title: Effects of chronic intrathecal infusion of a partial differential opioid agonist in dogs.
abstract: To define the effects of chronic spinal exposure to a highly selective partial differential opioid agonist c[DPen(2),DPen(5)]enkephalin (DPDPE), adult beagles were prepared with chronic lumbar intrathecal catheters. Groups of dogs received intrathecal infusions (100 micro l/h) of saline (vehicle), DPDPE 3 mg/ml or 6 mg/ml for 28 days. Over the 28-day period, saline or 3 mg/ml showed minimal changes in neurological function, whereas in the 6 mg/ml animals, prominent hind limb dysfunction evolved over the 28-day interval. Histopathology in control animals displayed a modest pericatheter reaction considered normal for this model. Dogs receiving DPDPE (three of four at 6 mg/ml and one of four at 3 mg/ml) but not saline (zero of four) developed large inflammatory masses (granulomas) in the intrathecal space located proximal to the catheter tip. In these masses, severe chronic inflammatory changes in combination with necrosis and fibrosis was detected. Occasional focal destruction of neuropil was detected also in the adjacent spinal cord parenchyma. These masses contained extensive accumulation of mouse antihuman macrophages (MAC)-positive inflammatory cells expressing tumor necrosis factor-alpha (TNF-alpha), revealing infiltration of macrophages, granulocytes, and monocytes. In separate animals, prepared with dual intrathecal catheters, lumbar CSF was sampled at specified time points following intrathecal bolus (3 mg/ml) and 24 h DPDPE infusion (3 mg/ml and 6 mg/ml). Steady-state cerebrospinal fluid (CSF) DPDPE levels were 18.6 +/- 1.0 and 22.6 +/- 4.0 micro g/ml for 3 mg/ml and 6 mg/ml infusions respectively. These results indicate that this partial differential opioid agonist DPDPE produces a concentration and time-dependent formation of an intrathecal inflammatory mass.
authors.affiliation: Department of Anesthesiology, University of California, San Diego, San Diego, California 92103, USA.
authors.forename: Kjersti
authors.initials: K
authors.lastname: Horais
authors.forename: Victor
authors.initials: V
authors.lastname: Hruby
authors.forename: Steven
authors.initials: S
authors.lastname: Rossi
authors.forename: Dasa
authors.initials: D
authors.lastname: Cizkova
authors.forename: Carol
authors.initials: C
authors.lastname: Meschter
authors.forename: Robert
authors.initials: R
authors.lastname: Dorr
authors.forename: Tony L
authors.initials: TL
authors.lastname: Yaksh
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D000818:Animals; D019540:Area Under Curve; D001522:Behavior, Animal / Q000187:drug effects*; D002408:Catheters, Indwelling; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D020881:Enkephalin, D-Penicillamine (2,5)- / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D005260:Female; D006099:Granuloma / Q000139:chemically induced* / Q000473:pathology; D007278:Injections, Spinal; D008297:Male; D009043:Motor Activity / Q000187:drug effects; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology; D013118:Spinal Cord Diseases / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000701:Analgesics, Opioid; D020881:Enkephalin, D-Penicillamine (2,5)-