Epidural administration of large dose of opioid μ receptor agonist may impair cardiac functions and myocardial viability via desensitizing transient receptor potential vanilloid 1

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The incidence of postoperative myocardial injury remains high as the underlying pathogenesis is still unknown. The dorsal root ganglion (DRG) neurons express transient receptor potential vanilloid 1 (TRPV1) and its downstream effector, calcitonin gene-related peptide (CGRP) participating in transmitting pain signals and cardiac protection. Opioids remain a mainstay therapeutic option for moderate-to-severe pain relief clinically, as a critical component of multimodal postoperative analgesia via intravenous and epidural delivery. Evidence indicates the interaction of opioids and TRPV1 activities in DRG neurons. Here, we verify the potential impairment of myocardial viability by epidural usage of opioids in postoperative analgesia. We found that large dose of epidural morphine (50 μg) significantly worsened the cardiac performance (+dP/dtmax reduction by 11% and -dP/dtmax elevation by 24%, all P < 0.001), the myocardial infarct size (morphine vs Control, 0.54 ± 0.09 IS/AAR vs. 0.23 ± 0.06 IS/AAR, P < 0.001) and reduced CGRP in the myocardium (morphine vs. Control, 9.34 ± 2.24 pg/mg vs. 21.23 ± 4.32 pg/mg, P < 0.001), while induced definite suppression of nociception in the postoperative animals. It was demonstrated that activation of μ-opioid receptor (μ-OPR) induced desensitization of TRPV1 by attenuating phosphorylation of the channel in the dorsal root ganglion neurons, via inhibiting the accumulation of cAMP. CGRP may attenuated the buildup of ROS and the reduction of mitochondrial membrane potential in cardiomyocytes induced by hypoxia/reoxygenation. The findings of this study indicate that epidurally giving large dose of μ-OPR agonist may aggravate myocardial injury by inhibiting the activity of TRPV1/CGRP pathway.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:483

Enthalten in:

Toxicology and applied pharmacology - 483(2024) vom: 01. Feb., Seite 116802

Sprache:

Englisch

Beteiligte Personen:

Ma, Xiang [VerfasserIn]
Guo, Zheng [VerfasserIn]
Li, Mu-Rong [VerfasserIn]
Chen, Lu [VerfasserIn]
Zhao, Xing [VerfasserIn]
Wang, Tian-Qi [VerfasserIn]
Sun, Tao [VerfasserIn]

Links:

Volltext

Themen:

76I7G6D29C
Analgesics, Opioid
CAMP-Dependent PKA
Calcitonin Gene-Related Peptide
Cardiac Dysfunction
JHB2QIZ69Z
Journal Article
Morphine
Myocardial Injury
Opioids
Postoperative Analgesia
Receptors, Opioid, mu
TRPV Cation Channels

Anmerkungen:

Date Completed 14.02.2024

Date Revised 23.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.taap.2023.116802

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366748971