Kappa-opioids produce significantly greater analgesia in women than in men
Kappa-opioids produce significantly greater analgesia in women than in men
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DOI：
10.1038/nm1196-1248
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发表时间：
1996-11-01
期刊：
影响因子：
82.9
通讯作者：
Levine, JD
中科院分区：
文献类型：
--
作者：
Gear, RW;Miaskowski, C;Levine, JD
人类对伤害性刺激和疼痛病理条件反应的性别差异通常表明，女性报告的疼痛水平高于男性，或对给定刺激强度的耐受性低于男性（参考文献1和2）。然而，研究尚未评估镇痛反应的性别差异。我们最近报道了阿片类激动剂-拮抗剂喷他佐辛，主要作用于κ受体，在接受手术切除第三磨牙（智齿）的患者中，女性术后镇痛效果明显优于男性（3，4）。在目前的研究中，我们评估了这种性别差异是κ阿片激动作用的一个特征的假设。为了确定是否存在与κ-阿片激动相关的性别差异，在接受第三磨牙拔除手术的男性和女性中比较了另外两种主要κ-阿片镇痛剂纳布啡和布托啡诺的镇痛疗效。我们发现，纳布啡和布托啡诺产生显着更大的镇痛作用，女性与男性相比。考虑到我们早期的研究结果，我们得出结论，κ阿片镇痛是女性比男性更大，可能反映了κ阿片激活的内源性疼痛调节电路的差异。
Sex differences in human responses to nociceptive stimuli and painful pathological conditions have generally indicated that women report higher pain levels or exhibit less tolerance than men for given stimulus intensities (reviewed in ref. 1 and 2). However, studies have not evaluated sex differences in analgesic responses. We recently reported the opioid agonist-antagonist that pentazocine, which acts predominantly at kappa-receptors, produced significantly better postoperative analgesia in females than in males(3,4) in patients who underwent surgery for the removal of their third molars (wisdom teeth). In the current study, we evaluated the hypothesis that this sex difference is a characteristic of kappa-opioid agonism. In order to determine whether there are sex differences associated with kappa-opioid agonism, the analgesic efficacy of two other predominantly kappa-opioid analgesics, nalbuphine and butorphanol, was compared in males and females who underwent surgery for the removal of third molar teeth. We found that both nalbuphine and butorphanol produced significantly greater analgesia in females as compared with males. Considering our earlier findings, we conclude that kappa-opioid analgesia is greater in females than in males, probably reflecting a difference in kappa-opioid-activated endogenous pain modulating circuits.