Journalartikel

Jahr der Veröffentlichung: 2006

Seiten: 113-121

Zeitschrift: The Clinical Journal of Pain

Bandnummer: 22

Heftnummer: 2

ISSN: 0749-8047

eISSN: 1536-5409

DOI Link: https://doi.org/10.1097/01.ajp.0000152327.01890.d6

Verlag: Lippincott, Williams & Wilkins

Abstract: 

Background: In the pituitary of lower species, pro-opiomelanocortin is expressed in corticotroph cells of the anterior and in melanotroph cells of the neurointermediate lobe; enzymatic processing in the corticotrophs results in the release of adrenocorticotropic hormone, beta-lipotropin, or beta- endorphin. In the melanotrophs, these fragments are further modified, eg, by N-terminal acetylation. In the human pituitary, these enzyme systems are located within the same cells in the anterior lobe. We studied the reactions of the pro-opiomelanocortin system under preoperative conditions as well as under postoperative pain.

Methods: In 17 patients undergoing hip or knee arthroplasty, we determined plasma concentrations of N-acetyl-beta-endorphin immunoreactive material, authentic beta-endorphin [beta-endorphin(1-31)], adrenocorticotropic hormone, beta-lipotropin immunoreactive material, and cortisol, as well as pain severity rated by the patients using a visual analogue scale before surgery, after surgery but still under spinal anesthesia, under postoperative pain, and 1 day after surgery.

Results: Only low levels of N-acetyl-beta-endorphin immunoreactive material were measured in 16 out of 17 patients. High concentrations (1st quartile/median/3rd quartile; pmol/L) of adrenocorticotropic hormone (22.5/55.8/124) and beta-lipotropin immunoreactive material (6.6/34.6/142) were observed under postoperative pain, accompanied by a small increase of beta-endorphin(1-31) concentrations (0.0/6.1/10.9). Preoperatively small but significantly elevated levels of corticotroph-type and melanotroph-type pro-opiomelanocortin derivatives were observed; in contrast, spinal anesthesia suppressed all pro-opiomelanocortin fragment release. Postoperative pain severity correlated with postoperative adrenocorticotropic hormone, beta-lipotropin immounreactive material, and beta-endorphin(1-31) concentrations.

Conclusions: We conclude that the melanotroph-type pro-opiomelanocortin system is not activated under postoperative pain; the increase of corticotroph-type pro-opiomelanocortin fragment levels is different in quantity and proportion under preoperative conditions or postoperative pain, respectively.

Harvard-Zitierstil: Matejec, R., Harbach, H., Bödeker, R., Hempelmann, G. and Teschemacher, H. (2006) Plasma levels of corticotroph-type pro-opiomelanocortin derivatives such as β-lipotropin, β-endorphin(1-31), or adrenocorticotropic hormone are correlated with severity of postoperative pain, The Clinical Journal of Pain, 22(2), pp. 113-121. https://doi.org/10.1097/01.ajp.0000152327.01890.d6

APA-Zitierstil: Matejec, R., Harbach, H., Bödeker, R., Hempelmann, G., & Teschemacher, H. (2006). Plasma levels of corticotroph-type pro-opiomelanocortin derivatives such as β-lipotropin, β-endorphin(1-31), or adrenocorticotropic hormone are correlated with severity of postoperative pain. The Clinical Journal of Pain. 22(2), 113-121. https://doi.org/10.1097/01.ajp.0000152327.01890.d6