Endogenous opioid systems alterations in pain and opioid use disorder.

Endogenous opioid systems alterations in pain and opioid use disorder.
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内源性阿片类药物系统改变疼痛和阿片类药物使用障碍。

DOI:
10.3389/fnsys.2022.1014768
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发表时间:
2022
影响因子:
3
通讯作者:
Moron, Jose A.
Moron, Jose A.
中科院分区:
医学3区
文献类型:
--
作者:
Higginbotham, Jessica A.;Markovic, Tamara;Massaly, Nicolas;Moron, Jose A.

文献摘要

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几十年的研究进展已经确立了内源性阿片系统在调节奖励处理、情绪、动机、学习和记忆、胃肠功能和疼痛缓解方面的核心作用。内源性阿片系统普遍存在于中枢和周围神经系统。它们由四个家族组成,即μ (MOPR)、κ (KOPR)、δ (DOPR)和痛觉啡肽/孤啡肽FQ (NOPR)阿片受体系统。这些受体通过其内源性阿片肽β-内啡肽、啡肽、脑啡肽和痛觉肽的作用发出信号,以维持正常生理状态下的体内平衡。由于其在疼痛调节中的突出作用,外源性阿片类药物-主要针对MOPR,历来被用作医学上的镇痛药,但其产生欣快作用的能力也存在滥用的高风险。疼痛和阿片类药物使用扰乱内源性阿片类系统功能的能力,特别是在中枢神经系统内,可能增加发生阿片类药物使用障碍(OUD)的可能性。今天,阿片类药物危机是一个重大的社会、经济和公共卫生问题。在这篇综述中,我们总结了关于内源性阿片系统在疼痛中的功能、表达、药理学和调节的文献现状。此外,我们讨论了内源性阿片系统在使用外源性阿片时的适应性,这有助于OUD的发展。最后,我们描述了疼痛、内源性阿片类系统和阿片类药物滥用倾向之间的复杂关系,以及在产生更安全和更有效的疼痛治疗方面的潜在进展。
Decades of research advances have established a central role for endogenous opioid systems in regulating reward processing, mood, motivation, learning and memory, gastrointestinal function, and pain relief. Endogenous opioid systems are present ubiquitously throughout the central and peripheral nervous system. They are composed of four families, namely the μ (MOPR), κ (KOPR), δ (DOPR), and nociceptin/orphanin FQ (NOPR) opioid receptors systems. These receptors signal through the action of their endogenous opioid peptides β-endorphins, dynorphins, enkephalins, and nociceptins, respectfully, to maintain homeostasis under normal physiological states. Due to their prominent role in pain regulation, exogenous opioids—primarily targeting the MOPR, have been historically used in medicine as analgesics, but their ability to produce euphoric effects also present high risks for abuse. The ability of pain and opioid use to perturb endogenous opioid system function, particularly within the central nervous system, may increase the likelihood of developing opioid use disorder (OUD). Today, the opioid crisis represents a major social, economic, and public health concern. In this review, we summarize the current state of the literature on the function, expression, pharmacology, and regulation of endogenous opioid systems in pain. Additionally, we discuss the adaptations in the endogenous opioid systems upon use of exogenous opioids which contribute to the development of OUD. Finally, we describe the intricate relationship between pain, endogenous opioid systems, and the proclivity for opioid misuse, as well as potential advances in generating safer and more efficient pain therapies.
DOI: 10.1016/j.neuron.2010.03.002
发表时间: 2010-04-15
期刊: NEURON
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Baliki, Marwan N.;Geha, Paul Y.;Fields, Howard L.;Apkarian, A. Vania
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