Document Detail


Endogenous opioids modify dyspnoea during treadmill exercise in patients with COPD.
MedLine Citation:
PMID:  19213787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Exogenous opioid drugs, such as morphine, relieve breathlessness. The present study hypothesis was that endogenous opioids, released during the stress of exercise, modify dyspnoea in patients with chronic obstructive pulmonary disease. After familiarisation, patients performed an incremental treadmill exercise test followed by constant work on the treadmill for 10 min. At subsequent visits (2 to 3 days apart), patients received two puffs of albuterol, had a catheter placed in an arm vein for removal of blood to measure beta-endorphin immunoreactivity, received normal saline or 10 mg of naloxone intravenously in randomised order, and then performed high-intensity constant work rate exercise on the treadmill. The mean+/-sd age of the 17 patients (eight females and nine males) was 63+/-7 yrs, and post-bronchodilator forced expiratory volume in one second was 50+/-17% predicted. In both conditions, beta-endorphin levels increased three-fold from rest to end-exercise. The regression slope of breathlessness as a function of oxygen consumption (primary outcome), mean ratings of breathlessness throughout exercise and peak ratings of breathlessness were significantly higher with naloxone than normal saline. There were no differences in physiological responses throughout exercise between conditions. In conclusion, endogenous opioids modify dyspnoea during treadmill exercise in patients with chronic obstructive pulmonary disease by apparent alteration of central perception.
Authors:
D A Mahler; J A Murray; L A Waterman; J Ward; W J Kraemer; X Zhang; J C Baird
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-02-12
Journal Detail:
Title:  The European respiratory journal     Volume:  33     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-01     Completed Date:  2009-07-22     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  771-7     Citation Subset:  IM    
Affiliation:
Section of Pulmonary and Critical Care Medicine, Dartmouth Medical School, Hanover, NH, USA. Donald.a.mahler@hitchcock.org
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00458419
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage
Adrenergic beta-Agonists / administration & dosage
Albuterol / administration & dosage
Bronchodilator Agents / administration & dosage
Double-Blind Method
Dyspnea / physiopathology*
Exercise Test
Female
Forced Expiratory Volume
Humans
Male
Middle Aged
Naloxone / administration & dosage
Narcotic Antagonists / administration & dosage
Opioid Peptides / physiology*
Oxygen Consumption / physiology
Pulmonary Disease, Chronic Obstructive / physiopathology*
Spirometry
Theophylline / administration & dosage
beta-Endorphin / blood
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Adrenergic beta-Agonists; 0/Bronchodilator Agents; 0/Narcotic Antagonists; 0/Opioid Peptides; 18559-94-9/Albuterol; 465-65-6/Naloxone; 58-55-9/Theophylline; 60617-12-1/beta-Endorphin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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