Distribution of opioid peptide receptors in muscles of lean and obese-diabetic mice

The Clash of Two Epidemics: the Relationship Between Opioids and Glucose Metabolism

PURPOSE OF REVIEW

We are currently in the midst of a global opioid epidemic. Opioids affect many physiological processes, but one side effect that is not often taken into consideration is the opioid-induced alteration in blood glucose levels.

RECENT FINDINGS

This review shows that the vast majority of studies report that opioid stimulation increases blood glucose levels. In addition, plasma levels of the endogenous opioid β-endorphin rise in response to low blood glucose. In contrast, in hyperglycaemic baseline conditions such as in patients with type 2 diabetes mellitus (T2DM), opioid stimulation lowers blood glucose levels. Furthermore, obesity itself alters sensitivity to opioids, changes opioid receptor expression and increases plasma β-endorphin levels. Thus, opioid stimulation can have various side effects on glycaemia that should be taken into consideration upon prescribing opioid-based medication, and more research is needed to unravel the interaction between obesity, glycaemia and opioid use.

Transfection of rat cells with proopiomeranocortin gene, precursor of endogenous endorphin, using radial shock waves suppresses inflammatory pain

STUDY DESIGN

The effect of proopiomelanocortin (POMC) gene transfer with radial shock waves (RSW) was investigated in vitro and in vivo rat pain models.

OBJECTIVE

To examine the efficacy of POMC gene transfer with RSW, efficiency of beta-endorphin production in transfected cells, and its effects and side effects in pain models.

SUMMARY OF BACKGROUND DATA

Opioids have been used to treat chronic pain originating from knee osteoarthritis and the lower back; however, several side effects have been reported. Endogenous opioids are safe, but they are not used for clinical treatment because their metabolism is very fast.

METHODS

POMC plasmid was produced from pretransformed rat brain cDNA. POMC gene was added to the muscle of rat in vitro and in vivo with RSWs. We assessed beta-endorphin activity using immunohistochemistry. For assessment of pain behavior, we evaluated change in pain score and the level of the inflammatory neuropeptide, calcitonin gene-related peptide (CGRP), after transfection of the POMC gene in an adjuvant induced pain model for 28 days after treatment.

RESULTS

POMC transfected using RSW expressed beta-endorphin at a significantly increased level in muscle cells compared with non-RSW transfection and controls in vitro and in vivo (P < 0.05).Animals showed significant pain sensitivity and increased CGRP expression in dorsal root ganglia neurons in this model; however, these findings decreased for 14 days after transfection of POMC into muscle. There was no significant difference in side effects, such as a change in the level of food pellet intake or constipation, between POMC-treated animals and untreated animals.

CONCLUSION

POMC transfection with RSW increased beta-endorphin expression in muscle for 14 days, and suppressed pain behavior and CGRP expression in dorsal root ganglia neurons without side effects. This suggested that transfer of POMC by RSW is an effective treatment for inflammatory pain.

Beta-endorphin decreases fatigue and increases glucose uptake independently in normal and dystrophic mice

beta-Endorphin and a C-terminal analogue have been shown to decrease muscle fatigue and increase glucose uptake in muscles of normal mice. In order to provide evidence whether these peptides might be useful in muscle-wasting conditions and whether the two actions of the peptides are interdependent, the effect of beta-endorphin on muscle fatigue and glucose uptake was studied using isolated hemidiaphragm preparations of dystrophic mice as well as normal mice. Muscle contractions were elicited by high-frequency stimulation of the phrenic nerve. Glucose uptake was measured using (nonmetabolizable) 2-deoxy-D-[1-(3)H]glucose. beta-Endorphin and the C-terminal analogue reduced fatigue in normal muscles of males but not females. Insulin had no effect in either sex. The peptides increased 2-deoxyglucose uptake in contracting and noncontracting muscles of normal males and females. beta-Endorphin reduced fatigue and increased deoxyglucose uptake in dystrophic muscles. The effect on fatigue was not due to increased glucose uptake, as the energy substrate present was pyruvate. Nerve stimulation released beta-endorphin immunoreactivity from intramuscular nerves of dystrophic mice. It is hypothesized that beta-endorphin released from motor nerves as well as from the pituitary could be responsible for improving muscle function during exercise. beta-Endorphin or analogues could have therapeutic use in muscle-wasting disease.

Enteric co-innervation of motor endplates in the esophagus: state of the art ten years after

The existence of a distinct ganglionated myenteric plexus between the two layers of the striated tunica muscularis of the mammalian esophagus represented an enigma for quite a while. Although an enteric co-innervation of vagally innervated motor endplates in the esophagus has been repeatedly suggested, it was not possible until recently to demonstrate this dual innervation. Ten years ago, we were able to demonstrate that motor endplates in the rat esophagus receive a dual innervation from both vagal nerve fibers originating in the brain stem and from varicose enteric nerve fibers originating in the myenteric plexus. Since then, a considerable amount of data could be raised on enteric co-innervation and its occurrence in a variety of species, including humans, its neurochemistry, spatial relationships on motor endplates, ontogeny, and possible roles during esophageal peristalsis. These data underline the significance of this newly discovered innervation component, although its function is still largely unknown. The aim of this review is to summarize current knowledge about enteric co-innervation of esophageal striated muscle and to provide some hints as to its functional significance.

Opioid receptors in fast and slow skeletal muscles of normal and dystrophic mice

The density of beta-endorphin receptors and the proportions of fibres that expressed the receptors was assessed in fast extensor digitorum longus muscle and slow soleus muscles of normal and dystrophic mice using [125I]beta-endorphin and autoradiography. In the EDL the density was approximately 3.5 times higher and the proportion of labelled fibres approximately 2.6 times higher in dystrophic mice than normal mice. In the soleus the density was approximately 6.4 times higher and the proportion of labelled fibres approximately 1.5 times higher in the dystrophic mice than the normal mice. The receptors were of the delta-opioid subtype.

Enteric co-innervation of striated muscle fibers in the esophagus: just a "hangover"?

Striated muscle of the esophagus was until recently considered to consist of "classical" skeletal muscle fibers innervated by cholinergic vagal motoneurons. The recently described co-innervation originating from enteric neurons expressing nNOS, VIP, NPY, and galanin added a new dimension of complexity. The aim of this study was to summarize current knowledge about, and to get further hints as to the possible function of enteric co-innervation of striated esophageal muscle fibers. Aldehyde fixed rat esophagi were processed for immunocytochemistry for CGRP or VAChT (to demonstrate vagal motor terminals), nNOS/NADPH-d, VIP, NPY, and galanin (to demonstrate enteric terminals), met-enkephalin, mu opiate receptor, muscarinic receptors m1-3, soluble guanylyl cyclase, and cGMP dependent kinase type I and II. Motor endplates were visualized using fluorochrome tagged alpha-bungarotoxin to label nicotinic receptors, or with AChE histochemistry. Besides light and confocal laser scanning microscopy, immuno electron microscopy was also employed. Up to 80% of motor endplates were co-innervated. In addition to nNOS, VIP, NPY, and galanin, many enteric terminals in esophageal motor endplates expressed met-enkephalin. Some appeared to stain for the muscarinic m(2) receptor. There was prominent immunostaining for the micro opioid receptor in the sarcolemma at both junctional and extrajunctional sites. Immunostaining for soluble guanylyl cyclase was prominent immediately beneath the clusters of nicotinic receptors. Enteric varicosities and vagal terminals intermingled in motor endplates often without intervening teloglial processes. During ontogeny, initially high co-innervation rates were reduced to adult levels in a cranio-caudally progressing manner. We conclude that, in addition to a possible nitrergic, VIP-, NPY-, and galaninergic modulation of neuromuscular transmission by enteric neurons, opioidergic mechanisms could play a role. On the other hand, cholinergic influence on enteric neurons may be exerted also by the nucleus ambiguus via motor endplates, in addition to the input from the dorsal motor nucleus. The observations that enteric nerve fibers contact striated muscle fibers at specialized sites, i.e., motor endplates, and that these contacts appear in an ordered cranio-caudal sequence after cholinergic motor endplates have been established point to a specific function in neuronal control of esophageal muscle rather than to be an unspecific "hangover" from the smooth muscle past of this organ.

Expression of beta-endorphin and its receptors in the spinal cord of obese-diabetic ob/ob mice

Immunocytochemistry was used to demonstrate the presence of beta-endorphin, and quantitative autoradiography with [125I]beta-endorphin was used to study beta-endorphin binding sites, in spinal cord of lean and obese diabetic ob/ob mice. The proportion of beta-endorphin-positive neurones was approximately 6-fold higher in the ventral horn, and 2-fold higher in the dorsal horn of ob/ob mice than in lean controls. The maximum density of beta-endorphin binding sites was significantly higher in the dorsal horn and intermediate zone of ob/ob mice. The Kd value for the binding was similar in the ventral horn and intermediate zone in lean and ob/ob mice, but slightly lower in the dorsal horn of ob/ob mice. The findings indicate upregulation of both beta-endorphin and its receptors in spinal neurones of ob/ob mice.

Endogenous opiates: 1996

This paper is the nineteenth installment of our annual review of research concerning the opiate system. It summarizes papers published during 1996 reporting the behavioral effects of the opiate peptides and antagonists, excluding the purely analgesic effects, although stress-induced analgesia is included. The specific topics covered this year include stress, tolerance and dependence; eating; drinking; gastrointestinal, renal, and hepatic function; mental illness and mood; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical-related activity; general activity and locomotion; sex, pregnancy, and development; immunological responses; and other behaviors.

Effect of beta-endorphin C-terminal peptides on glucose uptake in isolated skeletal muscles of the mouse

The uptake of a nonmetabolizable derivative of glucose, [3H]2-deoxy-D-glucose was examined in isolated slow (soleus) and fast (extensor digitorum longus, EDL) muscles of adult mice. An analogue of beta-endorphin (28-31), Ac-Lys-D-Lys-Sar-Glu, which is stable to proteolytic digestion, enhanced the uptake of glucose into the slow and fast muscles. The muscles of male mice were more sensitive to the peptide than those of female mice. The maximum uptake seen in the presence of the peptide was similar to that seen with insulin in the soleus muscle and greater than that seen with insulin in the EDL muscle.

Actions of beta-endorphin peptides on the contractions of mouse diaphragm muscle

The effect of derivatives of beta-endorphin on the contractile response to indirect stimulation in mouse diaphragm muscle was studied to determine whether the action of the peptide to increase muscle tension is an opioid effect. beta-Endorphin (1-27), beta-endorphin (30-31), and a beta-endorphin (28-31) analogue all increased the amplitude of the contractions. The C-terminal peptides were more potent than beta-endorphin or beta-endorphin (1-27). The beta-endorphin (28-31) analogue, like beta-endorphin, decreased the time to peak but beta-endorphin (1-27) did not. The effect of beta-endorphin (1-27), but not that of the beta-endorphin (28-31) analogue, was blocked by naloxone. Thus, beta-endorphin acts on muscle via both opioid and nonopioid receptors.