Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/102570
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Type: Journal article
Title: Opioidergic effects on enteric and sensory nerves in the lower GI tract: basic mechanisms and clinical implications
Author: Hughes, P.
Costello, S.
Bryant, R.
Andrews, J.
Citation: American Journal of Physiology, 2016; 311(3):G501-G513
Publisher: American Physiological Society
Issue Date: 2016
ISSN: 0002-9513
1522-1547
Statement of
Responsibility: 
Patrick A. Hughes, Samuel P. Costello, Robert V. Bryant and Jane M. Andrews
Abstract: Opioids are one of the most prescribed drug classes for treating acute pain. However, chronic use is often associated with tolerance as well as debilitating side effects, including nausea and dependence, which are mediated by the central nervous system, as well as constipation emerging from effects on the enteric nervous system. These gastrointestinal (GI) side effects limit the usefulness of opioids in treating pain in many patients. Understanding the mechanism(s) of action of opioids on the nervous system that shows clinical benefit as well as those that have unwanted effects is critical for the improvement of opioid drugs. The opioidergic system comprises three classical receptors (μ, δ, κ) and a nonclassical receptor (nociceptin), and each of these receptors is expressed to varying extents by the enteric and intestinal extrinsic sensory afferent nerves. The purpose of this review is to discuss the role that the opioidergic system has on enteric and extrinsic afferent nerves in the lower GI tract in health and diseases of the lower GI tract, particularly inflammatory bowel disease and irritable bowel syndrome, and the implications of opioid treatment on clinical outcomes. Consideration is also given to emerging developments in our understanding of the immune system as a novel source of endogenous opioids and the mechanisms underlying opioid tolerance, including the potential influence of opioid receptor splice variants and heteromeric complexes.
Keywords: opioid; immune; nervous system; irritable bowel syndrome; inflammatory bowel diseases
Rights: © 2016 the American Physiological Society
RMID: 0030051822
DOI: 10.1152/ajpgi.00442.2015
Published version: http://ajpgi.physiology.org/content/311/3/G501
Appears in Collections:Medicine publications

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