanced Chemistry of Catalonia (IQAC-CSIC), Barcelona, Spain.,Institut de Génomique Fonctionnelle (IGF), University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Ester Aso
- Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Neuropharmacology & Pain Group, Neuroscience Program, Bellvitge Institute for Biomedical Research, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Kristoffer Sahlholm
- Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Neuropharmacology & Pain Group, Neuroscience Program, Bellvitge Institute for Biomedical Research, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Gisela Cabré
- Departament de Química, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Jesús Giraldo
- Laboratory of Molecular Neuropharmacology and Bioinformatics, Unitat de Bioestadística and Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Yves De Koninck
- Institut Universitaire en Santé Mentale de Québec, Québec, Quebec, Canada.,Department of Psychiatry and Neuroscience, Université Laval, Québec, Quebec, Canada
| | - Jordi Hernando
- Departament de Química, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Amadeu Llebaria
- MCS, Laboratory of Medicinal Chemistry, Institute for Advanced Chemistry of Catalonia (IQAC-CSIC), Barcelona, Spain
| | - Víctor Fernández-Dueñas
- Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Neuropharmacology & Pain Group, Neuroscience Program, Bellvitge Institute for Biomedical Research, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francisco Ciruela
- Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Neuropharmacology & Pain Group, Neuroscience Program, Bellvitge Institute for Biomedical Research, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
5
|
Does the Addition of Naloxone in Buprenorphine/Naloxone Affect Retention in Treatment in Opioid Replacement Therapy?: A Systematic Review and Meta-Analysis. J Addict Nurs 2019; 30:254-260. [PMID: 31800516 DOI: 10.1097/jan.0000000000000308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Opioid maintenance therapy is an evidence-based first-line treatment approach to reduce the problems associated with opioid use disorders. Buprenorphine and methadone are the two most commonly recommended pharmacotherapies. Individuals who remain in treatment longer tend to have a reduced drug use, a higher social functioning, and a higher quality of life. The addition of naloxone to buprenorphine (bup/nx) was developed, in part, to help increase retention in treatment. However, this has not been shown in research. The objective of this review was to examine whether bup/nx is more effective than buprenorphine and methadone, to ultimately determine whether the addition of naloxone shows a clinical difference. METHODS The literature search was conducted using the electronic databases PubMed, Embase, and Cochrane. Search strategies were thoroughly developed and modified for each database by combining relevant MeSH and Emtree terms as well as keywords such as "bup/nx," "buprenorphine," and "naloxone." The outcome measure was treatment retention, as determined by the number of days a participant remains in a treatment program. RESULTS There were four studies included in the review. The data were analyzed with Review Manager software. There was no statistically significant result for bup/nx compared with methadone or buprenorphine. CONCLUSION Bup/nx may be an alternative to standard treatments such as buprenorphine and methadone as the addition of naloxone does not affect retention in treatment.
Collapse
|
8
|
Wilson RB. Morpheus and the Underworld-Interventions to Reduce the Risks of Opioid Use After Surgery: ORADEs, Dependence, Cancer Progression, and Anastomotic Leakage. J Gastrointest Surg 2019; 23:1240-1249. [PMID: 30937715 DOI: 10.1007/s11605-019-04167-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/08/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Perioperative pain management is a key element of enhanced recovery after surgery (ERAS) programs. A multimodal approach to analgesia as part of a coordinated ERAS includes the reduction of opioid use. This review aims to discuss opioid-related adverse events, strategies to reduce opioid use after surgery, and the relevance to the present "opioid crisis" in North America. METHODS A literature review of the pharmacology of opioid drugs, perioperative opioid reduction strategies, and the potential public health benefit was performed. This included current ERAS guidelines on multimodal analgesia, randomized controlled trials on perioperative analgesia, and intervention studies to decrease opioid use, misuse, and diversion in North America. RESULTS Reduction of perioperative opioid usage has been endorsed by joint clinical practice guidelines on the management of postoperative pain from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists. Interventions as part of an "opioid bundle" that can be incorporated into ERAS protocols include multimodal analgesia, regional anesthesia, opioid sparing drugs, carbon dioxide humidification during laparoscopy, changing opioid prescription practices, patient and physician education, and proper disposal of unused opioid medications. CONCLUSION There are substantial benefits in incorporating opioid reduction strategies into ERAS and clinical practice guidelines. These include faster return of function and mobility, and decreased opioid-related adverse drug events (ORADEs), postoperative morbidity and mortality, and length of hospital stay. Improved oncological outcomes after cancer surgery may be an additional benefit. Evidence-based interventions can also reduce opioid abuse and diversion in the community.
Collapse
Affiliation(s)
- Robert Beaumont Wilson
- Department of Upper Gastrointestinal Surgery, Liverpool Hospital, Suite 6, Level 2, 171 Bigge St, Liverpool, Sydney, NSW, 2170, Australia.
| |
Collapse
|
10
|
Ansari MI, Healy JR, Hom K, Deschamps JR, Matsumoto RR, Coop A. Synthesis and Structural Elucidation of a Pyranomorphinan Opioid and in Vitro Studies. Org Lett 2018; 20:2984-2987. [DOI: 10.1021/acs.orglett.8b01025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Mohd. Imran Ansari
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, Maryland 21201, United States
| | - Jason R. Healy
- West Virginia University, One Medical Center Drive, Morgantown, West Virginia 26506, United States
| | - Kellie Hom
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, Maryland 21201, United States
| | - Jeffrey R. Deschamps
- Naval Research Laboratory, Code 6910, 4555 Overlook Avenue, SW, Washington, DC 20375, United States
| | - Rae R. Matsumoto
- West Virginia University, One Medical Center Drive, Morgantown, West Virginia 26506, United States
- Touro University California, College of Pharmacy 1310 Club Drive, Vallejo, California 94592, United States
| | - Andrew Coop
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, Maryland 21201, United States
| |
Collapse
|