Transient apnea after an enkephalin analogue in the preterm rabbit

Relation of beta-casomorphin to apnea in sudden infant death syndrome

Sudden infant death syndrome (SIDS) is the most common cause of death in infants and its pathogenesis is complex and multifactorial. The aim of this review is to summarize recent novel findings regarding the possible association of beta-casomorphin (beta-CM) to apnea in SIDS, which has not been widely appreciated by pediatricians and scientists. beta-CM is an exogenous bioactive peptide derived from casein, a major protein in milk and milk products, which has opioid activity. Mechanistically, circulation of this peptide into the infant's immature central nervous system might inhibit the respiratory center in the brainstem leading to apnea and death. This paper will review the possible relationship between beta-CM and SIDS in the context of passage of beta-CM through the gastrointestinal tract and the blood-brain barrier (BBB), permeability of the BBB to peptides in infants, and characterization of the casomorphin system in the brain.

Respiratory and neuroendocrine responses of piglets to hypoxia during postnatal development

Breathing response to 12% and 6% O2 in N2 (at isocapnia) was measured in anaesthetized piglets, 1-5 and 19-25 days old, before and after 3 mg kg-1 i.v. naltrexone. The degree of interaction between the anaesthetic and naltrexone was assessed. At the end of each hypoxic trial, arterial blood was sampled for measurements of pH and gas tensions, (Met)enkephalin-Arg6-Phe7, adenosine, noradrenaline and adrenalin. Whereas respiration in older animals was stimulated by hypoxia, young piglets had a biphasic response with a pronounced ventilatory decrease in response to severe hypoxia (6% O2/N2). In young animals there was a greater ventilatory response with naltrexone than without the drug, and the biphasic hypoxic response was ameliorated or reversed by naltrexone. Levels of adrenalin increased and those of encephalin, adenosine and noradrenaline tended to increase during hypoxia in the younger age group. Levels of adenosine showed significant increase when data from both age groups and levels of hypoxia were pooled. Combined with previously reported physiological evidence regarding adenosine in hypoxic depression, we conclude that the present results are compatible with a role of opioid peptides and adenosine in the early postnatal response to hypoxia.

beta-Casomorphins induce apnea and irregular breathing in adult rats and newborn rabbits

Bovine beta-casomorphin, beta-casomorphin, morphiceptin or morphine were administered systemically (i.v. or i.p.) and intracerebroventricularly (lateral or IVth ventricles) to anesthetized adult rats and preterm newborn rabbits. All agents caused dose-related depressions of respiratory frequency and tidal volume. Morphiceptin and beta-casomorphin were approximately equipotent to morphine while beta-casomorphin was 10 times as potent after intracerebroventricular injection. The beta-casomorphins decreased inspiratory drive and prolonged the expiratory phase by delaying the setpoint for inspiration. A respiratory depression could be elicited by systemic administration of morphiceptin but not by beta-casomorphin or beta-casomorphin. All ventilatory effects induced by the beta-casomorphins could be readily reversed or prevented by naloxone. Intracerebroventricular but not intraperitoneal injection of beta-casomorphin depressed ventilation in preterm newborn rabbits in a similar pattern with apnoic periods to that seen in the adult rats. In addition, an irregular breathing pattern was elicited. Thus, the bovine beta-casomorphins possess potent central respiratory depressive effects. However, after systemic administration, only morphiceptin which is more metabolically stable induced a shortlasting effect on ventilation in adult rats.

Respiratory stimulant effects by TRH into the mesencephalic region in the rat

Thyrotropin-releasing hormone (TRH) has previously been found to have a potent respiratory stimulant effect following intracerebroventricular administration. One part of the respiratory response, the shortening of inspiratory time, seems to be elicited from the raphe obscurus in the medulla. The prominent tachypnoea however is not elicited after local injections in the medullary region. In the present paper a micro-injection technique was employed to study respiratory actions of TRH in lightly anaesthetized rats kept in a whole body plethysmograph. Thyrotropin-releasing hormone in a dose of 100 ng per 0.5 microliter was found to induce an immediate tachypnoea after injections into the region of the interpeduncular nucleus of the midbrain. No effects on systemic circulation were seen. More rostral or dorsal sites of injection were without effect. The localization of the sites responsible for respiratory stimulation corresponds to the reticular activating system where electrical stimulation induces hyperventilation in cats. The tachypnoea might be closely related to the well known arousal effects of TRH.

Development of methionine-enkephalin in microdissected areas of the rabbit brain

Microdissected areas of the rabbit brain were isolated at prenatal day E-29, postnatal days P-3, 7, 14, 21, 2 months and adults. Methionine-enkephalin (ME) was assayed by RIA and ME concentration [ME] was expressed relative to the protein content of the extracted brain tissues. In brain nuclei with important roles in respiratory control [ME] was higher in prenatal and early postnatal life than in adults. In contrast, the prenatal and early postnatal [ME] levels in other nuclei were lower than or equal to adult values. These data suggest an important and changing role for ME in respiratory control throughout development. Early high [ME] levels within brainstem respiratory control nuclei may contribute to the newborn's increased susceptibility to respiratory depression.

Post-mortem analyses of neuropeptides in brains from sudden infant death victims

The causative factors underlying SIDS are still unknown, but in recent years much interest has been focused on the central ventilatory control system. In this study, peptides which are known to affect respiration were examined in brains from SIDS victims and controls. The levels of Met-enkephalin and substance P were measured in cortex, medulla oblongata, pons and hypothalamus. Substance P1-7, substance P C-terminal fragments, Met-enkephalin-Lys6 and neuropeptide Y (NPY) were estimated in medulla oblongata. The substance P levels in the medulla oblongata from the SIDS victims were significantly elevated compared with the controls. No change, however, was observed in the Met-enkephalin levels, but a tendency to higher levels in the youngest infants was noticed. As substance P and enkephalins have opposite effects on respiration, their relative concentrations were calculated in each individual sample. The ratio was significantly higher in the medulla oblongata from the SIDS victims. The levels of NPY, substance P1-7, C-terminal fragments of substance P and Met-enkephalin-Lys6 were similar in both groups. A significant correlation between the NPY levels and age was observed, however.

A study of the endogenous opioid system in the sudden infant death syndrome

To investigate the possible role of the endogenous opioid system in the pathogenesis of the sudden infant death syndrome (SIDS), we measured met-enkephalin immunoreactivity by radioimmunoassay in brain, lung, and adrenal glands of SIDS victims and of infants (controls) dying of nonneurologic causes. Met-enkephalin was stable in brain tissue up to 24 hours after death. On inspection, met-enkephalin levels in the cerebral cortex of SIDS victims were similar to those in controls. Levels in the caudate nucleus were lower in infants than in adults. In the medulla, the levels in SIDS cases and controls were not found to differ significantly. The linear relationship between the levels in the medulla and age was not detectably different in SIDS and controls. However, as a subset, levels in the control group significantly decreased with increasing age (P = 0.005), whereas levels in the SIDS group showed no correlation with age (P = 0.33). Levels of met-enkephalin in the adrenal gland of SIDS victims were similar to those in controls and were considerably lower than adult values. Lung tissue was assayed for beta-endorphin immunoreactivity and met-enkephalin: for both peptides the values in SIDS cases were low (femtomolar range) and similar to those in controls. These data suggest that met-enkephalin is not markedly overproduced in brains of SIDS victims. Future postmortem studies should focus on more subtle evidence of endogenous opioid overactivity such as differences in age related changes, receptor number, and levels of other endogenous opioid peptides.

Effects of TRH and TRH analogues on the central regulation of breathing in the rat

Respiratory activity was studied in rats during light halothane anesthesia. Thyrotropin releasing hormone (TRH) and two TRH analogues: the desamidated form (TRH-OH) and gamma-butyrolactone-gamma-carbonyl-L-histidyl-L-prolinamide citrate (DN 1417) were administered intracerebroventricularly. TRH 0.5-5 micrograms induced a marked tachypnoea with a rapid onset and a duration of at least 20 min. DN 1417, a potent analogue of TRH with a very low TSH (thyroid stimulating hormone) releasing activity was more effective in stimulating respiratory frequency, while TRH-OH, regarded to have neither TSH releasing nor extra hypothalamic effects, at equimolar doses was unable to induce any changes in the respiratory pattern. When TRH was given into the fourth ventricle the dose response curve was slightly shifted to the left. In experiments employing the occluded breath technique, P0.1 was increased in the same magnitude as the mean inspiratory flow (VT/T1). The results also indicated an increase in the gain of the inflation reflex loop whereas the central bulbopontine setting for T1 and TTOT were not significantly changed. Local injection of TRH into the nucleus tractus solitarii induced a stimulation of respiratory frequency which was slower in onset compared to the response seen after injection into the lateral or fourth ventricles. Concomitantly to the respiratory changes, i.c.v. TRH injection induced a hypocarbia and an alkalosis. No changes in blood pressure or heart rate were seen. The respiratory stimulant effect of TRH could be potentiated by pretreatment with naloxone, methylatropine or a low dose of GABA. Haloperidol or propranolol did not significantly change the respiratory effects of TRH, while reserpine pretreatment seemed to blunt some of the ventilatory effects of TRH. It seems likely that TRH has few direct effects on brain stem neurones involved in the central regulation of respiration, but the main effects seem to be elicited in areas rostral to the brain stem. The respiratory stimulating effect of TRH is unrelated to TSH. Furthermore, other neurotransmitter systems might also be involved in modulation of the respiratory stimulation evoked by TRH.

Opiates, endorphins and the developing organism: a comprehensive bibliography

A comprehensive bibliography of the literature concerned with opiates, endorphins, and the developing organism is presented. A total of 1378 clinical and laboratory references, with citations beginning in 1875, are recorded. A series of indexed accompanies the citations in order to make the literature more accessible. These indexes are divided into clinical and laboratory topics. The clinical section is subdivided into: age of subject examined; maternal aspects; effects on the fetus; pharmacology, physiology, and the withdrawal syndrome; and "other" effects on the offspring. The laboratory section is subdivided into: type of opiate/endorphin studied; species utilized; and major subject areas explored.

Endogenous opiates: 1981

This paper is the fourth of an annual series reviewing the research concerning the endogenous opiate peptides. This installment covers only work published during 1981 and attempts to provide a comprehensive, but not exhaustive, survey of the area. Previous papers in the series have dealt with research done before 1981. Topics concerning endogenous opiates reviewed here include a delineation of their receptors, their distribution, their precursors and degradation, behavioral effects resulting from their administration, their possible involvement in physiological responses, and their interactions with other peptides and hormones. Due to the burgeoning literature in this field, the comprehensive nature of this review in the future will be limited to considerations of behavioral phenomena related to the endogenous opiates.