title: Opioid peptides attenuate blood pressure increase in acute respiratory failure.
abstract: Plasma opioid peptides, norepinephrine, atrial natriuretic factor (ANF) and blood pressure (BP) were assessed in 24 chronic obstructive pulmonary disease patients with acute respiratory failure. Hypoxemic-hypercapnic patients had high BP, beta-endorphin, Met-enkephalin and dynorphin B, whereas hypoxemic-normocapnic and hypoxemic-hypocapnic patients showed normal BP, high beta-endorphin, and normal Met-enkephalin and dynorphin B. Norepinephrine and ANF were high in all patients, particularly in hypoxemic-hypercapnic patients. Infusion with the opioid antagonist naloxone hydrochloride significantly increased systolic blood pressure (SBP) in hypoxemic-hypercapnic (182.0 +/- 3.2 versus 205.1 +/- 3.0 mmHg; P < 0.01), hypoxemic-normocapnic (149.3 +/- 1.8 versus 169.1 +/- 2.2 mmHg; P < 0.01) and hypoxemic-hypocapnic (147.3 +/- 1.3 versus 166.8 +/- 2.2 mmHg; P < 0.01) patients, norepinephrine in hypoxemic-hypercapnic patients (3583.2 +/- 371.8 versus 5371.3 +/- 260.0 fmol/ml; P < 0.01), and reduced ANF in hypoxemic-normocapnic (18.3 +/- 0.8 versus 11.9 +/- 1.0 fmol/ml; P < 0.05) and hypoxemic-hypocapnic (18.1 +/- 1.2 versus 12.1 +/- 2.1 fmol/ml; P < 0.05) patients. These results indicate that the endogenous opioid system attenuates SBP responses in acute respiratory failure by affecting norepinephrine or ANF release.
authors: Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Ospedale S. Orsola, Via Massarenti 9, 40138, Bologna, Italy. ffontana@almadns.unibot.it
authors: F
authors: F
authors: Fontana
authors: P
authors: P
authors: Bernardi
authors: L
authors: L
authors: Tartuferi
authors: S
authors: S
authors: Boschi
authors: R
authors: R
authors: Di Toro
authors: S
authors: S
authors: Spampinato
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000494:pharmacology; D009638:Norepinephrine / Q000097:blood; D018847:Opioid Peptides / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D010919:Placebos; D012131:Respiratory Insufficiency / Q000503:physiopathology*
chemical_list: D018847:Opioid Peptides; D010919:Placebos; D009270:Naloxone; D009320:Atrial Natriuretic Factor; D009638:Norepinephrine