Sensitivity to Enkephalin as a Cause of Non-Insulin Dependent Diabetes

Chlorpropamide ? alcohol flush: the case in favour

“…That CPAF might be related to the effect of opioids was suggested by the finding that flushers show a greater rise of facial temperature when given a met-enkephalin analogue intravenously than do non-rushers and that, in some cases at least, CPAF can be blocked by the opiate antagonist naloxone [17]. We speculated that CPAF might be due to an increased sensitivity to circulating enkephalin (or other opioid peptides).…”

Naloxone increases blood flow in the human hand.

“…In the course of an investigation of chlorpropamide alcohol flushing in diabetics and its blockade by intravenous injection of naloxone (Leslie, Pyke & Stubbs, 1979) we observed that, in some subjects, there was a small increase in skin temperature after intravenous (i.v.) injection of naloxone before alcohol was given.…”

Chlorpropamide-alcohol flush: a critical reappraisal

“…Furthermore, Hillson et al [12], Krbberling et al [17] and Wilkin [21] have all demonstrated that cheek temperature rise after ethanol is determined by the initial cheek temperature among other factors. Early studies at King's College Hospital, London declared there was 'no correlation between the increase in skin temperature and the basal skin temperature' [8], but one was found subsequently [19]. There was no bimodality of basal cheek temperature in patients on long-term chlorpropamide therapy studied in Oxford [11] or in patients given single doses of chlorpropamide or placebo in Germany [17].…”

“…In 1978 interest in CPAF was rekindled by Leslie and Pyke [3], who in this and subsequent papers [4][5][6][7][8] suggested that CPAF was: (1) dominantly inherited; (2) a possible marker for at least one type of maturity-onset diabetes mellitus; (3) a possible marker of a lesser tendency to develop some micro-and macrovascular complications of diabetes; and (4) a key towards understanding both the aetiology of some forms of Type 2 (non-insulin-dependent) diabetes and the mechanism of this type of flushing.…”

“…Visible flushing is subject to observer bias and very difficult to quantify, whereas temperature measurement provides a more objective method of assessing flushing, and has often been used [8,10,[12][13][14][15][16][17][18][19][20]. However, temperature changes should be clearly and repeatably separable, if CPAF-positive and CPAF-negative patients are to be unequivocally identified.…”