The role of spinal cholecystokinin in chronic pain states.
It is well established that cholecystokinin (CCK) reduces the antinociceptive effect of opioids. The level of CCK and CCK receptors, as well as CKK release, exhibits considerable plasticity after nerve injury and inflammation, conditions known to be associated with chronic pain. Such altered CCK release coupled in some situation with changes in CCK receptor levels may underlie the clinical phenomenon of varying opioid sensitivity in different clinical pain conditions. In particular, neuropathic pain after injury to the peripheral and central nervous system does not respond well to opioids, which is likely to be caused by increased activity in the endogenous CCK system. CCK receptor antagonists may thus be useful as analgesics in combination with opioids to treat neuropathic pain.
Wiesenfeld-Hallin
Zsuzsanna
Z
Department of Medical Laboratory Sciences and Technology, Section of Clinical Neurophysiology, Huddinge University Hospital, Stockholm, Sweden. zsuzsanna.wiesenfeldhallin@neurophys.hs.sll.se
Xu
Xiao-Jun
XJ
Hökfelt
Tomas
T
D000698:Analgesia; D000818:Animals; D002766:Cholecystokinin / Q000009:adverse effects / Q000134:cerebrospinal fluid / Q000502:physiology; D002908:Chronic Disease; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D009020:Morphine / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D010146:Pain / Q000209:etiology*; D051381:Rats; D011949:Receptors, Cholecystokinin / Q000037:antagonists & inhibitors / Q000187:drug effects / Q000502:physiology; D013119:Spinal Cord Injuries / Q000378:metabolism; D001615:beta-Endorphin / Q000037:antagonists & inhibitors* / Q000627:therapeutic use
D011949:Receptors, Cholecystokinin; D001615:beta-Endorphin; D009020:Morphine; D002766:Cholecystokinin