title: Morphine and remifentanil-induced cardioprotection: its experimental and clinical outcomes.
abstract: During the past few decades, a large number of animal studies demonstrated that commonly used opioids could provide cardioprotection against ischemia-reperfusion (I/R) injury. Opioid-induced preconditioning or postconditioning mimics ischemic preconditioning (I-Pre) or ischemic postconditioning (I-Post). Both δ- and κ-opioid receptors (OPRs) play a crucial role in opioid-induced cardioprotection (OIC). Down stream signaling effectors of OIC include ATP-sensitive potassium (K(ATP)) channels, protein kinase C (PKC), tyrosine kinase, phosphatidylinositol-3-kinase (PI3-kinase), extracellular signal regulated kinase1/2 (ERK1/2), glycogen synthase kinase-3β (GSK-3β), and mitochondrial permeability transition pore (MPTP), among others. Recently, various reports also suggest that opioids could provide cardioprotection in humans. This review will discuss OIC using mostly morphine and remifentanil which are widely used during cardiac anesthesia in addition to the clinical implications of OIC.
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University, Daegu, Korea.
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Kim
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Jang
authors.forename: Jun
authors.initials: J
authors.lastname: Kim