内生性オピオイドペプチドの局所鎮痛効果
C Stein1, A H Hassan, K Lehrberger
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
Lancet (London, England)
|August 7, 1993
まとめ
膝関節液中のオピオイドペプチドは,局所受容体を活性化することによって痛みを軽減します. これらの受容体を遮断すると,手術後の痛みが増加し,新しい外周疼痛緩和戦略を示唆します.
科学分野:
- 痛みに関する研究 痛みに関する研究
- 神経科学は神経科学である.
- 免疫学 免疫学とは
背景:
- オピオイドは,炎症した組織内の局所受容体に作用することで,痛みを和らげます.
- シノビア組織における内生性オピオイドペプチドの存在と機能は十分に理解されていません.
研究 の 目的:
- シノビア組織に内生性オピオイドペプチド (β-エンドルフィン,メット-エンケファリン,ダイノルフィン) の存在を調査する.
- これらのオピオイドペプチドが,関節内オピオイド受容体を通して痛みを抑制するかどうかを判断する.
- 術後の膝の痛みに対する関節内オピオイド受容体阻害の効果を評価する.
主な方法:
- 免疫ヒストロケミストリーは,シノビス炎の8人の患者のシノビアルサンプルにおけるオピオイドペプチドを検出するために使用されました.
- 膝関節顕微鏡手術を受けた22人の患者は,関節内または静脈内ナロキソン (オピオイド受容体ブロッカー) またはプラセボを受けるようにランダムに割り当てられました.
- 術後の痛みは,複数のスケールと24時間以上の鎮痛剤の消費を使用して評価されました.
主要な成果:
- シノビア組織サンプルでは,ベータエンドルフィンとメトエンケファリンに陽性な炎症細胞が示されました.
- 静脈内ナロキソン投与を受けた患者は,痛みのスコアが著しく高く,静脈内ナロキソン投与のグループと比較してより多くの鎮痛剤を摂取したと報告した.
- 疼痛スコアは,手術後の最初の4時間間に関節内ナロキソン群で有意に高かった.
結論:
- 内生性オピオイドペプチドは,炎症したシノビア組織に存在します.
- これらのペプチドは,関節内オピオイド受容体の活性化により,膝の手術による痛みを抑制します.
- 発見は,痛みのゲートコントロール理論を支持し,外周作用の鎮痛剤の開発を示唆しています.
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