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頁籤選單縮合
題名 | The Roles of Pain Facilitatory Systems in Opioid Tolerance=疼痛激活系統在類鴉片耐藥性所扮演之角色 |
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作者 | 許明滿; 汪志雄; Hsu, Ming-man; Wong, Chih-shung; |
期刊 | 麻醉學雜誌 |
出版日期 | 20000900 |
卷期 | 38:3 2000.09[民89.09] |
頁次 | 頁155-166 |
分類號 | 418.224 |
語文 | eng |
關鍵詞 | 疼痛激活系統; 類鴉片耐藥性; NMDA受器; 蛋白質激酶C:一氧化氮; 環氧化酶; 非類固醇抗發炎藥; Pain; Opioid; Drug tolerance; Receptors: N-methyl-D-aspartate; NMDA; Protein kinase C.; Nitric oxide; Anti-inflammatory agents: non-steroidal; |
中文摘要 | 數世紀以來,類鴉片為有效的止痛藥而且已被廣泛使用在臨床治療疼痛。然而,短期和長期使用類鴉片皆會產生耐藥性,意謂藥效減弱。Koom和Bloom提出藥物耐藥性之兩大可能機制:系統內與系統間。現較清楚類鴉片耐藥性之系統內機制:包括類鴉片受器與G蛋白失聯及類鴉片受器數目減少,特別是高親和力之受器的減少。近來,一系列有關系統間機制之研究,尤其是疼痛啟動系統,被認為也可能參與類鴉片耐藥性之形成。很多證據顯示,NMDA受器與PKC的活化和NO之生成可能扮演類鴉片耐藥性之系統間機制。最近,本實驗室與他人的研究也發現COX抑制劑也可以減低類鴉片耐藥性之產生,但并不含加強類鴉片之止痛效果。再者,由動物發炎模式之結果顯示NO可以影響COX酵素的活性。綜合上述的研究及證據,我們認為疼痛激活系統包括NMDA受器、NO、COX系統,可能在類鴉片耐藥性形成共同扮演重要的角色。總之,長期使用類鴉片產生耐藥性,除了類鴉片受器失聯及其高親和受器數目減少之外,同時也可能激活疼痛系統,這暗示著類鴉片受器,NMDA受器、NO、COX系統之間可能發生許多復雜的交互作用,是值得更進一步地研究與探討。 |
英文摘要 | Opioids are powerful analgesic agents and have been widely used in clinical pain management for decades. Nevertheless, both acute and chronic opioids administration may produce tolerance, as indicated by a lowered responsiveness to the drugs at a later time. Koob and Bloom described two possible mechanisms of drug tolerance: a within-system and a between-systems adaptation. Opioid receptors uncoupling from G-proteins and receptor down-regulation, in particular the receptor's high affinity sites, are well-known mechanisms (the within-system) of opioid tolerance. A series of recent studies have proposed that a between-systems, particularly the pain facilitatory systems (opiate-activated opponent systems), may also involve in the development of opioid tolerance. Several lines of evidence suggest that N-methyl-D-asparate (NMDA) receptors activation and the subsequent nitric oxide (NO) production probably play a between-systems mechanism of opioid tolerance. Recently, our and others' studies also found that cyclooxygenase (COX) inhibitors could attenuate the opioid tolerance without enhancing morphine's antinociceptive effect. Taking all these findings together, the pain facilitatory systems included the NMDA receptors, NO, and COX systems may also play important roles in opioid tolerance. In summary, except the opioid receptor uncoupling and opioid receptor down-regulation, chronic morphine treatment may also activate pain facilitatory systems QSMDA receptor activation, NO production, and COX ac-tivation) during opioid tolerance development. It implies that some complicated interactions may happen among the opioid receptor; NMDA-receptor, NO, and COX systems and are worth further investigations. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。