What do plasma beta‐endorphin levels reveal about endogenous opioid analgesic function?

Bruehl, Stephen; Burns, John W.; Chung, Ok Yung; Chont, Melissa

doi:10.1002/j.1532-2149.2011.00021.x

Cited by 49 publications

(45 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Resting plasma BE levels were stable across sessions (intraclass correlation = 0.91). Observed mean resting BE values (Table 1) were quite similar to those observed in our prior work using similar selection criteria and assays 26,27 .…”

Section: Methodssupporting

confidence: 84%

Do Resting Plasma β-Endorphin Levels Predict Responses to Opioid Analgesics?

Bruehl

Burns²,

Gupta³

et al. 2017

The Clinical Journal of Pain

View full text Add to dashboard Cite

Objectives Clinically-feasible predictors of opioid analgesic responses for use in precision pain medicine protocols are needed. This study evaluated whether resting plasma beta-endorphin (BE) levels predicted responses to an opioid analgesic, and whether chronic pain status or gender moderated these effects. Methods Participants included 73 individuals with chronic low back pain (CLBP) and 88 healthy controls, all using no daily opioid analgesics. Participants attended two identical laboratory sessions during which they received either intravenous morphine (0.08 mg/kg) or saline placebo, with blood samples obtained before drug administration to assay resting plasma BE levels. Once peak drug activity was achieved in each session, participants engaged in an ischemic forearm pain task (ISC) and a heat pain task. Morphine analgesic effects were derived reflecting the difference in pain outcomes between placebo and morphine conditions. Results In hierarchical regressions, significant Type (CLBP vs. Control) X BE interactions (p’s<.05) were noted for morphine effects on ISC tolerance, ISC intra-task pain ratings, and thermal VAS unpleasantness ratings. These interactions derived primarily from associations between higher BE levels and smaller morphine effects restricted to the CLBP subgroup. All other BE-related effects, including gender interactions, for predicting morphine analgesia failed to reach statistical significance. Discussion BE was a predictor of morphine analgesia for only 3 out of 9 outcomes examined, with these effects moderated by chronic pain status but not gender. On the whole, results do not suggest that resting plasma BE levels are likely to be a clinically useful predictor of opioid analgesic responses.

show abstract

Section: Methodssupporting

confidence: 84%

Do Resting Plasma β-Endorphin Levels Predict Responses to Opioid Analgesics?

Bruehl

Burns²,

Gupta³

et al. 2017

The Clinical Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Low b-EP concentrations have been hypothesised to reflect low analgesic activity in individuals. However, recent evidence suggests chronic pain patients with low b-EP concentrations have stronger analgesic activity when in pain through rapid upregulation of b-EP (94). In analgesic research with migraine patients b-EP could be a useful marker to study in more detail.…”

Section: Discussionmentioning

confidence: 99%

Migraine biomarkers in cerebrospinal fluid: A systematic review and meta-analysis

et al. 2016

View full text Add to dashboard Cite

Objective: To perform a meta-analysis of migraine biomarkers in cerebrospinal fluid (CSF) and of corresponding blood concentrations. Methods: We conducted a systematic search for studies that measured biochemical compounds in CSF of chronic or episodic migraineurs and non-headache controls. Subsequent searches retrieved studies with blood measurements of selected CSF biomarkers. If a compound was assessed in three or more studies, results were pooled in a meta-analysis with standardised mean differences (SMD) as effect measures. Results: Sixty-two compounds were measured in 40 CSF studies. Most important results include: increased glutamate (five studies, SMD 2.22, 95% CI: 1.30, 3.13), calcitonin gene-related peptide (CGRP) (three studies, SMD: 3.80, 95% CI: 3.19, 4.41) and nerve growth factor (NGF) (three studies, SMD: 6.47, 95% CI: 5.55, 7.39) in chronic migraine patients and decreased b-endorphin (b-EP) in both chronic (four studies, SMD: -1.37, 95% CI: -1.80, -0.94) and interictal episodic migraine patients (three studies, SMD: -1.12, 95% CI: -1.65, -0.58). In blood, glutamate (interictal) and CGRP (chronic, interictal and ictal) were increased and b-EP (chronic, interictal and ictal) was decreased. Conclusions: Glutamate, b-EP, CGRP and NGF concentrations are altered in CSF and, except for NGF, also in blood of migraineurs. Future research should focus on the pathophysiological roles of these compounds in migraine.

show abstract

“…A neuro-destructive method is, in principle, inappropriate for treating neuropathic pain [21,22]. Hence, a multidiscipline team including patient, doctor and care manager nurse shoud be involved in the shared decision making process of RF [23][24][25].…”

Section: Discussionmentioning

confidence: 99%