Opiate receptor-mediated mechanisms in the regulation of cerebral blood flow.

Z Benyó, M Wahl
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引用次数: 0

Abstract

Endogenous opioid peptides are present in cerebral perivascular nerves and in the CSF, and their concentrations are changing in response to stimuli that activate regulatory mechanisms of the cerebral circulation (e.g., alterations of the perfusion pressure or changes of the arterial O2 tension). Opiate receptors are expressed in the cells of the CNS and the cerebrovascular bed, and their activation modulates the function of other vasoregulatory mechanisms (i.e., the autonomic nervous system, nitric oxide, prostanoids, vasopressin) that are involved in the control of the cerebrovascular tone. The direct vasomotor effects of opioid peptides and opiates on the cerebral arteries under in vitro or in situ conditions appear to be weak or absent in several species. However, Met- and Leu-enkephalin induce pial arterial vasodilation in the newborn pig. In this species, beta-endorphin acts as a constrictor, whereas dynorphin may induce either dilation or constriction depending on the experimental conditions. The influence of exogenously applied natural and synthetic opioids on the cerebral blood flow (CBF) is determined mainly by their metabolic, neuronal, and respiratory effects. Hypothalamic and pituitary circulations are especially sensitive to opioids. Under resting conditions, endogenous opioid peptides do not participate in the regulation of the cerebrovascular tone and CBF. On the other hand, mu and delta opiate receptor stimulation by endogenous opioid peptides, interacting with other vasoactive factors, obviously contributes to the hypoxia- and hypercapnia-induced cerebral vasodilation. Furthermore, endogenous opioid mechanisms are involved in the autoregulation of the hypothalamic blood flow. Thus, the endogenous opioid system may well represent a latent regulatory mechanism, which is of limited importance under basal conditions, but becomes more important under conditions of stress. Synthetic exogenous opioids do not appear to influence the hypoxic or hypercapnic CBF responses or the cerebral autoregulatory process.

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阿片受体介导的脑血流调节机制。
内源性阿片肽存在于脑血管周围神经和脑脊液中,其浓度随着刺激激活脑循环的调节机制而变化(例如,灌注压的改变或动脉氧张力的改变)。阿片受体在中枢神经系统和脑血管床细胞中表达,它们的激活可调节其他参与脑血管张力控制的血管调节机制(即自主神经系统、一氧化氮、前列腺素、血管加压素)的功能。在体外或原位条件下,阿片肽和阿片类药物对大脑动脉的直接血管舒缩作用在一些物种中似乎很弱或没有。然而,蛋氨酸和亮氨酸脑啡肽可诱导新生猪的动脉血管舒张。在这个物种中,-内啡肽作为收缩剂,而动力啡则根据实验条件诱导扩张或收缩。外源性天然和合成阿片类药物对脑血流量(CBF)的影响主要取决于它们的代谢、神经元和呼吸作用。下丘脑和垂体循环对阿片类药物特别敏感。静息状态下,内源性阿片肽不参与脑血管张力和脑血流的调节。另一方面,内源性阿片肽刺激mu和delta阿片受体,与其他血管活性因子相互作用,明显有助于低氧和高碳酸血症诱导的脑血管舒张。此外,内源性阿片机制参与了下丘脑血流的自动调节。因此,内源性阿片系统很可能代表了一种潜在的调节机制,在基础条件下作用有限,但在应激条件下变得更加重要。合成外源性阿片类药物似乎不影响低氧或高碳酸血症CBF反应或大脑自调节过程。
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