Plasma beta-endorphin-like immunoreactivity, self reported pain perception and anxiety levels in women during pregnancy and labor

Nociceptive stimulus induces release of endogenous beta-endorphin in the rat brain

The hypothesis that the naturally occurring analgesic peptide, beta-endorphin, is released in the brain in response to pain had never been directly validated. In this study, we applied a brain microdialysis method for monitoring beta-endorphin release in vivo, to test this hypothesis in the brains of conscious, freely moving rats. Herein we first show that endogenous beta-endorphin can be measured in vivo in the brain under physiological conditions. Upon induction of a nociceptive stimulus by injection of formalin into the hind-paws of rats, the extracellular levels of beta-endorphin in their arcuate nucleus increased by 88%, corresponding to their nociceptive response. This direct evidence for the release of endogenous beta-endorphin in the brain in response to nociceptive stimulus indicates a possible mechanism for organisms to cope with pain.

Labor analgesia and infant brain development

A large percentage of newborns are exposed to pharmacological agents that affect the brain in connection with pain management during labor. The two most commonly used agents are meperidine, administered intravenously or intramuscularly, and bupivacaine, administered by the epidural route. Over the years, infant behavioral assessments have been used in the neonatal nursery to identify labor analgesia regimens with minimal impact on neonatal status. However, considerable controversy has centered on the general issue of possible harm to the neonate from use of analgesia and anesthesia in obstetrics. Due to limitations on experiments in the obstetric situation and a lack of suitable animal models, the broader issues concerning the effects of these agents on the developing brain and possible long-term consequences for infant adaptive functioning have received little attention. A series of studies has recently been completed using a rhesus monkey model for administration of labor analgesia under controlled experimental conditions and long-term behavioral evaluation of infants. Most of the assessments, including those of cognitive function, were not influenced by perinatal analgesia. However, these studies have confirmed the neonatal depressant effects of meperidine and have suggested that the course of behavioral maturation during certain periods of infancy is influenced by both meperidine and bupivacaine administration at birth. These effects could occur as a result of effects on vulnerable brain processes during a sensitive period, interference with programming of brain development by endogenous agents, or alteration in early experiences.

A biotin-avidin-based enzyme immunoassay for beta h-endorphin

An avidin-biotin enzyme-linked immunosorbent assay (ELISA) is described for beta h-endorphin (beta h-EP). Microtiter plates coated with commercially available antibodies were used together with beta h-EP tracer derivatives that were biotinylated in positions 24, 28, and 29 via a C6 spacer arm. Nonspecific binding of biotinylated derivatives to the microtiter plates was blocked with a mixture of 1% casein and 10% ethanolamine in 0.1 M NaHCO3. A sequential saturation procedure using a high-affinity antiserum in combination with an avidin-alkaline phosphatase complex matched the sensitivity of reported radioimmunoassays (RIAs), with a detection limit of 0.5 fmol/assay. The intra- and interassay coefficients of variation were 5 and 12%, respectively. Results obtained by ELISA and RIA showed good correlations (r = 0.95). The beta-EP concentration in extracted rat plasma after high-performance liquid chromatographic (HPLC) fractionation was determined by this method to be 1600 fmol/mol.

Human beta-casomorphin-8 immunoreactive material in the plasma of women during pregnancy and after delivery

A method for the extraction of human beta-casomorphin-8 immunoreactive material from human plasma and a radioimmunoassay for its determination in the plasma extracts were developed. Blood was collected from 34 men, from 35 non-pregnant women, from 35 pregnant women and from 138 women after delivery and plasma extracts were assayed for the presence of human beta-casomorphin-8 immunoreactive materials. No human beta-casomorphin-8 immunoreactive material was detected in the plasma of men or non-pregnant women, whereas such material was found in the plasma of 26 out of 35 pregnant women and in the plasma of 100 out of 138 women after parturition. Material collected from women after delivery was characterized by gel filtration and high-performance liquid chromatography (HPLC) and was found to be of different composition in various individuals; its components, one of which coeluted with human beta-casein from the HPLC column, have apparently higher molecular weights than human beta-casomorphin-8. Some of these compounds seem to be very stable against enzymatic degradation at 37 degrees C in human plasma, whereas human beta-casomorphin-8 proved to be degraded very fast under identical conditions. A physiological significance of mammary products of the beta-casomorphin type during pregnancy or after parturition is suggested.

Plasma endogenous opioids and dexamethasone suppression test in depression

Plasma levels of beta-endorphin plus beta-lipotropin were determined in 35 hospital patients with depression and in 23 controls before and after administration of 1 mg of dexamethasone (dxm). Dxm suppressed opioid secretion in both groups. The opioid levels of the patients were significantly higher than those of the controls both before and after dxm. All the controls were cortisol suppressors. Among the patients the post-dxm opioid levels of cortisol nonsuppressors (n = 14) were higher than those of cortisol suppressors (n = 21). A significant correlation between the opioid and cortisol levels was found in the patients. There was a significant association between the use of neuroleptics and high opioid levels, but the difference between the patients and the controls was not explained by the effect of any single class of drugs. The results support the concept of hypersecretion of corticotropin-releasing factor in depression.

Determination of β-Endorphin and Fragments Thereof in Human Plasma Using High-Performance Liquid Chromatography and a Multiple Radioimmunoassay System

A method for the determination of β-endorphin and β-endorphin fragments in human plasma was developed. β-Endorphin-related peptides were extracted from plasma using octadecasilyl-silica cartridges. Extracts were subjected to re versed-phase high-performance liquid chromatography (HPLC). Extracts as well as HPLC column eluates were assayed using a multiple radioimmunoassay system; several antibodies directed against various distinct regions of the β-endorphin molecule were employed. Using this method, evidence for the presence of multiple β-endorphin fragments in the plasma of healthy young volunteers (under normal conditions) was obtained.

The effect of naloxone administration on pregnancy-associated seizures

Pregnant mice are more susceptible to flurothyl-induced seizures than are non-pregnant controls. The possibility that the well-known increase in beta-endorphin concentration which accompanies pregnancy was involved in this effect was examined by testing whether naloxone administration could block the increased seizure susceptibility. Pregnant female, control female and male C3H mice were treated with 5-50 mg/kg naloxone 5 min before flurothyl seizure testing. Naloxone markedly increased clonic seizure susceptibility in all three groups at a dose of 50 mg/kg, but had little effect at lower doses. In contrast, naloxone had differential effects on myoclonic seizures in pregnant and control female mice, being anticonvulsant in the controls, but proconvulsant in the pregnant mice. A role for endogenous opiates is unlikely in mediating clonic seizures in pregnant mice, but may be involved in myoclonic seizures.

Opiates, endorphins, and the developing organism: a comprehensive bibliography, 1982-1983

A comprehensive bibliography of the literature concerned with opiates, endorphins, and the developing organism for 1982 and 1983 is presented. Utilized with a companion paper (Neurosci Biobehav Rev 6: 439-479, 1982) these articles cover clinical and laboratory references beginning in 1875. For the years 1982 and 1983, a total of 385 citations was recorded. A series of indexes accompanies the citations in order to make the literature more accessible. These indexes are divided into clinical and laboratory topics. The clinical section is subdivided into: age of subject examined, maternal aspects, the fetus, and the offspring. The laboratory section is subdivided into: type of opiate/endorphin studied, species utilized, and major subject areas explored.

beta-Endorphin immunoreactive materials in human plasma determined by a multiple radioimmunoassay system

Extracts of plasma obtained from adult humans before and immediately after physical stress were subjected to high pressure liquid chromatography (HPLC); extracts or HPLC fractions, resp., were analysed for the presence of human beta-endorphin (beta H-endorphin) or fragments thereof by several radioimmunoassays using antibodies directed against the C-terminus and two "middle" regions of beta H-endorphin. Using an antibody ("Don Antonio") apparently directed against a beta H-endorphin fragment including positions 17 to 22 or somewhat adjacent regions, concentrations of beta H-endorphin immunoreactivity were found to be in the well-known range under normal conditions and to increase after physical stress. However, only a minor portion of this material proved to be identical with beta H-endorphin, whereas the major portion behaved like a smaller fragment thereof. In addition, high amounts of an immunoreactive material obviously containing a C-terminal sequence of beta H-endorphin were found, indicating the presence of an immunologically relevant beta H-endorphin fragment in the plasma.