Assuntos
Catecolaminas/metabolismo , Cavalos/metabolismo , Hidrocortisona/sangue , Peptídeos/análise , Hipófise/metabolismo , Hormônio Adrenocorticotrópico/sangue , Hormônio Adrenocorticotrópico/líquido cefalorraquidiano , Animais , Arginina Vasopressina/sangue , Arginina Vasopressina/líquido cefalorraquidiano , Catecolaminas/sangue , Catecolaminas/líquido cefalorraquidiano , Cateterismo/veterinária , Cromatografia Líquida de Alta Pressão/veterinária , Dopamina/sangue , Dopamina/líquido cefalorraquidiano , Dinorfinas/sangue , Dinorfinas/líquido cefalorraquidiano , Encefalina Metionina/sangue , Encefalina Metionina/líquido cefalorraquidiano , Feminino , Cavalos/sangue , Cavalos/líquido cefalorraquidiano , Masculino , Norepinefrina/sangue , Norepinefrina/líquido cefalorraquidiano , Peptídeos/sangue , Peptídeos/líquido cefalorraquidiano , Radioimunoensaio/veterinária , Valores de Referência , beta-Endorfina/sangue , beta-Endorfina/líquido cefalorraquidianoRESUMO
Fibromyalgia is a chronic debilitating condition of unknown etiology. The clinical picture suggests increased activity and/or supersensitivity in nociceptive pathways or inadequate activity in endogenous pain attenuation mechanisms. One therapeutic approach in the treatment of this syndrome is the administration of serial local injections of lidocaine hydrochloride in the painful points. To evaluate the effect of this treatment on plasma met-enkephalin (ME) levels we studied 15 patients, all women with fibromyalgia under local treatment in the tender points, grouped as follows: 5 were treated with local injection of lidocaine hydrochloride, 5 were treated with local injection of saline and 5 treated with dry needling. Significant increases in plasma ME concentrations were observed in all groups in the last sampling of each session studied. These results show an increase in plasma ME levels 10 minutes after finishing each session, which is independent of the maneuver employed.
Assuntos
Encefalina Metionina/sangue , Fibromialgia/sangue , Fibromialgia/tratamento farmacológico , Adulto , Anestésicos Locais/administração & dosagem , Anestésicos Locais/uso terapêutico , Feminino , Humanos , Lidocaína/administração & dosagem , Lidocaína/uso terapêutico , Masculino , Pessoa de Meia-Idade , Medição da DorRESUMO
In order to explore opioid, sympathetic and hormonal parameters, we evaluated plasma met-enkephalin (ME), catecholamines (CA), estradiol (E2) and progesterone (P) in different phases of the menstrual cycle and during menstrual crisis in women suffering from menstrual migraine (MM) and in controls. No differences in P and E2 were found between controls and patients. We observed an increase in plasma ME and a decrease in plasma free norepinephrine (NE) levels on day 22 in MM group and an increase in plasma ME, free NE and total epinephrine (E) during pain. Our data, although obtained in a small number of patients, show clear modifications in plasma ME and in the sympathoadrenal function, not only during pain but also in the mid luteal phase.
Assuntos
Catecolaminas/sangue , Encefalina Metionina/sangue , Menstruação , Transtornos de Enxaqueca/sangue , Dor/sangue , Adulto , Estradiol/sangue , Feminino , Humanos , Ciclo Menstrual , Progesterona/sangueRESUMO
This study was undertaken to evaluate the effect of treatment with prednisone or verapamil on plasma met-enkephalin (ME), neutrophil met-enkephalin containing peptides (NMECP) and free and conjugated plasma catecholamines (CA) in cluster headache (CH) patients. After obtaining a basal sample, patients were randomly selected to be treated with either verapamil (n = 5) or prednisone (n = 5). A second blood sample was obtained 10 days after starting treatment. At this time all patients were free of symptoms. ME (0.49 +/- 0.10 pmol/mL) and NMECP (35.1 +/- 2.4 pmol/mg protein) levels after prednisone treatment were significantly higher (P < 0.05) than in basal conditions (0.29 +/- 0.08 pmol/mL and 27.14 +/- 2.4 pmol/mg protein), while no differences were found in catecholamine levels. No differences in ME, NMECP or CA were found during verapamil treatment. Our results suggest that in CH the two drugs act through different mechanisms. The relief of the bout obtained with prednisone may be related to the opioid system stimulation observed in these patients.
Assuntos
Catecolaminas/sangue , Cefaleia Histamínica/tratamento farmacológico , Encefalina Metionina/sangue , Prednisona/uso terapêutico , Sistema Nervoso Simpático/metabolismo , Verapamil/uso terapêutico , Cefaleia Histamínica/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Neutrófilos/metabolismo , Peptídeos/sangueRESUMO
We have previously demonstrated an increase in plasma met-enkephalin levels during the pain attacks in episodic cluster headache. The present study was undertaken in order to clarify the source of the plasma met-enkephalin increase. Recent evidence has shown that peripheral blood polymorphonuclear cells contain peptides derived from the proenkephalin A system, which can be released by specific stimuli. We studied neutrophil met-enkephalin containing peptides (NMECP) in 27 episodic cluster headache patients: 24 in a cluster period (6 of them during a pain attack), and 3 in the remission period. Neutrophil met-enkephalin containing peptide levels (after sequential enzymatic digestion with trypsin and carboxypeptidase B) were determined by radioimmunoassay with specific antiserum. Neutrophil peptide concentration (pmol/mg prot) was lower (p less than 0.01) in patients during the pain attack (14.4 +/- 0.36) than after their pain had subsided (36.7 +/- 0.31) and lower than in the remission period patients (35.8 +/- 0.4). We conclude that neutrophil met-enkephalin containing peptides decrease during pain in episodic cluster headache, and that they may be involved in the concomitant plasma met-enkephalin increase.
Assuntos
Cefaleia Histamínica/sangue , Encefalina Metionina/sangue , Neutrófilos/química , Peptídeos/sangue , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Since high levels of endogenous opioids (endorphins, enkephalins) were found in brain areas classically related to nociception, their peripheral levels in humans were studied in different pain syndromes yielding contradictory results. This study was undertaken to assess changes in plasma methionine-enkephalin (met-enkephalin) levels in patients with episodic cluster headache associated with the pain period. Twenty-nine patients, 24 in the cluster period (6 of them during an attack) and 3 in the remission period were studied. Two other patients were subjected to a longitudinal follow-up. Plasma met-enkephalin levels were determined by radioimmunoassay (RIA) with specific antibody. Plasma peptide concentration (pmol/ml) was higher (p less than 0.001) in patients during the pain attack (3.97 +/- 1.18) than in controls (0.25 +/- 0.03). When measured 4 and 48 h after the pain attack lower levels were found (0.46 +/- 0.06) which decreased to control values after 24 h. These results may suggest involvement of peripheral enkephalins in pain modulation in patients with episodic cluster headache.
Assuntos
Cefaleia Histamínica/sangue , Encefalina Metionina/sangue , Adulto , Cefaleia Histamínica/fisiopatologia , Epinefrina/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Norepinefrina/sangue , Dor/sangue , Dor/fisiopatologia , Fatores de TempoRESUMO
Several reports indicate that enkephalins participate in lymphocyte proliferation and several events of the immune response. It has been proposed that peptides involved in these processes may originate in the nervous system or endocrine glands. We have found that human peripheral blood lymphocytes (PBL) activated with a mitogenic agent contain and release proenkephalin derived peptides. The kinetics of met-enkephalin and cryptic products of proenkephalin in PBL activated with phytohemaglutinin (PHA) were studied. Peptides were released to the supernatant of stimulated PBL, reaching the highest values after 18 to 24 hours. The material secreted corresponds to high, intermediate and low molecular weight peptides derived from proenkephalin, displaying met-enkephalin and synenkephalin (proenkephalin 1-70) immunoreactivity. Therefore, an intrinsic lymphocytic proenkephalin system is induced by PHA and may play an important role in the regulation of the immune response.