DOI
https://doi.org/10.25772/VKJ5-CV11
Defense Date
2019
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Pharmacology & Toxicology
First Advisor
Hamid Akbarali
Abstract
Opioids are powerful analgesics. Despite their high efficacy for the management of moderate to severe pain, their clinical utility is limited due to the occurrence of adverse effects. The main problem associated with opioid use is the differential rate of tolerance development to the various pharmacological effects of opioids, with tolerance to respiratory depression occurring at a slower rate than analgesic and euphoric effects. The development of analgesic tolerance, where the efficacy of the drug progressively diminishes with repeated administration, requires higher doses of the drug to achieve a maximum effect. Reports have implicated inflammation as a major driver of analgesic tolerance development. With surmounting evidence that the prototypical opioid, morphine induces pro-inflammatory cytokine release in the brain, spinal cord, and gastrointestinal tract, a question arises of whether pro-inflammatory cytokine release in the gut as a result of chronic morphine treatment is paralleled with the development of morphine antinociceptive tolerance. This dissertation investigated the rate at which antinociceptive tolerance to various doses of morphine developed to a different degree in the presence of colonic inflammation. Using a mouse model, colonic inflammation was induced with 2,4,6-Trinitrobenzenesulfonic acid (TNBS) and then the mice were pelleted with 25 mg, 50 mg (2x25), or 75 mg morphine pellet. Antinociceptive tolerance to morphine was determined in a warm-water tail-immersion assay upon an administration of a morphine challenge dose (10 mg/kg). Inflammatory cytokine expressions and protein levels were measured from whole colon using qPCR and ELISA, respectively. Morphine antinociceptive tolerance was significantly enhanced in the presence of colonic inflammation in a dose and time dependent manner. With a daily injection of 0.5 mg/kg peripheral opioid receptor antagonist 6β-N-heterocyclic substituted naltrexamine derivative (NAP), mice pelleted with 25 mg, 50 mg (2x25), or 75 mg morphine pellets were tested on day 5, 4, or 3, respectively. Tolerance to morphine as well as the enhanced tolerance observed in the presence of colonic inflammation was prevented with daily NAP treatment. However, NAP did not block morphine-induced or TNBS-induced inflammation. Collectively, our findings indicate that inflammation is a major modulator of morphine antinociceptive tolerance and peripheral opioid receptors may be responsible for mediating antinociceptive tolerance.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
5-7-2019