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Vol. 282, Issue 1, 355-362, 1997
Departments of Pharmacology (C.A.P. and J.H.W.) and Psychology (J.H.W.), The University of Michigan Medical School, Ann Arbor, Michigan
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Abstract |
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The antinociceptive and ventilatory effects of morphine and other opioid agonists were determined in three rhesus monkeys during a period of morphine maintenance, as well as before and after the chronic exposure to morphine. Before the onset of the daily dosing regimen, morphine increased tail-withdrawal latencies from 50°C water, with an ED50 of 6.4 ± 2.1 mg/kg. Daily injection of 3.2 mg/kg morphine produced a rightward displacement of the morphine dose-response curve, increasing the ED50 of morphine to 28.4 ± 12.3 mg/kg. Doubling the daily morphine dose to 6.4 mg/kg resulted in a further shift to the right of the dose-response curve of morphine. After cessation of the daily dosing regimen, the morphine dose-response curve for producing antinociceptive effects returned toward baseline. The antinociceptive effects of the kappa opioid agonist, ethylketazocine, were similar during the period of daily exposure to morphine, and after cessation of the daily dosing regimen. Before the onset of the daily dosing regimen, morphine, ethylketazocine, fentanyl, butorphanol and nalbuphine decreased ventilation in the presence of air or air mixed with CO2. The baseline ED50 value of morphine for decreasing minute volume in the presence of 5% CO2 was 2.9 ± 0.8 mg/kg. The ventilatory effects of morphine and other mu opioid agonists tested were not attenuated during the daily morphine-dosing regimen. After 40 weeks of daily injections of 3.2 mg/kg morphine, the ED50 of morphine for decreasing minute volume in 5% CO2 was 2.3 ± 1.0 mg/kg, and when the daily dose was doubled to 6.4 mg/kg morphine, the ED50 of morphine was 1.5 ± 0.5 mg/kg. The ventilatory depressant effects of the daily injection 3.2 mg/kg morphine were also unchanged during morphine maintenance. The differential development of tolerance to the antinociceptive and ventilatory effects of morphine demonstrates a separation of these two mu opioid agonist effects in rhesus monkeys.
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Introduction |
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Chronic opioid use often results
in the development of tolerance to the effects of opioid drugs, yet the
emergence and expression of tolerance to different opioid effects is
not well understood. For instance, it is widely assumed that tolerance
to the respiratory depressant effects of opioids necessarily develops,
based on observations that opioid-experienced addicts and cancer
patients can tolerate doses of opioid drugs that are lethal in people
who are opioid-naive (Reisine and Pasternak, 1995
). However, tolerance
to the respiratory depressant effects of opioids in humans has been
directly examined in relatively few studies and these have produced
mixed results. For example, in one study of morphine-dependent human
subjects, morphine initially decreased respiratory rate by 15 to 20%,
and this respiratory suppression was unchanged for the duration of the
study, which suggests that tolerance did not develop to the ventilatory
effects of opioids (Martin and Jasinski, 1969
). However, the
respiratory responses to 60 and 120 mg of morphine were less in both
morphine-dependent subjects than were the responses to 15 and 30 mg
morphine in nondependent subjects (Martin et al., 1968
).
Similarly, in cancer patients receiving morphine for pain relief,
decreases in the effects of morphine on measures of pCO2 and minute volume were correlated to morphine dose and the duration of
treatment (Pfeifer et al., 1989
). These latter results
suggest that tolerance may develop to some of the respiratory effects of morphine.
The development of tolerance to the antinociceptive effects of opioids
in humans is similarly unclear. In a clinical study that examined
analgesic dosing requirements in cancer patients, opioid-experienced
patients required higher doses of morphine postoperatively than did the
opioid-naive patients (de Leon-Casasola et al., 1993
). In
addition, dose escalation is common in the prescription of opioids to
patients with terminal cancer, as the doses originally prescribed fail
to continuously provide adequate analgesia, which suggests that the
antinociceptive effects of mu opioid agonists in humans are
subject to tolerance (Reisine and Pasternak, 1995
). In another clinical
report, however, the analgesic effects of morphine were not altered in
cancer patients receiving 20 to 120 mg of morphine daily (Pfeifer
et al., 1989
) and it has been argued that when dose
escalation occurs, the higher doses of analgesics are necessitated not
by the development of tolerance, but by disease progression and
intensifying pain (Portenoy and Foley, 1986
). Some of the difficulties
in resolving whether opioid tolerance develops in humans might arise
from various methodological problems or practical limitations of
clinical research, and the development of analgesic tolerance to
opioids in humans remains a topic of debate (e.g., Colpaert,
1996
).
In contrast to studies of opioid tolerance in humans, experiments with
various animal models have consistently demonstrated that chronic
exposure to morphine-like drugs results in the development of tolerance
to many opioid effects. In rodents, tolerance has been observed
repeatedly in both behavioral and physiological responses to opioids.
After chronic exposure to morphine, the dose-response curves for
effects of morphine and morphine-like drugs on schedule-controlled
responding (Adams and Holtzman, 1990
; Picker et al., 1991
),
antinociception (Lange et al., 1980
; Paronis and Holtzman,
1992
) and respiration (McGilliard and Takemori, 1978
) are shifted to
the right. The tolerance induced by chronic exposure to morphine
appears pharmacological in that it is restricted to mu
opioid agonists (Craft et al., 1989
), and the magnitude of
the rightward displacement of the dose-response curves is dependent on
the dose of morphine administered chronically (Paronis and Holtzman,
1992
). However, the degree of tolerance can vary according to the
response that is measured. For example, implantation of 50-mg morphine
pellets in mice resulted in a 2- to 3-fold shift to the right of the
respiratory dose-response function for morphine, but a 5- to 6-fold
shift to the right in the dose-response curve of morphine-induced
antinociception (McGilliard and Takemori, 1978
). Thus, although various
rodent models of opioid effects may be used to measure morphine
tolerance, the development of tolerance to these effects is not
uniform.
Most studies involving chronic administration of morphine in monkeys
have focused on the effects of opioid dependence; comparatively few
studies have examined opioid tolerance in non-human primates. However,
some studies have indicated that morphine tolerance will develop in
monkeys. The daily administration of morphine to squirrel monkeys
produced a receptor-selective tolerance to mu opioid agonist effects on responses in a shock titration procedure, as well as to
opioid effects on food-maintained, schedule-controlled behavior (Craft
and Dykstra, 1990
; Doty et al., 1989
). Likewise, in rhesus monkeys receiving 10 to 15 mg/kg of morphine daily, the morphine dose-response curve for food-maintained, schedule-controlled behavior was shifted 5- to 10-fold to the right relative to the position of the
morphine curve before the onset of the daily injections (Woods and
Carney, 1978
; Bergman and Schuster, 1985
). Similarly, studies of other
characteristic effects of mu opioid agonists in rhesus
monkeys demonstrated that daily administration of morphine produced
tolerance to the muscle relaxing and stupor-inducing effects of
mu opioid agonists, but did not alter the overt behavioral effects of kappa opioid agonists (Gmerek et al.,
1987
). The results of these studies demonstrate that after repeated
morphine administration tolerance will develop to at least some of the
behavioral effects of opioids in monkeys. To date, however, no studies
have directly examined the development of tolerance to the
antinociceptive and respiratory depressant effects of morphine in
rhesus monkeys.
In an effort to further characterize opioid tolerance in non-human
primates, the present studies examined ventilatory effects of morphine
and other mu opioid agonists in rhesus monkeys receiving daily injections of 3.2 or 6.4 mg/kg morphine. The mu opioid
agonists used in these studies covered a range of efficacies, from the partial agonist, nalbuphine, to the full agonist, fentanyl, and included the mixed mu/kappa opioid agonist, ethylketazocine.
The antinociceptive effects of morphine and ethylketazocine were also assessed in the same group of monkeys. These studies were completed in
conjunction with another series of experiments that characterized ventilatory effects of morphine withdrawal in rhesus monkeys (Paronis and Woods, 1997
). The results of the present experiments demonstrate that tolerance does develop to the antinociceptive effects of morphine
in monkeys. Daily injections of morphine, however, did not result in
tolerance to the ventilatory depressant effects of morphine.
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Methods |
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Subjects
Subjects were two adult male (909B and S67) and one adult female (F2) rhesus monkeys. The weights of the subjects remained relatively stable throughout the study and were 6.5 kg (F2), 7.5 kg (S67) and 9 kg (909B). Subjects 909B and F2 had been used previously in experiments involving opioids. Monkeys were housed singly in a temperature-controlled colony room with a 12-hr light/dark cycle (lights on at 6:00 A.M.). Water was available ad libitum, and the monkeys were fed approximately 30 biscuits (Purina Monkey Chow) daily, supplemented twice weekly with fresh fruit.
Apparatus
The apparatus used to measure ventilation was similar to that
described by Howell et al. (1988)
. Subjects were seated in a standard primate restraint chair enclosed within a sound-attenuating chamber. A Plexiglas helmet that was placed over the head of the subject served as a pressure-displacement plethysmograph. Customized Plexiglas plates and rubber dams were used to provide an airtight seal
around the monkey's neck. A continuous flow, 10 liters/min, of either
air or a mixture of 5% CO2 in air (hereafter referred to
only by the CO2 concentration) was introduced through a
port at the front of the helmet, and was extracted at the same rate through a port in the back of the helmet. Changes in flow within the
plethysmograph were measured by a pressure transducer connected to a
polygraph (model 7E, Grass Instrument Co., Quincy, MA) and computer
(IBM/PCjr). Pressure displacement was converted to a volume measure by
a polygraph integrator (model 7P122E, Grass Instrument Co.). Minute
volume (VE) was determined by integration of changes in
flow through the plethysmograph, frequency of ventilation (f) was directly determined and tidal volume
(VT) was calculated as the quotient VT = VE/f.
Experimental sessions generally consisted of four to six consecutive
cycles, each comprising a 23-min exposure to air followed by a 7-min
exposure to 5% CO2. Data from the first
air/CO2 cycle were used for session-control values.
Cumulative dosing procedures similar to those described by Howell
et al. (1988)
were used. At the start of each test cycle,
graded doses of drug were administered i.m. so that the total dose
increased by 0.25 or 0.5 log unit increments throughout the session.
When ventilatory responses to single injections of morphine were
measured, experimental sessions consisted of two 63-min cycles in which
7-min exposures to increasing concentrations of CO2
alternated with 14-min exposures to air. Animals received an i.m.
injection of drug after the end of the first cycle. Data obtained from
the first cycle served as session-control values.
Antinociception was measured by a tail-withdrawal procedure described
by Dykstra and Woods (1986)
. Monkeys were seated in standard primate
restraint chairs and the distal 10 cm of the shaved tail was immersed
in a thermos flask containing water at 40°C, 50°C or 55°C.
Tail-withdrawal latencies were manually timed by a hand-held stopwatch,
and the maximal withdrawal latency was set at 20 sec to prevent damage
to the tail. At least 1 min intervened between observations at the
different temperatures; one latency measure was recorded per
temperature per drug dose. Drugs were administered i.m. with a
cumulative dosing procedure. Injections were given at 30-min intervals,
starting 15 min after control tail-withdrawal latency determinations.
Subsequent withdrawal latencies were determined 15 to 20 min after each
drug injection.
Experimental Design
Drug tests were conducted during four phases, baseline, single-dosing, double-dosing and abstinence, during which the subjects were exposed repeatedly to morphine and other mu opioid agonists, to the opioid antagonist, naltrexone, and to several nonopioid drugs. Experimental sessions were conducted at least twice a week to ensure stable patterns of ventilation, and at least 2 days intervened between drug tests. Five to seven days intervened between tests when the daily dosing schedule was interrupted to assess abstinence-associated withdrawal effects, or when the monkeys received large doses of drugs. The order of the drug tests was randomized between subjects within each phase of the study to minimize the influence of duration of exposure to the maintenance dose of morphine on the responses to the test drug.
Baseline phase. During the baseline phase, the ventilatory effects of morphine, naltrexone, nalbuphine, ethylketazocine, butorphanol and fentanyl were determined in all monkeys. Dose-response curves for the antinociceptive effects of morphine were determined in all monkeys, and the antinociceptive effects of ethylketazocine were determined in 909B and S67. This phase of the study lasted 14 weeks in S67 and 16 weeks in 909B and F2. Data obtained during this phase are referred to throughout this paper as baseline values, and should be distinguished from the session-control values obtained at the start of individual test sessions.
Single-dosing phase.
During the single-dosing phase, the
monkeys received injections of 3.2 mg/kg morphine every morning, either
in the test chamber or, on days when they were not tested, in the home
cage. Except where noted, tests occurred 24 hr after injection of the
maintenance dose of morphine. Only the ventilatory effects of morphine
were studied during the first 4 weeks of the single-dosing phase.
Subsequently, the ventilatory effects of a range of opioid drugs,
including naltrexone, morphine, nalbuphine, butorphanol,
ethylketazocine and fentanyl, and several nonopioid drugs (midazolam,
flumazenil and
-carboline-3-carboxylic acid; reported in Paronis
et al., 1994
) were examined. The order in which drugs were
studied was randomized among subjects, with the exception that morphine
dose-response curves for antinociception and ventilation were
periodically determined in all monkeys at approximately the same time
points. When naltrexone or a nonopioid drug was studied, the daily
morphine dose was administered immediately after the test session.
Finally, the antinociceptive effects of ethylketazocine were determined
in all monkeys. This phase of the study lasted 40 weeks in S67 and 57 weeks in 909B and F2.
Double-dosing phase. During the double-dosing phase, monkeys received two injections of 3.2 mg/kg morphine daily. The injections were spaced by 12 ± 2 hr, and usually were given at 9:00 A.M. and 9:00 P.M. This phase of the study lasted 12 weeks in S67 and 17 weeks in 909B and F2. During this time, the ventilatory effects of naltrexone and morphine, and the antinociceptive effects of morphine and ethylketazocine, were examined in all monkeys. Except where noted, tests occurred 24 hr after morphine.
Abstinence phase. During the abstinence phase, daily morphine injections were discontinued and the monkeys were drug-free for 4 weeks. Experiments continued throughout this time to assess any effects of abstinence-associated withdrawal. After at least 28 days, the ventilatory effects of morphine and naltrexone and the antinociceptive effects of morphine and ethylketazocine were redetermined in all monkeys.
Data Analysis
Antinociceptive data are presented as a percentage of the M.P.E.
according to the following equation: [(test latency
control latency)/(20 sec
control latency)] × 100%. Drug effects on
ventilation were determined with data from the last 3 min of exposure
to air or CO2 within each cycle and are presented as a
percentage of the session-control values. ED50 values were
calculated by linear regression of individual dose-response curves, and
the individual ED50 values were averaged to determine group
means and S.E. For ventilatory measures, ED50 values
represent the dose required to decrease minute volume in 5%
CO2 to 50% of session-control values. For antinociceptive
measures, ED50 values represent the dose required to
increase tail withdrawal latencies in 50°C water to 50% of the
M.P.E. Dose-effect curves were compared by repeated measures one-way or
two-way ANOVA, followed by Student-Neuman-Keuls multiple comparison
test. Significance was set at P < .05.
Drugs
Morphine sulfate (Mallinckrodt, Inc., St. Louis, MO), nalbuphine HCl (DuPont Pharmaceuticals, Garden City, NY), butorphanol tartrate (Bristol Myers Squibb, Wallingford, CT), fentanyl HCl (Research Technology Branch, National Institute on Drug Abuse, Rockville, MD) and ethylketazocine (Sterling Winthrop, Rensselaer, NY) were dissolved in sterile water and injected i.m. in a volume of 0.1 to 1.0 ml. Drug doses are expressed as the weight of the salt.
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Results |
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Antinociception.
Morphine dose-dependently increased
tail-withdrawal latencies in all monkeys under baseline conditions
(fig. 1, top panel). Session-control tail-withdrawal
latencies from 50°C and 55°C water were 1.6 ± 0.3 and
1.1 ± 0.1 sec, respectively. Morphine produced only 25% of the
M.P.E. when the monkeys were tested with 55°C water. In contrast,
when the monkeys were tested with 50°C water, 18 to 32 mg/kg morphine
produced a full antinociceptive effect and the baseline
ED50 of morphine was 6.4 ± 2.1 mg/kg. Daily
injections of 3.2 mg/kg morphine did not consistently alter
session-control tail-withdrawal latencies; however, the cumulative
morphine dose-response curve was increasingly shifted to the right
during the single-dosing phase of the study. After 12, 19 and 40 weeks
of daily morphine administration, the ED50 values of
morphine for producing antinociception were 8.9 ± 0.7, 14.4 ± 2.6 and 28.4 ± 12.3 mg/kg, respectively. After 40 weeks of
daily morphine administration, the mean antinociceptive effect in
50°C water produced by 32 mg/kg morphine was 60 ± 12% of the
M.P.E. (fig. 1). The morphine dose-response curve was displaced further
to the right during the double-dosing phase of the study. ED50 values for antinociception could not be calculated
reliably during the double-dosing phase. Twenty-four hours after
morphine during the double-dosing phase, a cumulative dose of 32 mg/kg morphine produced only 23% of the M.P.E., and a dose of 56 mg/kg morphine failed to produce greater than 70% analgesia in any of the
three monkeys. Two-way ANOVA revealed significant effects for drug dose
(F3,6 = 92.88, P < .001), phase of testing
(F3,6 = 7.31, P < .02) and dose × phase interaction (F9,18 = 5.41, P < .01).
Post hoc analysis indicated that the morphine dose-effect curve for antinociceptive effects during the double-dosing phase was
significantly different from the curves obtained during the baseline
phase, and that the effects of 10 and 32 mg/kg morphine during the last
determination of the single-dosing phase and during the double-dosing
phase differed from the baseline effects of these doses.
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Ventilatory effects.
Morphine (0.32-32.0 mg/kg)
dose-dependently decreased all measures of ventilation in both air and
5% CO2 during the baseline phase of the study (fig.
2). The ventilatory depressant effects of morphine were
most evident in measures of minute volume, and ventilation was more
readily suppressed by morphine in the presence of CO2 than
in the presence of normal air. During the baseline phase, the mean
ED50 value (±1 S.E.) of morphine for ventilatory depressant effects in air was 13.5 ± 1.3 mg/kg; in the presence of 5% CO2 the mean ED50 value of morphine was
2.9 ± 0.8 mg/kg. The effects of 3.2 mg/kg morphine given as a
single injection decreased minute volumes in the presence of air and
5% CO2 to 75 ± 8% and 44 ± 3% of
session-control values, respectively.
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Discussion |
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Opioid tolerance is generally described as a decreased effect of a
given dose of a drug or, more fully, as a shift to the right of the
dose-response curve. In the present study, daily administration of 3.2 mg/kg morphine to rhesus monkeys resulted in the development of
tolerance, which was observed in the rightward displacement of the
dose-response curve of morphine for producing antinociceptive effects.
The antinociceptive effects of ethylketazocine were similar during the
single-dosing, double-dosing and abstinence phases of the study, and
are in line with published reports of the antinociceptive effects of
ethylketazocine in rhesus monkeys that did not receive morphine daily
(Dykstra et al., 1987
; Butelman et al., 1993
;
France et al., 1994
). Earlier studies of the effects of
ethylketazocine in rhesus monkeys demonstrated that
ethylketazocine-induced antinociception is mediated by kappa
opioid receptors (Dykstra et al., 1987
). The present
observation that the morphine dose-response curve for antinociceptive
effects was displaced to the right and the ethylketazocine
dose-response curve was unchanged indicates that the tolerance that
developed in the morphine-maintained monkeys was mu opioid
selective. These results are in agreement with previous studies of
opioid tolerance in monkeys, in which daily morphine injections
produced rightward displacements of the dose-response curves of
morphine, but not ethylketazocine, in a shock-titration procedure or in
measures of overt behavioral responses (Craft and Dykstra, 1990
; Gmerek
et al., 1987
). In the present experiments, tolerance to the
antinociceptive effects of morphine increased when the daily dose of
morphine was doubled and returned toward baseline after termination of
the daily dosing regimen. The time- and dose-dependent nature of
tolerance to the antinociceptive effects of opioids has been previously
demonstrated in rodents (Adams and Holtzman, 1990
). The present work
extends these results by demonstrating that the development of
tolerance to the antinociceptive effects of morphine in monkeys also is
time- and dose-dependent.
In contrast to the tolerance that developed to the antinociceptive
effects of morphine, daily morphine administration did not produce
tolerance to the ventilatory effects of morphine or other mu
opioid agonists. Among the drugs tested, nalbuphine and butorphanol
have been characterized as low to intermediate efficacy mu
opioid agonists in monkeys (Gerak et al., 1994
; Butelman
et al., 1995
). Based on previous results (Paronis and
Holtzman, 1992
) it was expected that tolerance to the effects of lower
efficacy agonists would develop more readily; however, the ventilatory effects of nalbuphine and butorphanol were unaltered by the daily dosing regimen with morphine. Likewise, the dose-response curve of
morphine was not shifted to the right, nor were the ventilatory responses to 3.2 mg/kg morphine attenuated despite daily exposure to
this dose of morphine for more than 40 weeks. The lack of tolerance to
the ventilatory effects of morphine was a surprising result, especially
in light of the tolerance that developed to its antinociceptive effects.
The present results directly contrast with those of a previous
investigation in human subjects, in which tolerance developed to the
respiratory, but not the antinociceptive, effects of morphine (Pfeifer
et al., 1989
). Studies in rodents also have demonstrated that tolerance will develop to the respiratory effects of opioids. For
example, the ED50 values of morphine, heroin and etorphine for decreasing respiratory rate in mice were increased by 5- to 7-fold
after 3-day exposures to morphine pellets (Roerig et al., 1987
). Similarly, respiratory responses to sufentanil were attenuated after 7-day infusions of 4 µg/hr sufentanil in rats (Ayesta and Flórez, 1989
). It is unclear why tolerance to the ventilatory effects of opioids did not develop in monkeys.
A lack of uniformity in the development of tolerance to the respiratory
and antinociceptive effects of morphine has been reported previously
and it was suggested that these two mu opioid effects might
be mediated by different receptor subtypes, each associated with
different regulatory mechanisms (Pfeifer et al., 1989
;
Roerig et al., 1987
). In support of this idea, the
mu opioid antagonist, naloxonazine, was shown to antagonize
the antinociceptive, but not the respiratory effects of morphine in
rats, leading to the proposal that the antinociceptive effects of
morphine are mediated by the mu-1 receptor type, whereas the
respiratory depressant effects are mediated by mu-2
receptors (Ling et al., 1985
). In more recent studies,
however, naloxonazine was found to antagonize the antinociceptive and
the ventilatory depressant effects of the mu opioid agonist,
levorphanol, to the same degree, consistent with the notion that both
of these opioid effects in monkeys are mediated by the same type of
mu opioid receptor (Gatch et al., 1996
).
Therefore tolerance might be expected to develop equally to both of
these mu opioid effects.
The different results in the present studies and previous
investigations of tolerance to the ventilatory effects of opioids may
be caused, in part, by procedural differences. In studies of tolerance
to the respiratory effects of opioids in rodents, either drug pellets
or drug-filled osmotic minipumps were used to administer the
tolerance-inducing agent continuously, and drug effects were determined
while the pellets or osmotic minipumps remained implanted. In contrast,
the current experiments used a daily injection procedure in which drug
effects were measured 24 hr after morphine, a time at which the
subjects likely experienced some degree of opioid withdrawal (Paronis
and Woods, 1997
; France and Woods, 1989
). If the appearance of opioid
withdrawal did alter the ventilatory effects of morphine, then the
degree of tolerance to the ventilatory effects of opioids that could be
measured might have been compromised. This suggestion is speculative,
however, because studies in rodents that have addressed the issue of
whether opioid tolerance is best revealed in the presence or absence of the tolerance-inducing drug have produced ambiguous results. For example, in mice implanted for 3-days with 75-mg morphine pellets, tolerance to the antinociceptive effects of s.c. injected morphine was
much greater when subjects were tested with the morphine pellets still
implanted than in subjects tested 3 hr after removing the pellets
(Lange et al., 1980
; Paktor and Vaught, 1984
). In contrast, however, to the results obtained with s.c. injected morphine, when the
morphine-pelleted mice were tested with intracerebroventricularly injected morphine, tolerance was more pronounced after removal of the
pellets than in the presence of the morphine pellets (Lange et
al., 1980
; Paktor and Vaught, 1984
). The results obtained in the
antinociceptive studies indicate that morphine tolerance can be
assessed at 24 hr after administration of the maintenance dose; nonetheless, the conditions under which opioid tolerance is
best measured in monkeys remain to be determined.
It is possible that the maintenance doses of morphine used in the
present study simply were not high enough to induce tolerance to the
ventilatory effects of mu opioid agonists. The dose of 3.2 mg/kg/day morphine is relatively low in comparison with previous studies of morphine tolerance in rhesus monkeys, in which the subjects
received 12 to 15 mg/kg morphine daily (Bergman and Schuster, 1985
;
Gmerek et al., 1987
). However, daily administration of 3.2 mg/kg morphine was adequate to produce opioid dependence in the monkeys
used in the present studies (Paronis and Woods, 1997
). Moreover, the
maintenance dose of 3.2 mg/kg morphine clearly produced tolerance to
the antinociceptive effects of morphine, which demonstrates that this
relatively low dose of morphine, administered daily, is indeed large
enough to induce tolerance to at least some behavioral effects of
opioids in monkeys.
In conclusion, the results presented here, together with the results
presented in the companion paper (Paronis and Woods, 1997
), indicate
that daily dosing regimens with low doses of morphine are adequate to
produce both opioid tolerance and dependence in rhesus monkeys. The
tolerance and dependence that developed after chronic exposure to
morphine were not apparent within the same behavioral measures. The
ventilatory responses that permitted orderly, quantitative assessments
of precipitated and abstinence-associated opioid withdrawal provided
little evidence for opioid tolerance. In contrast, tolerance did
develop in a dose-dependent fashion to the antinociceptive effects of
morphine. The lack of tolerance to the ventilatory effects of morphine
in the present study was surprising, given the clinical and anecdotal
evidence that tolerance does develop to the respiratory depressant
effects of opioids in humans. The expression of tolerance to the
ventilatory effects of mu opioid agonists in the present
experiments may have been hindered by the timing and dosing parameters
used, or by influences of nonopioid compensatory mechanisms.
Alternatively, it may be that the mu opioid receptors that
mediate the antinociceptive effects of morphine are differentially
regulated from those that mediate the ventilatory effects. These
explanations are speculative, however, and the mechanisms underlying
the differential development of tolerance to the antinociceptive and
ventilatory effects of opioids are unclear at this point. Nonetheless,
the apparent differences in the tolerance and dependence that developed
to antinociceptive and ventilatory effects of morphine within the same
subjects suggest that, in whole animals, not all mu opioid
receptors are affected in the same manner by chronic drug
administration.
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Acknowledgments |
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The authors thank J. Bergman and W.H. Morse for helpful comments on the manuscript and W.Z. Wu for technical assistance.
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Footnotes |
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Accepted for publication March 31, 1997.
Received for publication October 16, 1996.
1 This work was supported by USPHS grants DA00254, DA 07268 and DA 05653 from NIDA.
2 Preliminary results were presented at the 56th annual meeting of the College on Problems of Drug Dependence, Palm Beach, FL, 1994.
Send reprint requests to: Carol A. Paronis, Harvard Medical School, ADARC-McLean Hospital, 115 Mill St., Belmont, MA 02178-9108.
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Abbreviations |
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M.P.E., maximum possible effect; EKC, ethylketazocine; ANOVA, analysis of variance; f, breathing frequency, VT, tidal volume; VE, minute volume.
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M. R. Brandt and C. P. France Chronic l-alpha -Acetylmethadol (LAAM) in Rhesus Monkeys: Tolerance and Cross-Tolerance to the Antinociceptive, Ventilatory, and Rate-Decreasing Effects of Opioids J. Pharmacol. Exp. Ther., July 1, 2000; 294(1): 168 - 178. [Abstract] [Full Text] |
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F. C. Dalman and K. L. O'Malley kappa -Opioid Tolerance and Dependence in Cultures of Dopaminergic Midbrain Neurons J. Neurosci., July 15, 1999; 19(14): 5750 - 5757. [Abstract] [Full Text] [PDF] |
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