Literature DB >> 22504149

Local anesthetic-like inhibition of voltage-gated Na(+) channels by the partial μ-opioid receptor agonist buprenorphine.

Andreas Leffler1, Georg Frank, Katrin Kistner, Florian Niedermirtl, Wolfgang Koppert, Peter W Reeh, Carla Nau.   

Abstract

BACKGROUND: Opioids induce analgesia mainly by inhibiting synaptic transmission via G protein-coupled opioid receptors. In addition to analgesia, buprenorphine induces a pronounced antihyperalgesia and is an effective adjuvant to local anesthetics. These properties only partially apply to other opioids, and thus targets other than opioid receptors are likely to be employed. Here we asked if buprenorphine inhibits voltage-gated Na(+) channels.
METHODS: Na(+) currents were examined by whole cell patch clamp recordings on different recombinant Na(+) channel α-subunits. The effect of buprenorphine on unmyelinated mouse C-fibers was examined with the skin-nerve preparation. Data are presented as mean ± SEM.
RESULTS: Buprenorphine induced a concentration-dependent tonic (IC(50) 33 ± 2 μM) and use-dependent block of endogenous Na(+) channels in ND7/23 cells. This block was state-dependent and displayed slow on and off characteristics. The effect of buprenorphine was reduced on local anesthetic insensitive Nav1.4-mutant constructs and was more pronounced on the inactivation-deficient Nav1.4-WCW mutant. Neuronal (Nav1.3, Nav1.7, and Nav1.8), cardiac (Nav1.5), and skeletal muscle (Nav1.4) α-subunits displayed small differences in tonic block, but similar degrees of use-dependent block. According to our patch clamp data, buprenorphine blocked electrically evoked action potentials in C-fiber nerve terminals. Buprenorphine was more potent than other opioids, including morphine (IC(50) 378 ± 20 μM), fentanyl (IC(50) 95 ± 5 μM), sufentanil (IC(50) 111 ± 6 μM), remifenatil (IC(50) 612 ± 17 μM), and tramadol (IC(50) 194 ± 9 μM).
CONCLUSIONS: Buprenorphine is a potent local anesthetic and blocks voltage-gated Na(+) channels via the local anesthetic binding site. This property is likely to be relevant when buprenorphine is used for pain treatment and for local anesthesia.

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Year:  2012        PMID: 22504149     DOI: 10.1097/ALN.0b013e3182557917

Source DB:  PubMed          Journal:  Anesthesiology        ISSN: 0003-3022            Impact factor:   7.892


  23 in total

Review 1.  Neurotoxicity of common peripheral nerve block adjuvants.

Authors:  Joshua B Knight; Nicholas J Schott; Michael L Kentor; Brian A Williams
Journal:  Curr Opin Anaesthesiol       Date:  2015-10       Impact factor: 2.706

Review 2.  Adjuvant Agents in Regional Anesthesia in the Ambulatory Setting.

Authors:  Veerandra Koyyalamudi; Sudipta Sen; Shilpadevi Patil; Justin B Creel; Elyse M Cornett; Charles J Fox; Alan D Kaye
Journal:  Curr Pain Headache Rep       Date:  2017-01

Review 3.  [Background and current use of adjuvants for regional anesthesia : From research to evidence-based patient treatment].

Authors:  M Schäfer; S A Mousa; M Shaqura; S Tafelski
Journal:  Anaesthesist       Date:  2019-01       Impact factor: 1.041

4.  The opioid methadone induces a local anaesthetic-like inhibition of the cardiac Na⁺ channel, Na(v)1.5.

Authors:  V Schulze; C Stoetzer; A O O'Reilly; E Eberhardt; N Foadi; J Ahrens; F Wegner; A Lampert; J de la Roche; A Leffler
Journal:  Br J Pharmacol       Date:  2014-01       Impact factor: 8.739

Review 5.  [Update on the pharmacology and effects of local anesthetics].

Authors:  J Ahrens; A Leffler
Journal:  Anaesthesist       Date:  2014-05       Impact factor: 1.041

Review 6.  Treating Chronic Pain: An Overview of Clinical Studies Centered on the Buprenorphine Option.

Authors:  Mellar P Davis; Gavril Pasternak; Bertrand Behm
Journal:  Drugs       Date:  2018-08       Impact factor: 9.546

7.  Comparison of intrathecal dexmedetomidine with buprenorphine as adjuvant to bupivacaine in spinal asnaesthesia.

Authors:  Mahima Gupta; S Shailaja; K Sudhir Hegde
Journal:  J Clin Diagn Res       Date:  2014-02-03

8.  Knee strength retention and analgesia with continuous perineural fentanyl infusion after total knee replacement: randomized controlled trial.

Authors:  Devanand Mangar; Rachel A Karlnoski; Collin J Sprenker; Katheryne L Downes; Narrene Taffe; Robert Wainwright; Kenneth Gustke; Thomas L Bernasek; Enrico Camporesi
Journal:  J Anesth       Date:  2013-08-25       Impact factor: 2.078

9.  Local Anesthetic Peripheral Nerve Block Adjuvants for Prolongation of Analgesia: A Systematic Qualitative Review.

Authors:  Meghan A Kirksey; Stephen C Haskins; Jennifer Cheng; Spencer S Liu
Journal:  PLoS One       Date:  2015-09-10       Impact factor: 3.240

10.  Inhibition of voltage-gated sodium channels by sumatriptan bioisosteres.

Authors:  Roberta Carbonara; Alessia Carocci; Julien Roussel; Giuseppe Crescenzo; Canio Buonavoglia; Carlo Franchini; Giovanni Lentini; Diana Conte Camerino; Jean-François Desaphy
Journal:  Front Pharmacol       Date:  2015-07-24       Impact factor: 5.810

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