The spinal basis of opioid tolerance and physical dependence: Involvement of calcitonin gene-related peptide, substance P, and arachidonic acid-derived metabolites

Peptides. 2005 Aug;26(8):1346-55. doi: 10.1016/j.peptides.2005.03.031. Epub 2005 Apr 13.

Abstract

Chronic opioid use in the management of pain is limited by development of analgesic tolerance and physical dependence. The mechanisms underlying tolerance-dependence are not entirely clear, however, recent evidence suggests that spinal adaptations leading to increased activity of sensory neuropeptides (calcitonin gene-related peptide (CGRP), substance P) and their downstream signaling messengers derived from metabolism of arachidonic acid: prostaglandins (PG), lipoxygenase (LOX) metabolites, and endocannabinoids, plays an important role in this phenomenon. In this communication we review the evidence implicating these factors in the induction and expression of opioid tolerance and physical dependence at the spinal level.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics, Opioid / pharmacology
  • Animals
  • Arachidonic Acids / metabolism
  • Arachidonic Acids / physiology*
  • Calcitonin Gene-Related Peptide / drug effects
  • Calcitonin Gene-Related Peptide / physiology*
  • Drug Tolerance
  • Humans
  • Models, Biological
  • Pain Measurement / methods
  • Spinal Cord / drug effects
  • Spinal Cord / physiology*
  • Substance P / drug effects
  • Substance P / physiology*

Substances

  • Analgesics, Opioid
  • Arachidonic Acids
  • Substance P
  • Calcitonin Gene-Related Peptide