Z Rheumatol 2001 Dec;60(6):416-24
Peripheral
analgesic and antiinflammatory effects of opioids.
Stein C, Machelska H, Schafer M
Department of Anesthesiology
and Critical Care Medicine, Klinikum Benjamin
Franklin Freie Universitat Berlin Hindenburgdamm 30,
12000 Berlin, Germany. cstein@medizin.fu-berlin.de
[Medline record in process]
Traditionally, opioids were
considered the prototype of centrally acting
analgesics. In the past decade a substantial
literature has emerged demonstrating that opioids
can produce potent and clinically measurable analgesia
by activation of opioid receptors on peripheral
terminals of primary sensory neurons. In addition,
endogenous ligands of these peripheral receptors
were discovered in immune cells. Major recent
findings in peripheral opioid analgesia include the relative lack of tolerance under
inflammatory conditions, tetrapeptides as novel
peripherally restricted compounds, the potent
antiinflammatory activity of mu- and kappa-agonists
and the identification of selectins as important
molecules governing the homing of opioid cells to
injured tissue. In addition to the extensively
documented efficacy of locally applied morphine in
post-surgical pain, clinical studies have now moved
into the field of chronic arthritic pain.
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