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Heurtebize MA, Faillie JL. Drug-induced hyperglycemia and diabetes. Therapie 2024; 79:221-238. [PMID: 37985310 DOI: 10.1016/j.therap.2023.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/14/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Drug-induced hyperglycemia and diabetes have negative and potentially serious health consequences but can often be unnoticed. METHODS We reviewed the literature searching Medline database for articles addressing drug-induced hyperglycemia and diabetes up to January 31, 2023. We also selected drugs that could induce hyperglycemia or diabetes according official data from drug information databases Thériaque and Micromedex. For each selected drug or pharmacotherapeutic class, the mechanisms of action potentially involved were investigated. For drugs considered to be at risk of hyperglycemia or diabetes, disproportionality analyses were performed using data from the international pharmacovigilance database VigiBase. In order to detect new pharmacovigilance signals, additional disproportionality analyses were carried out for drug classes with more than 100 cases reported in VigiBase, but not found in the literature or official documents. RESULTS The main drug classes found to cause hyperglycemia are glucocorticoids, HMG-coA reductase inhibitors, thiazide diuretics, beta-blockers, antipsychotics, fluoroquinolones, antiretrovirals, antineoplastic agents and immunosuppressants. The main mechanisms involved are alterations in insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells and increases in glucose production. Pharmacovigilance signal were found for a majority of drugs or pharmacological classes identified as being at risk of diabetes or hyperglycemia. We identified new pharmacovigilance signals with drugs not known to be at risk according to the literature or official data: phosphodiesterase type 5 inhibitors, endothelin receptor antagonists, sodium oxybate, biphosphonates including alendronic acid, digoxin, sartans, linosipril, diltiazem, verapamil, and darbepoetin alpha. Further studies will be needed to confirm these signals. CONCLUSIONS The risks of induced hyperglycemia vary from one drug to another, and the underlying mechanisms are multiple and potentially complex. Clinicians need to be vigilant when using at-risk drugs in order to detect and manage these adverse drug reactions. However, it is to emphasize that the benefits of appropriately prescribed treatments most often outweigh their metabolic risks.
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Affiliation(s)
- Marie-Anne Heurtebize
- CHU de Montpellier, Medical Pharmacology and Toxicology Department, 34000 Montpellier, France
| | - Jean-Luc Faillie
- CHU de Montpellier, Medical Pharmacology and Toxicology Department, 34000 Montpellier, France; IDESP, Université de Montpellier, Inserm, 34295 Montpellier, France.
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Toledo FGS, Martin WF, Morrow L, Beysen C, Bajorunas D, Jiang Y, Silverman BL, McDonnell D, Namchuk MN, Newcomer JW, Graham C. Insulin and glucose metabolism with olanzapine and a combination of olanzapine and samidorphan: exploratory phase 1 results in healthy volunteers. Neuropsychopharmacology 2022; 47:696-703. [PMID: 34887529 PMCID: PMC8782841 DOI: 10.1038/s41386-021-01244-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/15/2021] [Accepted: 11/19/2021] [Indexed: 02/05/2023]
Abstract
A combination of olanzapine and samidorphan (OLZ/SAM) received US Food and Drug Administration approval in May 2021 for the treatment of adults with schizophrenia or bipolar I disorder. OLZ/SAM provides the efficacy of olanzapine, while mitigating olanzapine-associated weight gain. This exploratory study characterized the metabolic profile of OLZ/SAM in healthy volunteers to gain mechanistic insights. Volunteers received once-daily oral 10 mg/10 mg OLZ/SAM, 10 mg olanzapine, or placebo for 21 days. Assessments included insulin sensitivity during an oral glucose tolerance test (OGTT), hyperinsulinemic-euglycemic clamp, other measures of glucose/lipid metabolism, and adverse event (AE) monitoring. Treatment effects were estimated with analysis of covariance. In total, 60 subjects were randomized (double-blind; placebo, n = 12; olanzapine, n = 24; OLZ/SAM, n = 24). Olanzapine resulted in hyperinsulinemia and reduced insulin sensitivity during an OGTT at day 19, changes not observed with OLZ/SAM or placebo. Insulin sensitivity, measured by hyperinsulinemic-euglycemic clamp, was decreased in all treatment groups relative to baseline, but this effect was greatest with olanzapine and OLZ/SAM. Although postprandial (OGTT) glucose and fasting cholesterol concentrations were similarly increased with olanzapine or OLZ/SAM, other early metabolic effects were distinct, including post-OGTT C-peptide concentrations and aspects of energy metabolism. Forty-nine subjects (81.7%) experienced at least 1 AE, most mild or moderate in severity. OLZ/SAM appeared to mitigate some of olanzapine's unfavorable postprandial metabolic effects (e.g., hyperinsulinemia, elevated C-peptide) in this exploratory study. These findings supplement the body of evidence from completed or ongoing OLZ/SAM clinical trials supporting its role in the treatment of schizophrenia and bipolar I disorder.
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Affiliation(s)
- Frederico G. S. Toledo
- grid.21925.3d0000 0004 1936 9000Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA USA
| | | | | | | | - Daiva Bajorunas
- Vault Bioventures, San Diego, CA USA ,Present Address: DBMD Consulting, Pompano Beach, FL USA
| | - Ying Jiang
- grid.422303.40000 0004 0384 9317Alkermes, Inc., Waltham, MA USA
| | | | - David McDonnell
- grid.472773.20000 0004 0384 2510Alkermes Pharma Ireland Limited, Dublin, Ireland
| | - Mark N. Namchuk
- grid.422303.40000 0004 0384 9317Alkermes, Inc., Waltham, MA USA ,grid.38142.3c000000041936754XPresent Address: Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA USA
| | - John W. Newcomer
- Thriving Mind South Florida, Miami, FL USA ,grid.4367.60000 0001 2355 7002Washington University School of Medicine, St. Louis, MO USA
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Hedayati-Moghadam M, Moezi SA, Kazemi T, Sami A, Akram M, Zainab R, Khazdair MR. The effects of Papaver somniferum (Opium poppy) on health, its controversies and consensus evidence. TOXIN REV 2021. [DOI: 10.1080/15569543.2021.1958232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Seyyed Ali Moezi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Toba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Abdul Sami
- University College of Conventional Medicine, Faculty of Medicine and Allied Health Sciences, The Islamia University of Bahawalpur, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Rida Zainab
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Mohammad Reza Khazdair
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Akhigbe RE, Ajayi LO, Ajayi AF. Codeine exerts cardiorenal injury via upregulation of adenine deaminase/xanthine oxidase and caspase 3 signaling. Life Sci 2020; 273:118717. [PMID: 33159958 DOI: 10.1016/j.lfs.2020.118717] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/28/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
AIMS Codeine treatment has been shown to be associated with glucolipid deregulation, though data reporting this are inconsistent and the mechanisms are not well understood. Perturbation of glutathione-dependent antioxidant defense and adenosine deaminase (ADA)/xanthine oxidase (XO) signaling has been implicated in the pathogenesis of cardiometabolic disorders. We thus, hypothesized that depletion of glutathione contents and upregulation of ADA/XO are involved in codeine-induced glucolipid deregulation. The present study also investigated whether or not codeine administration would induce genotoxicity and apoptosis in cardiac and renal tissues. MATERIALS AND METHODS Male New Zealand rabbits received per os distilled water or codeine, either in low dose (4 mg/kg) or high dose (10 mg/kg) for 6 weeks. KEY FINDINGS Codeine treatment led to reduced absolute and relative cardiac and renal mass independent of body weight change, increased blood glucose, total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL-C), as well as increased atherogenic indices and triglyceride-glucose index (TyG). Codeine administration significantly increased markers of cardiac and renal injury, as well as impaired cardiorenal functions. Codeine treatment also resulted in increased cardiac and renal malondialdehyde, Advanced Glycation Endproducts (AGE) and 8-hydroxydeoxyguanosine (8-OH-dG), and myeloperoxidase (MPO), ADA, XO, and caspase 3 activities. These observations were accompanied by impaired activities of cardiac and renal proton pumps. SIGNIFICANCE Findings of this study demonstrate that upregulation of ADA/XO and caspase 3 signaling are, at least partly, contributory to the glucolipid deregulation and cardiorenal injury induced by codeine.
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Affiliation(s)
- R E Akhigbe
- Department of Physiology, College of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo, Nigeria; Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Nigeria
| | - L O Ajayi
- Department of Biochemistry, Adeleke University, Ede, Osun State, Nigeria
| | - A F Ajayi
- Department of Physiology, College of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo, Nigeria.
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de Campaigno EP, Kebir I, Montastruc JL, Rueter M, Maret D, Lapeyre-Mestre M, Sallerin B, Despas F. Drug-Induced Dental Caries: A Disproportionality Analysis Using Data from VigiBase. Drug Saf 2017; 40:1249-1258. [DOI: 10.1007/s40264-017-0575-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Walter KN, Wagner JA, Cengiz E, Tamborlane WV, Petry NM. Substance Use Disorders among Patients with Type 2 Diabetes: a Dangerous but Understudied Combination. Curr Diab Rep 2017; 17:2. [PMID: 28101793 DOI: 10.1007/s11892-017-0832-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW This paper reviews research on substance use and disorders (SUDs) among adults with diabetes. It describes epidemiological data on SUDs in persons with type 2 diabetes, overviews effects of substance use on diabetes outcomes, and discusses treatments for SUDs in patients with diabetes. RECENT FINDINGS Rates of current smoking range from 10 to 26% and alcohol use disorders are 0-5%. Rates of illicit SUDs are 3-4%, but there are no population-based studies using nationally representative samples. Smoking increases the risk for long-term diabetes complications and premature death. Alcohol and illicit drug use can also impact long-term diabetes complications by impairing glucose homeostasis and adversely influencing self-management behaviors. There is mixed evidence about psychosocial smoking cessation interventions in adults with diabetes and little on alcohol and illicit SUD interventions. Limited data exist on pharmacotherapies for SUDs in this population, but a recent study suggests that varenicline is safe and effective for treating smoking in patients with diabetes. Substance use is an understudied problem in type 2 diabetes, and addressing substance use holds potential for improving outcomes. Additional large population-based epidemiological studies in those with type 2 diabetes are needed, particularly for alcohol and illicit SUDs. Longitudinal studies should be conducted to better understand the time course of diabetes onset and outcomes in relation to SUDs. Randomized controlled trials are needed to assess safety and efficacy of promising psychosocial and pharmacological interventions.
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Affiliation(s)
- Kimberly N Walter
- University of Connecticut School of Medicine (MC 3944), 263 Farmington Ave., Farmington, CT, 06030-3944, USA
| | - Julie A Wagner
- University of Connecticut School of Dental Medicine, 263 Farmington Ave., Farmington, CT, USA
| | - Eda Cengiz
- Yale University School of Medicine, PO Box 208064, New Haven, CT, USA
| | | | - Nancy M Petry
- University of Connecticut School of Medicine (MC 3944), 263 Farmington Ave., Farmington, CT, 06030-3944, USA.
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Najafipour H, Beik A. The Impact of Opium Consumption on Blood Glucose, Serum Lipids and Blood Pressure, and Related Mechanisms. Front Physiol 2016; 7:436. [PMID: 27790151 PMCID: PMC5061814 DOI: 10.3389/fphys.2016.00436] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 09/13/2016] [Indexed: 11/23/2022] Open
Abstract
Aim: Substance abuse has become a universal crisis in our modern age. Among illegal substances, opium and its derivatives have been ranked second in terms of usage after cannabis in the world. In many Asian regions, the use of opium enjoys a high social acceptance; hence, some common people and even medical practitioners believe that opium lowers blood glucose and pressure and treat dyslipidemia. How much this belief is scientifically justified? Method: The results of available studies on both humans and animals searched in different search engines up to mid-2016 were integrated (78 articles). Upon the findings we try to offer a more transparent picture of the effects of opium on the mentioned factors along with the probable underlying mechanisms of its action. Results: Taken together, a variety of evidences suggest that the consumption of opium has no scientific justification for amendment of these biochemical variables. The mechanisms proposed so far for the action of opium in the three above disorders are summarized at the end of the article. Short term effects seems to be mostly mediated through central nervous system (neural and hormonal mechanisms), but long term effects are often due to the structural and functional alterations in some body organs. Conclusion: Although opium may temporarily reduce blood pressure, but it increases blood glucose and most of blood lipids. Moreover its long term use has negative impacts and thus it aggravates diabetes, dyslipidemia and hypertension. Accordingly, it is necessary to inform societies about the potential disadvantages of unauthorized opium consumption.
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Affiliation(s)
- Hamid Najafipour
- Cardiovascular Research Center and Department of Physiology, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences Kerman, Iran
| | - Ahmad Beik
- Physiology Research Center, Kerman University of Medical Sciences Kerman, Iran
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Abstract
Drug-induced hyperglycaemia and diabetes is a global issue. It may be a serious problem, as it increases the risk of microvascular and macrovascular complications, infections, metabolic coma and even death. Drugs may induce hyperglycaemia through a variety of mechanisms, including alterations in insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells and increases in glucose production. Antihypertensive drugs are not equally implicated in increasing serum glucose levels. Glycaemic adverse events occur more frequently with thiazide diuretics and with certain beta-blocking agents than with calcium-channel blockers and inhibitors of the renin-angiotensin system. Lipid-modifying agents may also induce hyperglycaemia, and the diabetogenic effect seems to differ between the different types and daily doses of statins. Nicotinic acid may also alter glycaemic control. Among the anti-infectives, severe life-threatening events have been reported with fluoroquinolones, especially when high doses are used. Protease inhibitors and, to a lesser extent, nucleoside reverse transcriptase inhibitors have been reported to induce alterations in glucose metabolism. Pentamidine-induced hyperglycaemia seems to be related to direct dysfunction in pancreatic cells. Phenytoin and valproic acid may also induce hyperglycaemia. The mechanisms of second-generation antipsychotic-associated hyperglycaemia, diabetes mellitus and ketoacidosis are complex and are mainly due to insulin resistance. Antidepressant agents with high daily doses seem to be more frequently associated with an increased risk of diabetes. Ketoacidosis may occur in patients receiving beta-adrenergic stimulants, and theophylline may also induce hyperglycaemia. Steroid diabetes is more frequently associated with high doses of glucocorticoids. Some chemotherapeutic agents carry a higher risk of hyperglycaemia, and calcineurin inhibitor-induced hyperglycaemia is mainly due to a decrease in insulin secretion. Hyperglycaemia has been associated with oral contraceptives containing high doses of oestrogen. Growth hormone therapy and somatostatin analogues may also induce hyperglycaemia. Clinicians should be aware of medications that may alter glycaemia. Efforts should be made to identify and closely monitor patients receiving drugs that are known to induce hyperglycaemia.
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Yang SP, Muo CH, Wang IK, Chang YJ, Lai SW, Lee CWS, Morisky DE. Risk of type 2 diabetes mellitus in female breast cancer patients treated with morphine: A retrospective population-based time-dependent cohort study. Diabetes Res Clin Pract 2015; 110:285-90. [PMID: 26515910 DOI: 10.1016/j.diabres.2015.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 08/24/2015] [Accepted: 10/02/2015] [Indexed: 12/30/2022]
Abstract
AIMS We aimed to examine whether morphine treatment is associated with type 2 diabetes mellitus (T2DM) in female breast cancer patients. METHODS We conducted a retrospective cohort analysis of the Longitudinal Health Insurance Database for Catastrophic Illness Patients in Taiwan. A total of 31,112 women with breast cancer without T2DM history during the period 2000-2005 were identified, divided into morphine and non-morphine users (8071 and 23,041 patients, respectively), and the hazard ratios of newly diagnosed T2DM during the period 2005-2010 were calculated. We used a Cox proportional hazard model with time-dependent exposure covariates to estimate the risk of T2DM. The dosage of morphine was counted as defined daily dose and its effect was assessed by multivariable Cox proportional hazard regression controlling age, Charlson comorbidity index, outpatient department visits, antipsychotics, and breast cancer drugs. RESULTS Morphine users were 1.24 times more likely to suffer from T2DM than non-morphine users (95% CI=1.04-1.49). Risk increased slightly with the morphine dosage, in patients aged 35-49 years, and with tamoxifen, aromatase inhibitors, and antipsychotics treatment. CONCLUSIONS The incidence of T2DM is associated with morphine treatment in female breast cancer patients. A higher risk was observed in patients aged 35-49 years using higher dose of morphine, and may be increased by tamoxifen and aromatase inhibitors.
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Affiliation(s)
| | - Chih-Hsin Muo
- Department of Public Health, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - I-Kuan Wang
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Kidney Disease, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yen-Jung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Shih-Wei Lai
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; China Medical University, Taichung, Taiwan
| | - Cynthia Wei-Sheng Lee
- China Medical University, Taichung, Taiwan; Center for Drug Abuse and Addiction, China Medical University Hospital, Taichung, Taiwan.
| | - Donald E Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Aghadavoudi O, Eizadi-Mood N, Najarzadegan MR. Comparing cardiovascular factors in opium abusers and non-users candidate for coronary artery bypass graft surgery. Adv Biomed Res 2015; 4:12. [PMID: 25625118 PMCID: PMC4300596 DOI: 10.4103/2277-9175.148294] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 01/05/2014] [Indexed: 12/04/2022] Open
Abstract
Background: In some opinions, opium consumption has traditionally been considered to be a means to lower blood lipids and to put off heart diseases. In this study, the relationship between opium consumption and risk factors of coronary artery diseases, hemodynamic factors and cardiac related functions before and after surgery was evaluated. Materials and Methods: In a cross-sectional study 325 patient's candidate for elective coronary artery bypass grafting were enrolled in a period of 6 months. Opium addicted patients were recognized based on taking history from the patients by an anaesthesiologist. Serum lipid profile was determined at the beginning of the study. Frequency and distribution of coronary artery diseases were assessed according to the pre-operative coronary angiography. Results: From 325 patients, 117 patients were opium abusers and 208 patients were not. Mean duration of opium abuse was 12.6 ± 7.7 years. Mean total serum cholesterol levels were not significantly different in abusers and non-users patients (185 ± 47 vs. 190 ± 49, P > 0.05). Mean level of low-density lipoprotein cholesterol was significantly higher in addicted group (121 ± 27 vs. 81 ± 22, P < 0.05). Mean triglyceride level was also higher in addicted patients (203 ± 114 vs. 162 ± 98, P < 0.05). The prevalence of diabetes and glucose levels was considerably lower in opium addicted cases. Mean body mass index was also lower in addicted patients significantly (25.3 ± 3.7 vs. 27.5 ± 4.1, P < 0.05). Conclusion: There may be a relationship between opium abuse and aggravating lipid profile and hypercholesterolemia and coronary artery disease.
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Affiliation(s)
- Omid Aghadavoudi
- Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nastaran Eizadi-Mood
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Najarzadegan
- Department of Psychiatry, Tehran Institute of Psychiatry-Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
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Singh P, Sharma B, Gupta S, Sharma BM. In vivo and in vitro attenuation of naloxone-precipitated experimental opioid withdrawal syndrome by insulin and selective KATP channel modulator. Psychopharmacology (Berl) 2015; 232:465-75. [PMID: 25059539 DOI: 10.1007/s00213-014-3680-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/02/2014] [Indexed: 12/01/2022]
Abstract
RATIONALE Opiate exposure for longer duration develops state of dependence in humans and animals, which is revealed by signs and symptoms of withdrawal precipitated by opioid receptor antagonists. The sudden withdrawal of opioids produces a withdrawal syndrome in opioid-dependent subjects. Insulin and ATP-sensitive potassium (KATP) channel-mediated glucose homeostasis have been shown to modulate morphine withdrawal. OBJECTIVE Present study has been structured to investigate the role of insulin and pharmacological modulator of KATP channel (gliclazide) in experimental morphine withdrawal syndrome, both invivo and invitro. METHODS In this study, naloxone-precipitated morphine withdrawal syndrome in mice (invivo) as well as in rat ileum (invitro) were utilized to assess opioid withdrawal phenomenon. Morphine withdrawal syndromes like jumping and rearing frequency, forepaw licking, circling, fore paw tremor, wet dog shake, sneezing, overall morphine withdrawal severity (OMWS), serum glucose, brain malondialdehyde (MDA), glutathione (GSH), nitrite/nitrate, and calcium (Ca(+2)) were assessed. RESULTS Naloxone has significantly increased morphine withdrawal syndrome, both invivo and invitro. Insulin and gliclazide have significantly attenuated, naloxone induced behavioral changes like jumping and rearing frequency, forepaw licking, wet dog shake, sneezing, straightening, circling, OMWS, and various biochemical impairments such as serum glucose, brain MDA, GSH, nitrite/nitrate, and Ca(+2) in morphine-dependent animals (invivo). In vitro, insulin and gliclazide have significantly reduced naloxone-induced contraction in morphine-withdrawn rat ileum preparation. CONCLUSIONS Insulin and gliclazide (KATP channel blocker) have attenuated naloxone-precipitated morphine withdrawal syndrome, both invivo and invitro. Thus, insulin and KATP channel modulation may provide new avenues for research in morphine withdrawal.
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Affiliation(s)
- Prabhat Singh
- Neuropharmacology Laboratory, Department of Pharmacology, School of Pharmacy, Bharat Institute of Technology, Partapur Bypass, Meerut, 250103, Uttar Pradesh, India
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Gozashti MH, Mohammadzadeh E, Divsalar K, Shokoohi M. The effect of opium addiction on thyroid function tests. J Diabetes Metab Disord 2014; 13:5. [PMID: 24393239 PMCID: PMC3922854 DOI: 10.1186/2251-6581-13-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 10/27/2013] [Indexed: 11/26/2022]
Abstract
Background A number of abnormalities has been identified among drug addicted users especially heroin addicts. However, there are a few studies to assess the opium effects on thyroid hormones. the aim of the present study is to investigate the effect of opium on the thyroid function tests. Method In this case–control, 50 male addicts, aged 20–50 years, with history of addiction to opium lasting more than two years, and 50 male non-addicts as control group were randomly selected. 10 cc blood sample was taken for measurements of TSH, total T4 and T3, free T4 and T3, and T3 resin uptake (T3RU) and 50 cc urine sample for opium testing. Results The univariate analysis revealed that there was not a significant association between opium and serum levels of T4 and TSH, but compared with control group, a slight increase in total T3 and a decrease in T3RU were observed among addicts (P < 0.05). In multivariate analysis, opium was also found to exert a lowering effect on serum free T4 level after adjusting of age and cigarette smoking (P < 0.05). Conclusion The findings of the present study demonstrated that opium can influence on thyroid function by increasing total T3 and decreasing T3RU and free T4 levels.
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Affiliation(s)
| | | | | | - Mostafa Shokoohi
- Research center for modeling in health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Fareed A, Byrd-Sellers J, Vayalapalli S, Drexler K, Phillips L. Predictors of Diabetes Mellitus and Abnormal Blood Glucose in Patients Receiving Opioid Maintenance Treatment. Am J Addict 2013; 22:411-6. [DOI: 10.1111/j.1521-0391.2013.12043.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 01/11/2012] [Accepted: 12/01/2012] [Indexed: 12/15/2022] Open
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Kouros D, Tahereh H, Mohammadreza A, Minoo MZ. Opium and heroin alter biochemical parameters of human's serum. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2010; 36:135-9. [PMID: 20465370 DOI: 10.3109/00952991003734277] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Iran is a significant consumer of opium, and, generally, of opioids, in the world. Addiction is one of the important issues of the 21st century and is an imperative issue in Iran. Long-term consumption of opioids affects homeostasis. OBJECTIVE To determine the effects of opium and heroin consumption on serum biochemical parameters. METHODS In a cross-sectional study, subjects who had consumed heroin (n = 35) or opium (n = 42) for more than two years and 35 nonaddict volunteers as the control group were compared in regard to various biochemical parameters such as fasting blood sugar (FBS), Na(+), K(+), Ca(2+), blood urea nitrogen (BUN), uric acid (UA), triglyceride (TG), cholesterol, creatinine, and total protein. Chromatography was used to confirm opioid consumption, and the concentration of biochemical parameters was determined by laboratory diagnostic tests on serum. RESULTS No significant differences were found in Na(+), Ca(2+), BUN, UA, TG, creatinine, and total protein concentrations among the three groups. FBS, K(+), and UA levels were significantly lower in opium addicts compared to the control group. Serum Ca(2+) concentration of heroin addicts showed a significant decrease compared to that of the control group. Both addict groups showed a significant decrease in serum cholesterol levels. CONCLUSION Chronic use of opium and heroin can change serum FBS, K(+), Ca(2+), UA, and cholesterol. SCIENTIFIC SIGNIFICANCE This study, one of few on the effects of opium on serum biochemical parameters in human subjects, has the potential to contribute to the investigation of new approaches for further basic studies.
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Affiliation(s)
- Divsalar Kouros
- Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Azod L, Rashidi M, Afkhami-Ardekani M, Kiani G, Khoshkam F. Effect of opium addiction on diabetes. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2008; 34:383-8. [PMID: 18584567 DOI: 10.1080/00952990802122580] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Type 2 diabetes is a common disorder that is recognized as a major health problem in Iran. Diabetes is a major cause of morbidity, mortality, and economic burden to the society. Some people believe that smoking opium can reduce serum glucose and lipids in diabetes mellitus. This study was designed to compare blood glucose and lipids in opium addicts with non-addicts among patients with type 2 diabetes. METHODS In this case, control study subjects were chosen from type 2 diabetic patients. Twenty-three males with type 2 diabetes and addicted to opium were selected as the case group, and 46 patients with no addiction to opioid drugs were chosen as control group. Blood Sugar (BS), glycated hemoglobin (HbA1C), lipids and microalbumin in urine were measured in two groups. RESULTS Our results showed that the mean FBS and 2-hour post prandial were significantly different between two groups. (P = .04). No significant difference was observed in HbA1C, triglyceride, total cholesterol, LDL, and HDL between the two groups (P > .05). CONCLUSIONS Our finding showed that while opium might decrease blood glucose temporarily, it had no clear and long-lasting effects on blood glucose, as it had no significant effect on HbA1c.
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Affiliation(s)
- Laila Azod
- Yazd Diabetes Research Center, Shahid Sadougdi University of Medical Science, Yazd, Iran
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Boyd JJ, Kuisma MJ, Alaspää AO, Vuori E, Repo JV, Randell TT. Outcome after heroin overdose and cardiopulmonary resuscitation. Acta Anaesthesiol Scand 2006; 50:1120-4. [PMID: 16987342 DOI: 10.1111/j.1399-6576.2006.01142.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The survival of heroin overdose patients resuscitated from cardiac arrest is reported to be poor. The aim of our study was to investigate the outcome and characteristics of survivors after cardiac arrest caused by heroin overdose. METHODS This was a retrospective study in a medium-sized city (population, 560,000). Between 1 January 1997 and 31 December 2000, there were 94 combined cardiac arrests caused by acute drug poisonings. The main outcome measure was survival to discharge. RESULTS Cardiopulmonary resuscitation was attempted in 19 heroin overdose patients (group A) and in 53 patients with cardiac arrest caused by other poisonings (group B). Three (16%) vs. six (11%) patients were discharged alive (group A vs. B, respectively). The survivors in group A had an Emergency Medical Service (EMS)-witnessed cardiac arrest or the Emergency Dispatching Centre was called before the arrest occurred. There was no statistically significant difference between the two groups in terms of survival. Survivors in both groups suffered from acute renal failure (two), hypoglycaemia (four) and hypothermia (three). CONCLUSION Survival after cardiac arrest caused by heroin overdose is possible if the arrest is EMS witnessed or the Emergency Dispatching Centre is called before the cardiac arrest occurs. In comparison with cardiac arrests caused by other poisonings, there was no difference in survival. The incidence and mechanism of hypoglycaemia should be examined in further studies.
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Affiliation(s)
- J J Boyd
- Helsinki Emergency Medical Service, Helsinki University Central Hospital, Helsinki, Finland.
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Jacobson DA, Cho J, Landa LR, Tamarina NA, Roe MW, Buxbaum JD, Philipson LH. Downstream regulatory element antagonistic modulator regulates islet prodynorphin expression. Am J Physiol Endocrinol Metab 2006; 291:E587-95. [PMID: 16621893 DOI: 10.1152/ajpendo.00612.2005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Calcium-binding proteins regulate transcription and secretion of pancreatic islet hormones. Here, we demonstrate neuroendocrine expression of the calcium-binding downstream regulatory element antagonistic modulator (DREAM) and its role in glucose-dependent regulation of prodynorphin (PDN) expression. DREAM is distributed throughout beta- and alpha-cells in both the nucleus and cytoplasm. As DREAM regulates neuronal dynorphin expression, we determined whether this pathway is affected in DREAM(-/-) islets. Under low glucose conditions, with intracellular calcium concentrations of <100 nM, DREAM(-/-) islets had an 80% increase in PDN message compared with controls. Accordingly, DREAM interacts with the PDN promoter downstream regulatory element (DRE) under low calcium (<100 nM) conditions, inhibiting PDN transcription in beta-cells. Furthermore, beta-cells treated with high glucose (20 mM) show increased cytoplasmic calcium (approximately 200 nM), which eliminates DREAM's interaction with the DRE, causing increased PDN promoter activity. As PDN is cleaved into dynorphin peptides, which stimulate kappa-opioid receptors expressed predominantly in alpha-cells of the islet, we determined the role of dynorphin A-(1-17) in glucagon secretion from the alpha-cell. Stimulation with dynorphin A-(1-17) caused alpha-cell calcium fluctuations and a significant increase in glucagon release. DREAM(-/-) islets also show elevated glucagon secretion in low glucose compared with controls. These results demonstrate that PDN transcription is regulated by DREAM in a calcium-dependent manner and suggest a role for dynorphin regulation of alpha-cell glucagon secretion. The data provide a molecular basis for opiate stimulation of glucagon secretion first observed over 25 years ago.
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Karam GA, Reisi M, Kaseb AA, Khaksari M, Mohammadi A, Mahmoodi M. Effects of opium addiction on some serum factors in addicts with non-insulin-dependent diabetes mellitus. Addict Biol 2004; 9:53-8. [PMID: 15203439 DOI: 10.1080/13556210410001674095] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to determine the effect of opium on biochemical parameters in addicts with non-insulin-dependent diabetes mellitus (NIDDM). Twenty-three males and 26 females between 35 and 65 years of age, with NIDDM, addicted to opium, were selected as the case group. Twenty-three males and 26 females with NIDDM and no opium addiction served as controls. Fasting glucose, glycated haemoglobin (HbA1c), total cholesterol, high density lipoproteins-cholesterol (HDL-c), triglycerides (TGs), sodium (Na(+)), potassium (K(+)), calcium (Ca(2+)), iron (Fe(2+)), total iron binding capacity (TIBC), serum total protein, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid and urea were measured in the serum of the two groups. Serum protein electrophoresis was also carried out. Compared to the control group, in addicted males with NIDDM, HbA1c, K(+) and Fe(2+) were higher, and serum total protein, ALT and HDL-c were lower. No significant difference was observed between other factors. Albumin was lower in addicts, but no significant difference was observed between the albumin/globulin ratios. In addicted females with NIDDM, serum total protein, TIBC, ALT and AST were lower compared to non-addicts. Cholesterol tends to be lower in diabetic addicted males, HbA1c in addicted females and uric acid in addicted males was higher compared to non-addicted diabetics. Their differences, however, were not significant. According to our results, smoking opium increases serum glucose and decreases HDL-c, and thus adds to metabolic disorders in NIDDM patients. It also increases potassium and Fe(2) in males and decreases TIBC in females, and could therefore potentially interfere with water and iron metabolism.
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Affiliation(s)
- Gholamreza Asadi Karam
- Department of Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Abstract
1. Naloxone, which is often regarded as a pure opioid antagonist, produces effects similar to those produced by morphine. 2. In conscious rabbits implanted with an intracerebroventricular (i.c.v.) cannula, naloxone, whether given intravenously (1 mg/kg) or i.c.v. (1-100 microg), produced a significant rise in blood glucose levels. 3. Hyperglycaemia in response to naloxone (1 mg/kg, i.v., or 100 microg, i.c.v.) was not influenced by the selective alpha1-adrenoceptor antagonist WB-4101 given either i.v. (50 microg) or i.c.v. (5 microg). 4. Hyperglycaemia in response to naloxone (1 mg/kg, i.v., or 100 microg, i.c.v.) was completely blocked by pretreatment with the alpha2-adrenoceptor antagonist yohimbine (1 mg/kg, i.v., or 100 microg, i.c.v.). However, hyperglycaemia to i.c.v. naloxone (100 microg) was not influenced by i.v. yohimbine (1 mg/kg). 5. Because naloxone behaves like morphine and produces hyperglycaemia in conscious rabbits, the drug may have an appreciable agonist activity and the hyperglycaemic response to naloxone is principally mediated via alpha2- but not alpha1-adrenoceptors.
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Affiliation(s)
- H A Abouazra
- Department of Pharmacology, Faculty of Medicine, Al-Arab Medical University, Benghazi, Libya.
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Sood A, Thakur VS, Karmarkar MG, Ahuja MM. Effect of chronic morphine administration on glucose tolerance and insulin binding to isolated rat adipocytes. Endocr Res 2001; 27:215-21. [PMID: 11428713 DOI: 10.1081/erc-100107182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Morphine addiction was induced in six male Wistar rats. Improved glucose tolerance (peak value less by 28%, p<0.01) was observed in chronically morphinized rats as compared to the control rats, injected with saline. An increase in the maximal specific binding of 125I-labeled insulin to unit membrane area of adipocytes was observed in the experimental group (p < 0.01). The changes in insulin receptor number could be responsible for the improved glucose tolerance observed during morphine addiction.
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Affiliation(s)
- A Sood
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield 62794-9636, USA
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Francisco-DoPrado J, Zambelli JE, Melo-Lima MH, Ribeiro-DaSilva G. The hyperinsulinemia produced by concanavalin A in rats is opioid-dependent and hormonally regulated. Braz J Med Biol Res 1998; 31:697-703. [PMID: 9698777 DOI: 10.1590/s0100-879x1998000500015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The present study examines the effect of concanavalin A (Con A) on the blood insulin and glucose levels of rats. Male and female rats treated with Con A (62.5-500 micrograms/kg) for three days showed a dose- and time-dependent hyperinsulinemia that lasted more than 48 h. Male rats were more sensitive to Con A. Thus, 6 h after treatment with Con A the circulating insulin levels in male rats had increased by 85% (control: 10.2 +/- 0.9 mU/l and Con A-treated: 18.8 +/- 1 mU/l) compared to only 38% (control: 7.5 +/- 0.2 mU/l; Con A-treated: 10.3 +/- mU/l) in females. An identical response was seen after 12 h. Con A (250 micrograms/kg) produced time-dependent hypoglycemia in both sexes but more pronounced in males. There was no correlation between the hypoglycemia and hyperinsulinemia described above. The Con A-induced hyperinsulinemia in rats of both sexes was abolished in gonadectomized animals (intact males: +101 +/- 17% vs orchiectomized males: -5 +/- 3%; intact females: +86 +/- 23% vs ovariectomized females: -18 +/- 7.2%). Pretreating intact male and female rats with human chorionic gonadotropin also significantly inhibited the Con A-induced hyperinsulinemia. Estradiol (10 micrograms/kg,i.m.) significantly blocked the Con A-induced increase in circulating insulin in male rats (101 +/- 17% for controls vs 32 +/- 5.3% for estradiol-treated animals, P < 0.05) while testosterone (10 mg/kg, i.m.) had no similar effect on intact female rats. Pretreating Con A-injected rats with opioid antagonists such as naloxone (1 mg/kg, s.c.) and naltrexone (5 mg/kg, s.c.) blocked the hyperinsulinemia produced by the lectin in males (control: +101 +/- 17% vs naloxone-treated: +5 +/- 14%, or naltrexone-treated: -23 +/- 4.5%) and females (control: +86 +/- 23% vs naloxone-treated: +21 +/- 20%, or naltrexone-treated: -18 +/- 11%). These results demonstrate that Con A increases the levels of circulating insulin in rats and that this response is opioid-dependent and hormonally regulated.
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Affiliation(s)
- J Francisco-DoPrado
- Departamento de Farmacologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, SP, Brasil
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Meijerink WJ, Molina PE, Lang CH, Abumrad NN. Contribution of excitatory amino acids to morphine-induced metabolic alterations. Brain Res 1996; 706:123-8. [PMID: 8720499 DOI: 10.1016/0006-8993(95)01205-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Previous studies have indicated that excitatory amino acids are involved in the analgesic and addictive properties of morphine. However, their role in the morphine-induced alterations in glucose metabolism is not known. This study assessed the contribution of NMDA receptor activation to the morphine-induced hormonal and metabolic alterations in conscious unrestrained chronically catheterized rats. Whole body glucose flux was assessed with a primed constant intravenous infusion of [3-3H]glucose in rats pretreated with the NMDA-receptor antagonist MK-801 (0.25 mg/kg, intraarterial) or an equal volume (1.5 ml) of sterile saline (0.9%) administered 15 min prior to i.c.v. injection of H2O (Con; 5 microliters) or morphine sulfate (80 micrograms). No significant alterations were noted in metabolic and hormonal parameters of H2O injected rats. i.c.v. morphine increased the plasma glucose concentration (60%), hepatic glucose production (Ra; 60%) and whole body glucose utilization (Rd; 53%), but did not alter the glucose metabolic clearance rate (MCR). MK-801 alone resulted in transient hyperglycemia (25%), stimulation of glucose Ra (60%) and glucose Rd (53%), and a significant (30%) increase in MCR. MK-801 pretreatment blunted the morphine-induced hyperglycemia and the increased glucose Ra and Rd. Morphine increased the plasma concentration of epinephrine (4-fold), norepinephrine (2-fold) and corticosterone (67%); however, no alterations in plasma insulin and glucagon were detected. MK-801 pretreatment, blunted the morphine-induced increase in corticosterone and norepinephrine, and elicited a significant rise in insulin concentrations. These results indicate that activation of the NMDA receptors contributes to the morphine-induced hyperglycemia and hormonal alterations. Furthermore, this response appears partially mediated by activation of sympathetic outflow and suppression of insulin release, which is blunted by inhibition of NMDA receptors.
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Affiliation(s)
- W J Meijerink
- Department of Surgery, State University of New York, Stony Brook 11794-8191
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23
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Fatouros JG, Goldfarb AH, Jamurtas AZ. Low carbohydrate diet induces changes in central and peripheral beta-endorphins. Nutr Res 1995. [DOI: 10.1016/0271-5317(95)02039-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Molina PE, Hashiguchi Y, Ajmal M, Mazza M, Abumrad NN. Differential hemodynamic, metabolic and hormonal effects of morphine and morphine-6-glucuronide. Brain Res 1994; 664:126-32. [PMID: 7895021 DOI: 10.1016/0006-8993(94)91962-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Although the hyperglycemic effect of morphine has been previously described, it is not clear whether this is the result of increased glucose production and/or decreased glucose utilization and if this metabolic effect is lost with glucuronidation. This study assessed the hemodynamic (heart rate; HR and mean arterial blood pressure; MABP), hormonal and whole body glucose metabolic effects of morphine (MOR) and its metabolite morphine 6-glucuronide (MOR-6G) in conscious unrestrained chronically catheterized rats. Whole body glucose kinetics were assessed with a primed constant intravenous infusion of [3-3H]glucose in rats infused i.c.v. with H2O (Con; 5 microliters/h), MOR (80 micrograms/h) or MOR-6G (1 microgram/h) for a total of 4 h. MOR administration resulted in a significant 20% elevation in HR and no change in MABP. MOR-6G produced a 14% increase in HR and no change in MABP. A significant rise in plasma glucose (+23%), hepatic glucose production (Ra; +27-61%) and whole body glucose utilization (Rd; +31-61%) was also observed within 60 min of MOR administration. I.c.v. MOR-6G resulted in hyperglycemia (+60%), stimulation of glucose Ra (+60%) and glucose Rd (+50%). No significant alterations were noted in hemodynamic, metabolic and hormonal parameters of H2O infused rats. I.c.v. MOR resulted in a significant increases in epinephrine (2-fold), norepinephrine (50%), corticosterone (97%) with no alterations in plasma insulin and glucagon. I.c.v. MOR-6G resulted in more marked elevations in norepinephrine (5-fold), epinephrine (7-fold) and similar elevation in corticosterone (99%) and modest elevation of glucagon (40%).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P E Molina
- Department of Surgery, SUNY at Stony Brook 11794-8191
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Molina PE, Abumrad NN. Metabolic effects of opiates and opioid peptides. ADVANCES IN NEUROIMMUNOLOGY 1994; 4:105-16. [PMID: 7952827 DOI: 10.1016/s0960-5428(05)80005-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- P E Molina
- Department of Surgery, State University of New York at Stony Brook 11794-8191
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Johansen O, Tønnesen T, Jensen T, Burhol PG, Jorde R, Reikerås O. Morphine and morphine/naloxone modification of glucose, glucagon and insulin levels in fasted and fed rats. Scand J Clin Lab Invest 1993; 53:805-9. [PMID: 8140390 DOI: 10.3109/00365519309086492] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In rats weighing 200-250 g catheters were placed in the internal jugular vein and carotid artery. After 1 week of accommodation the training for the experimental situation, morphine (10 mg kg-1) was injected intravenously alone or in combination with naloxone (0.04 mg ml-1, 0.8 ml h-1). Otherwise no form of anaesthesia was used during the experiments. In control fed and fasted rats, there were no significant differences in blood glucose. In fed rats, morphine increased blood glucose as compared to control rats (p < 0.001). This was not seen in the fasted rats. The morphine induced increase in blood glucose in the fed rats was abolished by naloxone (p < 0.001). Glucagon was significantly higher in fasted than in fed control rats (p < 0.01). It was significantly increased after morphine in fed (p < 0.05), but not in fasted rats. The morphine induced increase in glucagon in fed rats was abolished by naloxone (p < 0.01). Insulin was significantly higher in fed than in fasted control rats (p < 0.05). Morphine increased insulin levels significantly in fed and fasted rats (p < 0.001), p < 0.01). The morphine induced increase in insulin in the fed rats was abolished by naloxone treatment. It is concluded that morphine stimulates glucose and glucagon release in fed but not fasted rats, and that these increases are caused by opioid action. Insulin increases after morphine were proved to be opioid-mediated only in the fed state.
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Affiliation(s)
- O Johansen
- Department of Orthopaedics, Tromsø University Hospital, Norway
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Abstract
Canatoxin, a proteic neurotoxin from Canavalia ensiformis seeds, raises circulating insulin levels and induces hypoglycemia in rats. The hyperinsulinemia produced by canatoxin (6 micrograms kg-1, 20 min; 108% of increase in female rats) was both time and dose dependent and lasted only about 30 min, while the fall in blood glucose levels (around 30%) was long lasting. The hyperinsulinemic response to canatoxin was greater in females (+108 +/- 18%) than males (+43 +/- 8%), but no difference was noted in the hypoglycemia. Pretreatment of rats with either naloxone, naltrexone, atropine or hexamethonium abolished both the hyperinsulinemia and the hypoglycemia. These data suggest that these phenomena are influenced by opioids and depend on parasympathetic stimulation.
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Affiliation(s)
- G Ribeiro-DaSilva
- Department of Pharmacology, Faculdade de Ciĕncias Médicas, Universidade Estadual de Campinas, S. Paulo, Brazil
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Pasquali R, Cantobelli S, Casimirri F, Bortoluzzi L, Boschi S, Capelli M, Melchionda N, Barbara L. The role of the opioid peptides in the development of hyperinsulinemia in obese women with abdominal body fat distribution. Metabolism 1992; 41:763-7. [PMID: 1619995 DOI: 10.1016/0026-0495(92)90317-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In this study, we investigated the hypothesis that increased opioid activity may be involved in the development of hyperinsulinemia in women with obesity and abdominal body fat distribution. Two groups of nine obese body (body mass index [BMI], 30 to 40 kg/m2) women with abdominal (A-ob) (waist to hip ratio [WHR] greater than 0.85) or gluteo-femoral (F-ob) (WHR greater than or equal to 0.80) fat distribution were examined and compared with eight normal-weight controls. Basal beta-endorphin levels were higher in the A-ob group than in the other groups. Each woman underwent two oral glucose tolerance tests (OGTT, 75 g glucose). A bolus of naloxone (0.8 mg) followed by a constant infusion of naloxone (0.04 mg/kg/h) or saline was also administered during the glucose challenge in random order, and blood samples for glucose, insulin, and C-peptide were collected at regular times after glucose administration. No difference was observed in basal or stimulated glucose concentrations between the three groups, nor between the saline or naloxone study. However, basal and stimulated insulin levels were significantly higher in obese women (particularly in the A-ob group) than in controls. Naloxone administration, however, did not significantly modify insulin and C-peptide glucose-stimulated concentrations in controls and in the F-ob group, whereas it significantly reduced (by approximately 47%) insulin levels in the A-ob group. Partial correlation coefficients showed a significant negative correlation between percent variation of glucose-stimulated insulin incremental areas during the naloxone study and the WHR in all women considered together (r = .544, P less than .025).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R Pasquali
- Institute of Clinical Medicine and Gastroenterology, University Alma Mater and Central Laboratory, S. Orsola Hospital, Bologna, Italy
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Johansen O, Tønnesen T, Jensen T, Jorde R, Burhol PG, Reikerås O. Increments in glucose, glucagon and insulin after morphine in rats, and naloxone blocking of this effect. Life Sci 1992; 51:1237-42. [PMID: 1528092 DOI: 10.1016/0024-3205(92)90361-r] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In awake rats adapted to experimental conditions and allowed food ad libitum, hyperglycemia was induced by the administration of morphine 10 mg/kg through indwelling catheters in the external jugular vein. High glucose values were measured at 5, 15 and 25 min. Glucagon values were high at 5 and 15 min, and again at basal level at 25 min. Insulin was increased after morphine both at 5, 15 and 25 min, whereas somatostatin levels did not change after morphine. When morphine was administered together with naloxone after an initial 10 min period of naloxone administration, there was no increment in glucose, insulin or somatostatin values; neither at 5, 15 or 25 min. There was a remarkable glucagon decrease after naloxone and morphine remaining from 5 to 25 min. Then, one of the possible mechanisms for the hyperglycemic response after morphine may be an opioid effect on pancreas, stimulating glucagon and thereby causing hepatic glucose output.
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Affiliation(s)
- O Johansen
- Department of Orthopaedics, Tromsø University Hospital, Norway
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Miller RJ, Hirning LD. Opioid Peptides of The Gut. Compr Physiol 1989. [DOI: 10.1002/cphy.cp060226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Tang F. Changes in met-enkephalin and beta-endorphin contents in the hypothalamus and the pituitary in diabetic rats: effects of insulin therapy. Clin Exp Pharmacol Physiol 1989; 16:65-75. [PMID: 2523766 DOI: 10.1111/j.1440-1681.1989.tb01530.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
1. Immunoreactive (IR)-met-enkephalin and beta-endorphin contents in the hypothalamus and the pituitary were measured in alloxan-diabetic rats with or without insulin treatment. 2. Both IR-met-enkephalin and IR-beta-endorphin in the pituitary were substantially reduced in alloxan-diabetic rats 1 month after treatment. 3. Hypothalamic IR-beta-endorphin content was also significantly lower. 4. Gel-filtration chromatography showed that the peaks co-eluting with met-enkephalin precursor, met-enkephalin and beta-endorphin were lower in the pituitaries from the diabetic rats, whereas the peaks co-eluting with beta-endorphin precursor and beta-lipotropin were not. 5. In another experiment, the IR-beta-endorphin contents of the neuro-intermediate lobe and hypothalamus, but not the anterior lobe were significantly lowered in diabetic rats, whereas IR-met-enkephalin contents were significantly reduced in both the anterior and neuro-intermediate lobe. 6. All these changes were reversed by insulin treatment. 7. As a decrease in general protein synthesis could not explain the recorded changes, these results suggest a possible direct role of insulin in regulating the opioid peptide content of the hypothalamus and pituitary.
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Affiliation(s)
- F Tang
- Department of Physiology, Faculty of Medicine, University of Hong Kong
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Radosevich PM, Lacy DB, Brown LL, Williams PE, Abumrad NN. Central effects of beta-endorphins on glucose homeostasis in the conscious dog. THE AMERICAN JOURNAL OF PHYSIOLOGY 1989; 256:E322-30. [PMID: 2521986 DOI: 10.1152/ajpendo.1989.256.2.e322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The effects of centrally administered beta-endorphins on glucose homeostasis in the conscious dog were studied. Intracerebroventricular administration of beta-endorphin (0.2 mg/h) caused a 70% increase in plasma glucose. The mechanism of the hyperglycemia was twofold: there was an early increase in glucose production and a late inhibition of glucose clearance. These changes are explained by marked increases in plasma epinephrine (30-fold) and norepinephrine (6-fold) that occurred during infusion of beta-endorphin. Central administration of beta-endorphin also resulted in increased levels of adrenocorticotropic hormone and cortisol. In addition there was an increase in plasma insulin but no increase in plasma glucagon. Intravenous administration of beta-endorphin did not alter glucose homeostasis. Intracerebroventricular administration of acetylated beta-endorphin did not perturb glucose kinetics or any of the hormones that changed during infusion of the unacetylated peptide. We conclude that beta-endorphin acts centrally to cause hyperglycemia by stimulating sympathetic outflow and the pituitary-adrenal axis. Acetylation of beta-endorphin abolishes the in vivo activity of the peptide.
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Affiliation(s)
- P M Radosevich
- Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee 37232
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Radosevich PM, Lacy DB, Brown LL, Williams PE, Abumrad NN. Effects of insulin-induced hypoglycemia on plasma and cerebrospinal fluid levels of ir-beta-endorphins, ACTH, cortisol, norepinephrine, insulin and glucose in the conscious dog. Brain Res 1988; 458:325-38. [PMID: 2850080 DOI: 10.1016/0006-8993(88)90475-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study was designed to assess effects of insulin-induced hypoglycemia on plasma and cerebrospinal fluid (CSF) levels of immunoreactive (ir) beta-endorphins, adrenocorticotropin (ACTH), cortisol, norepinephrine, insulin, and glucose in the conscious, overnight fasted dog. Dogs received either an intravenous infusion of saline or insulin (5 mU/kg/min) for 3 h. Infusion of saline alone in conjunction with acute sampling of CSF caused no measurable perturbations of glucose homeostasis. Insulin infusion caused a 60% drop in both plasma and CSF glucose. Plasma levels of ir-beta-endorphins, ACTH and cortisol rose markedly. CSF levels of ir-beta-endorphins and ACTH also increased. While the magnitude of the increase was smaller than that in the plasma, it was greater than would be expected if crossover of the peptides from the plasma were the sole source of the increase. Hypoglycemia also induced elevations in CSF cortisol and insulin. In addition, there was a 45% decrease in CSF norepinephrine in spite of large elevations of norepinephrine in the plasma. We conclude that hypoglycemia is associated with marked changes in central as well as peripheral levels of neuroendocrine factors. The importance of these changes in mediating acute and long-term responses to hypoglycemia remains to be established.
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Affiliation(s)
- P M Radosevich
- Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232
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Affiliation(s)
- D Giugliano
- Institute of General Medicine, Medical Therapy and Metabolic Disease, Faculty of Medicine I, University of Naples, Italy
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Buck M, Marrazzi MA. Atypical responses to morphine in mice: a possible relationship to anorexia nervosa? Life Sci 1987; 41:765-73. [PMID: 3613840 DOI: 10.1016/0024-3205(87)90457-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
According to our previously proposed auto-addiction hypothesis of chronic anorexia nervosa, patients become addicted to an initial period of dieting through endogenous opioid mediated mechanisms. Morphine causes hyperactivity and anorexia in the mouse, symptoms of anorexia nervosa but responses opposite to those of most species including rats and normal human subjects. This suggests that the atypical opioid systems in the mouse may resemble those of the chronic anorexia nervosa patient in contrast to those of most species including the normal human. Characterization of this atypical opioid system may be useful in understanding the pathophysiology of anorexia nervosa.
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Brubaker PL, Sun A, Vranic M. Lack of effect of beta-endorphin on basal or glucagon-stimulated hepatic glucose production in vitro. Metabolism 1987; 36:432-7. [PMID: 2952864 DOI: 10.1016/0026-0495(87)90039-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
beta-Endorphin appears to have effects on hepatic glucose production in vivo. In order to determine whether beta-endorphin modulates glucose production directly, the effects of beta-endorphin on isolated rat hepatocytes were investigated. This permitted isolation of the effects of beta-endorphin from hormonal and/or neuronal influences. A significant dose-related stimulatory effect of glucagon (10(-10) to 10(-6) mol/L) on both hepatic glucose production and glycogen phosphorylase a activity was demonstrated. No effect of either physiologic (10(-11) to 10(-9) mol/L) or supraphysiologic (10(-6) mol/L) concentrations of beta-endorphin on these parameters, under basal or glucagon-stimulated conditions, could be detected. These results suggest that reported in vivo effects of beta-endorphin to inhibit hepatic glucose production were either indirect or centrally mediated.
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Schleicher RL, Chawla RK, Coan PA, Martino-Saltzman D, Collins DC. Beta-endorphin-induced hyperglycemia in rabbits: effects of a glucose or arginine challenge. THE AMERICAN JOURNAL OF PHYSIOLOGY 1987; 252:E255-9. [PMID: 2950769 DOI: 10.1152/ajpendo.1987.252.2.e255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The effects of beta-endorphin on glucose, insulin, and glucagon levels were studied in normal fasted adult male rabbits. An intravenous bolus of glucose (0.7 g/kg body wt) produced a hyperglycemic state (peak plasma glucose 306 +/- 22 mg/dl; means +/- SE) that lasted approximately 90 min. beta-Endorphin (31 micrograms/g body wt; iv) administered immediately prior to the glucose challenge resulted in plasma glucose levels that were significantly higher from 10 to 90 min after the glucose challenge (P less than 0.001-0.05). From 10 to 30 min, plasma insulin levels were significantly lower in the beta-endorphin group (P less than 0.001-0.05), peaking at one-half the control group levels. Glucagon levels were unchanged by the glucose bolus in either the control or beta-endorphin-treated group (means +/- SE = 102.8 +/- 4 pg/ml). In another experiment, a 30-min infusion of L-arginine (13 mg-1 X kg body wt-1 X min iv) in normal fasted rabbits produced a rapid (10 min) increase in plasma insulin and glucagon and a return to base-line levels 60 min after withdrawing the arginine stimulus. Plasma glucose levels were not altered by arginine (mean +/- SE = 94.5 +/- 1 mg/dl). Administration of beta-endorphin (31 micrograms/kg body wt iv) at the start of the arginine infusion resulted in a rapid (10 min) and long-lasting (up to 60 min) hyperglycemic effect associated with a significant decrease in insulin levels (10-20 min; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Leach RP, Allan EH, Titheradge MA. The stimulation of glycogenolysis in isolated hepatocytes by opioid peptides. Biochem J 1985; 227:191-7. [PMID: 3994681 PMCID: PMC1144825 DOI: 10.1042/bj2270191] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Addition of the opioid peptides, [Leu]enkephalin and [Met]enkephalin, to isolated hepatocytes was shown to produce a stimulation of glycogenolysis comparable with that observed in the presence of maximal concentrations of glucagon, adrenaline or angiotensin. This stimulation was demonstrated to be the result of an activation of phosphorylase by a rapid Ca2+-dependent mechanism and was not decreased by the presence or either alpha- or beta-adrenergic antagonists, although it was dependent on the presence of the N-terminal tyrosine residue in the enkephalin molecule. It is suggested that this may be further evidence for specific opioid receptors in the liver. Addition of [Leu]enkephalin also inhibited lactate formation, indicating that the opioid peptides exert a concerted effect on hepatic carbohydrate metabolism to enhance glucose output. The transient nature of the effect of the enkephalins was shown to be the result of a rapid breakdown of the peptides in the incubation as a result of aminopeptidase activity, the initial product being the inactive des-tyrosine derivative.
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Radosevich PM, Williams PE, Lacy DB, McRae JR, Steiner KE, Cherrington AD, Lacy WW, Abumrad NN. Effects of morphine on glucose homeostasis in the conscious dog. J Clin Invest 1984; 74:1473-80. [PMID: 6148357 PMCID: PMC425317 DOI: 10.1172/jci111560] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This study was designed to assess the effects of morphine sulfate on glucose kinetics and on glucoregulatory hormones in conscious overnight fasted dogs. One group of experiments established a dose-response range. We studied the mechanisms of morphine-induced hyperglycemia in a second group. We also examined the effect of low dose morphine on glucose kinetics independent of changes in the endocrine pancreas by the use of somatostatin plus intraportal replacement of basal insulin and glucagon. In the dose-response group, morphine at 2 mg/h did not change plasma glucose, while morphine at 8 and 16 mg/h caused a hyperglycemic response. In the second group of experiments, morphine (16 mg/h) caused an increase in plasma glucose from a basal 99 +/- 3 to 154 +/- 13 mg/dl (P less than 0.05). Glucose production peaked at 3.9 +/- 0.7 vs. 2.5 +/- 0.2 mg/kg per min basally, while glucose clearance declined to 1.7 +/- 0.2 from 2.5 +/- 0.1 ml/kg per min (both P less than 0.05). Morphine increased epinephrine (1400 +/- 300 vs. 62 +/- 8 pg/ml), norepinephrine (335 +/- 66 vs. 113 +/- 10 pg/ml), glucagon (242 +/- 53 vs. 74 +/- 14 pg/ml), insulin (30 +/- 9 vs. 10 +/- 2 microU/ml), cortisol (11.1 +/- 3.3 vs. 0.9 +/- 0.2 micrograms/dl), and plasma beta-endorphin (88 +/- 27 vs. 23 +/- 6 pg/ml); all values P less than 0.05 compared with basal. These results show that morphine-induced hyperglycemia results from both stimulation of glucose production as well as inhibition of glucose clearance. These changes can be explained by rises in epinephrine, glucagon, and cortisol. These in turn are part of a widespread catabolic response initiated by high dose morphine that involves activation of the sympathetic nervous system, the endocrine pancreas, and the pituitary-adrenal axis. Also, we report the effect of a 2 mg/h infusion of morphine on glucose kinetics when the endocrine pancreas is clamped at basal levels. Under these conditions, morphine exerts a hypoglycemic effect (25% fall in plasma glucose, P less than 0.05) that is due to inhibition of glucose production (by 25-43%, P less than 0.05). The hypoglycemia was independent of detectable changes in insulin, glucagon, epinephrine and cortisol, and was not reversed by concurrent infusion of a slight molar excess of naloxone. Therefore, we postulate that the hypoglycemic effect of morphine results from the interaction of the opiate with non-mu receptors either in the liver or the central nervous system.
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Radosevich PM, Williams PE, McRae JR, Lacy WW, Orth DN, Abumrad NN. Beta-endorphin inhibits glucose production in the conscious dog. J Clin Invest 1984; 73:1237-41. [PMID: 6323537 PMCID: PMC425139 DOI: 10.1172/jci111311] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The effect of human beta-endorphin (h beta E) infusion (0.2 mg/h) on glucose homeostasis was studied in 10 conscious overnight fasted dogs in which endocrine pancreatic function was fixed at basal levels with somatostatin plus intraportal replacement of basal insulin and glucagon. h beta E caused a fall in plasma glucose from 107 +/- 5 to 76 +/- 6 mg/dl by 3 h (P less than 0.01). This was due to a 25% fall in tracer-determined glucose production (Ra; P less than 0.01). A significantly larger fall in Ra was observed in four dogs in which hypoglycemia was prevented by use of an exogenous glucose infusion (45 vs. 25%, P less than 0.05). These changes occurred in the absence of changes in circulating levels of insulin, glucagon, epinephrine, norepinephrine, and cortisol. We conclude that the naturally occurring opioid peptide, beta-endorphin, inhibits glucose production by the liver in vivo. This appears to be a direct effect of the opioid on the liver, since the inhibition took place in the absence of changes in the other hormones measured. These results suggest that endorphins act on glucose homeostasis in a complex way, both by affecting other glucoregulatory hormones as demonstrated elsewhere, and by directly modulating hepatic glucose production as shown here.
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Abstract
Administration of human beta-endorphin (2.5 mg IV bolus) to three subjects with non-insulin-dependent diabetes mellitus (type II) induced prompt and simultaneous increments in the plasma concentrations of insulin and glucagon lasting up to 90 minutes. In contrast to the hyperglycemic response previously observed in normal subjects following beta-endorphin, these diabetics showed a progressive decline in plasma glucose throughout the study period. This disparity may be related to a relatively greater release of insulin and lesser rise in glucagon observed in diabetic subjects than in nondiabetic subjects. These preliminary findings suggest that further studies to elucidate the role of pancreatic beta-endorphin on glucoregulation may be rewarding.
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Schusdziarra V, Holland A, Maier V, Pfeiffer EF. Effect of naloxone on pancreatic and gastric endocrine function in response to carbohydrate and fat-rich test meals. Peptides 1984; 5:65-71. [PMID: 6143305 DOI: 10.1016/0196-9781(84)90053-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The present study was designed to determine the effect of naloxone, a specific opiate receptor antagonist, on postprandial levels of insulin, glucagon, pancreatic polypeptide (PP), somatostatin-like immunoreactivity (SLI) and gastrin in response to carbohydrate and fat-rich test meals in a group of 6 healthy volunteers. The addition of naloxone to a meal consisting of 50 g sucrose dissolved in 200 ml water augmented the rise of plasma insulin levels significantly during the first 30 min after its ingestion and reduced the rise in plasma insulin and pancreatic polypeptide and elevated glucagon levels during the last 30 min of the experimental period. When sucrose was dissolved in 200 ml cream the addition of naloxone augmented the postprandial rise of insulin levels between 15 and 60 min after ingestion of the meal and elicited an increase of plasma SLI and PP levels throughout the entire experimental period which indicates that post-prandial levels of insulin, glucagon, PP and SLI are modulated via endogenous opiate receptors during the ingestion of carbohydrate and fat test meals and that this effect depends on the composition of the ingested nutrients. These data raise the possibility that endogenous opiates participate in the regulation of postprandial insulin, glucagon, somatostatin and pancreatic polypeptide release not only in certain disease states as demonstrated recently for insulin secretion in type II diabetes mellitus but endogenous opiates may also be of importance under physiological conditions.
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Passariello N, Giugliano D, Quatraro A, Consoli G, Sgambato S, Torella R, D'Onofrio F. Glucose tolerance and hormonal responses in heroin addicts. A possible role for endogenous opiates in the pathogenesis of non-insulin-dependent diabetes. Metabolism 1983; 32:1163-5. [PMID: 6358781 DOI: 10.1016/0026-0495(83)90065-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Plasma glucose, insulin, glucagon, and growth hormone responses to intravenous glucose stimulation were investigated in 15 heroin-dependent men and in 15 control subjects matched for age, sex, and weight. Although the fasting concentrations of insulin, glucagon, and GH were significantly higher in the heroin addicts, they had markedly reduced plasma insulin responses to intravenous glucose (acute insulin response, calculated as the mean change in insulin levels over 3 to 10 minutes: 10 +/- 5 microU/mL in the addicts v 44 +/- 9 microU/mL in the controls, P less than 0.001) and glucose utilization rates in the diabetic range (KG: 0.96 +/- 0.09%/min in the addicts v 1.65 +/- 0.10%/min in the controls, P less than 0.01). These results show that chronic heroin administration produces a state of fasting hyperinsulinemia even in the absence of obesity, glucose intolerance, and a marked reduction of the first phase of insulin secretion. A possible role for endogenous opiates in the pathogenesis of non-insulin-dependent diabetes is hypothesized.
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Schusdziarra V, Rewes B, Lenz N, Maier V, Pfeiffer EF. Evidence for a role of endogenous opiates in postprandial somatostatin release. REGULATORY PEPTIDES 1983; 6:355-61. [PMID: 6138819 DOI: 10.1016/0167-0115(83)90264-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Previously, we have demonstrated the effects of exogenously administered opiates on somatostatin release in dogs and therefore the present study was designed to determine the effect of endogenous opiates via naloxone-induced opiate receptor blockade on somatostatin release. Additionally, plasma insulin and pancreatic polypeptide (PP) levels were determined in response to intragastrically instilled protein, carbohydrate and fat test meals in a group of eight conscious dogs. To all test meals either naloxone (4 mg) or saline was added. The rise of plasma somatostatin levels in response to liver extract, sucrose and fat was attenuated significantly by naloxone. Naloxone had no effect on the rise of postprandial plasma insulin and PP levels. The present data demonstrate that endogenous opiates have a stimulatory effect on postprandial somatostatin release in dogs which indicates a tight interaction that might be of relevance for nutrient homeostasis.
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Schusdziarra V, Schick R, Holland A, de la Fuente A, Specht J, Maier V, Brantl V, Pfeiffer EF. Effect of opiate-active substances on pancreatic polypeptide levels in dogs. Peptides 1983; 4:205-10. [PMID: 6622287 DOI: 10.1016/0196-9781(83)90115-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Feldman M, Kiser RS, Unger RH, Li CH. Beta-endorphin and the endocrine pancreas. Studies in healthy and diabetic human beings. N Engl J Med 1983; 308:349-53. [PMID: 6296674 DOI: 10.1056/nejm198302173080701] [Citation(s) in RCA: 92] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Beta-endorphin is present in the endocrine pancreas, suggesting that endorphins may have a role in islet-cell function. To evaluate this possibility, we infused synthetic human beta-endorphin intravenously in healthy volunteers and in insulin-dependent diabetic patients. In both groups, beta-endorphin increased plasma glucagon concentrations, and this rise was accompanied by a significant increase in plasma glucose concentrations. In nondiabetic subjects, beta-endorphin also increased plasma insulin concentrations. The threshold dose of beta-endorphin for producing increased plasma concentrations of glucose and glucagon was 0.005 mg--a dose that acutely increased plasma concentrations of beta-endorphin by approximately 40-fold. Glucose, glucagon, and insulin responses to beta-endorphin could not be blocked by intravenous naloxone. These studies suggest that endorphins may be involved in gluco-regulation, that their hyperglycemic action is mediated at least in part by glucagon, and that the effect of beta-endorphin on islet-cell function is relatively resistant to naloxone.
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Schusdziarra V, Holland A, Schick R, de la Fuente A, Klier M, Maier V, Brantl V, Pfeiffer EF. Modulation of post-prandial insulin release by ingested opiate-like substances in dogs. Diabetologia 1983; 24:113-6. [PMID: 6341135 DOI: 10.1007/bf00297392] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Thornhill JA, Saunders WS. Acute stimulation of feeding with repeated injections of morphine sulphate to non-obese and fatty Zucker rats. Prog Neuropsychopharmacol Biol Psychiatry 1983; 7:477-85. [PMID: 6364234 DOI: 10.1016/0278-5846(83)90014-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Food intake studies with genetically obese rodents show that these hyperphagic animals, which have increased central and peripheral levels of endogenous opioid peptides (E.O.P.), have an increased sensitivity to the suppressive feeding effects of narcotic antagonists compared to lean controls. Feeding experiments were conducted to determine if genetically obese rats, with enhanced E.O.P., have a reduced sensitivity toward the narcotic agonist property of stimulated feeding seen in non-obese rats. Food intake was monitored continuously over each experimental day in groups of female Sprague-Dawley (S.D.,), fatty Zucker (fa/fa) and their lean heterozygote littermates (Fa/fa) following subcutaneous a.m. injections of sterile saline, morphine sulphate (5 or 10 mg/kg) or naloxone HCl (10 mg/kg) and during recovery. Acute 4-h post-injection feeding was reduced in all groups with the first 10 mg/kg injection of morphine sulphate. With repeated morphine administration, a phase of stimulated feeding occurred in both obese and non-obese groups. Due to the post-injection phase of vigorous feeding with repeated morphine injections, the circadian pattern of day/night food intake of all groups was altered such that daytime feeding increased from saline control levels. Naloxone HCl abolished the post-injection phase of stimulated feeding seen with chronic morphine injections and reduced 4-h post-injection food intakes. Plasma glucose and serum insulin levels were decreased in non-obese rats from saline controls of blood samples taken 2-h following the 7th daily M.S. injection. These levels increased again by the end of the recovery period. No blood glucose or insulin changes were seen in the obese Zucker rats with morphine administration.(ABSTRACT TRUNCATED AT 250 WORDS)
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Thornhill JA, Taylor B, Marshall W, Parent K. Central, as well as peripheral naloxone administration suppresses feeding in food-deprived Sprague-Dawley and genetically obese (Zucker) rats. Physiol Behav 1982; 29:841-6. [PMID: 7156223 DOI: 10.1016/0031-9384(82)90334-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Food intake over 90 min post-injection was studied in groups of food deprived (20 hr) female Sprague-Dawley (S.D.) rats, fatty Zucker (fa/fa) rats and their heterozygous lean litter mates (Fa/fa) of various ages, that bar-pressed for food pellets on a FR-1 schedule following a subcutaneous (SC) or an intracerebroventricular (IVT) injection of sterile saline or naloxone HCl. Subcutaneous injections of naloxone HCl (10 mg/kg) reduced feeding in all three groups of rats compared to SC saline; in addition, a greater percentage reduction in food intake over the whole 90 min test period occurred in the fa/fa rats given SC naloxone compared to the Fa/fa group. Intracerebroventricular naloxone (50 micrograms) decreased feeding over the initial 30 min period in the S.D. and Fa/fa rats but a 100 micrograms IVT dose was needed to reduce feeding in the fa/fa group. The results demonstrate that central naloxone administration can suppress feeding in both non-obese and obese strains of rats as it is known to do when given peripherally. These findings add yet further evidence to the premise that endogenous opioid peptides may play an intricate and important physiological role in the regulation of feeding behavior.
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