The spinal basis of opioid tolerance and physical dependence: Involvement of calcitonin gene-related peptide, substance P, and arachidonic acid-derived metabolites.
Chronic opioid use in the management of pain is limited by development of analgesic tolerance and physical dependence. The mechanisms underlying tolerance-dependence are not entirely clear, however, recent evidence suggests that spinal adaptations leading to increased activity of sensory neuropeptides (calcitonin gene-related peptide (CGRP), substance P) and their downstream signaling messengers derived from metabolism of arachidonic acid: prostaglandins (PG), lipoxygenase (LOX) metabolites, and endocannabinoids, plays an important role in this phenomenon. In this communication we review the evidence implicating these factors in the induction and expression of opioid tolerance and physical dependence at the spinal level.
Trang
Tuan
T
Department of Pharmacology and Toxicology, Faculty of Health Sciences, Queen's University, Kingston, Ont., Canada K7L 3N6.
Quirion
Remi
R
Jhamandas
Khem
K
D000701:Analgesics, Opioid / Q000494:pharmacology; D000818:Animals; D001095:Arachidonic Acids / Q000378:metabolism / Q000502:physiology*; D015740:Calcitonin Gene-Related Peptide / Q000187:drug effects / Q000502:physiology*; D004361:Drug Tolerance; D006801:Humans; D008954:Models, Biological; D010147:Pain Measurement / Q000379:methods; D013116:Spinal Cord / Q000187:drug effects / Q000502:physiology*; D013373:Substance P / Q000187:drug effects / Q000502:physiology*
D000701:Analgesics, Opioid; D001095:Arachidonic Acids; D013373:Substance P; D015740:Calcitonin Gene-Related Peptide