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吗啡等阿片类镇痛药反复使用造成的镇痛耐受是临床上的一大难题。近期的研究表明,内皮素、P物质前体分子-前体速激肽及黑皮素等三种非阿片小肽与吗啡镇痛和耐受密切相关。内皮素通过内皮素A受体(ETAR)、黑皮素通过黑皮素4受体(MC4R)分别以不同机制调节吗啡镇痛并能够预防其耐受的发生,而前体速激肽则可能是调控吗啡镇痛和耐受的关键分子,本文综述了上述非阿片小肽对吗啡耐受调节的研究进展,以期为吗啡耐受的治疗提供新的思路。
Morphine and other opioid analgesics caused by repeated use of analgesic tolerance is a major clinical problem. Recent studies have shown that endothelin, substance P precursors - precursor tachykinins and melanocortin and other three non-opioid peptides are closely related to morphine analgesia and tolerance. Endothelin regulates morphine analgesia via a different mechanism via the endothelin A receptor (ETAR) and melanocortin through the melanocortin 4 receptor (MC4R), respectively, and is able to prevent its tolerance, whereas the precursor tachykinins are likely Is a key molecule that regulates morphine analgesia and tolerance. This review summarizes the progress in the regulation of morphine tolerance by the above non-opiate peptides, with a view to providing new ideas for the treatment of morphine intoxication.