Molecular Modulation of In Vivo Tolerance
作者： Charles E. Inturrisi , Ann M. Gregus
DOI: 10.1007/978-1-60761-993-2_16
关键词: Opioid 、 Hyperalgesia 、 Mechanism (biology) 、 Opioid-induced hyperalgesia 、 Neuroscience 、 Cross-tolerance 、 Biology 、 Receptor 、 Internalization 、 G protein
摘要: Opioid tolerance can limit the clinical utility of opioids for pain management. It is a neuroadaptive response to repeated administration an opioid. predominantly pharmacological (nonassociative) and pharmacodynamic type. Possible contributions at receptor level include desensitization, internalization, recycling. Alterations G proteins, other intracellular signaling cascades receptor–receptor interactions also may be involved. At systems level, opioid-induced hyperalgesia, N-methyl-d-aspartate mechanisms, activation immune system, genetic factors have all been implicated. Each these potential contributors discussed. Establishing mechanism(s) remains elusive as well continuing challenge. However, some mechanisms discussed in this chapter appear provide new approaches reducing or eliminating development opioid tolerance.
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