beta-endorphin and Burns

Topics: Adolescent; Adolescent Behavior; Bandages; beta-Endorphin; Burns; Child; Child Behavior; Child, Hospitalized; Child, Preschool; Clinical Protocols; Depression; Humans; Hydrocortisone; Infant; Narcotics; Pain; Reproducibility of Results

We investigated acupuncture, a potential contributor for burn care, on physiological and pathological pain mechanisms and systemic and local inflammatory responses in a rat experimental burn model. Forty male Sprague-Dawley rats were divided into two groups. One-hour groups (five rats/group) were observed for 1 hour and included Sh1 (sham/observation), ShA1 (sham + acupuncture/observation), Brn1 (burn/observation), and BrnA1 (burn + acupuncture/observation). Seven-day groups (five rats/group) were observed for 7 days and included Sh7 (sham/observation), ShA7 (sham + acupuncture/observation), Brn7 (burn/observation), and BrnA7 (burn + acupuncture/observation). "Pain-distress scores" were noted daily, and acupuncture was repeated within every wound-dressing change on alternate days. After observation periods, blood samples for interleukin 6 and beta-endorphin and skin biopsies for inflammatory changes and immunohistochemical staining of interleukin 6 were collected for analysis(P < .05). In 1-hour groups, interleukin 6 accumulation in burn wounds of BrnA1 was less than Brn1, with Brn1 having the highest mean blood level (P < .05). Mean beta-endorphin levels were higher in ShA1, Brn1, and BrnA1 than in Sh1 (P < .05). In all 7-day groups, the agonizing period was 48 to 72 hours after burn, with Brn7 most affected (P < .05). Microvessels were multiplied in the Brn7 group, with significantly higher numbers in burn wounds of BrnA7 (P ˂ .05). Burn wounds of BrnA7 had less accumulation of interleukin 6 than Brn7 with the Brn7 group having the highest mean blood level and Sh7, ShA7, and BrnA7 having similarly low levels (P ˃ .05). Beta-endorphin levels in ShA7, Brn7, and BrnA7 were lower than in Sh7 (P < .05). Acupuncture contributed to the management of physiological and pathological pain, modulation of inflammatory responses, and associated enhancement of angiogenesis in the acute phase of burn injury in rats.

Topics: Acupuncture Therapy; Animals; beta-Endorphin; Burns; Interleukin-6; Male; Pain; Rats; Rats, Sprague-Dawley; Wound Healing

To observe the expression of beta-endorphin and micro-opioid receptor (MOR) during wound healing process in rat with deep partial-thickness scald.. Thirty-six Wistar rats were randomly divided into control( n = 6, without treatment) , and scald ( n = 30, with 5% TBSA deep-partial thickness scald) groups. Skin specimens from wound were harvested immediately after scald and on 3, 7, 14, 21 post-scald days( PSD) for the determination of 1-endorphin and MOR expression with immunofluorescent staining.. beta-endorphin and MOR were mainly distributed in nerve terminal at the border of dermis and epidermis , keratinocyte in some epidermis , in the fibroblast in dermis , with a weak expression The expression of beta-endorphin peaked in whole layer of skin on 3 PSD( 196 +/-16, P <0. 01) ,while that of MOR was concentrated in keratinocytes in the basal layer and the basement membrane. The expression of MOR was strengthened on 7 PSD with disarrangement of collagen , and it peaked on 14 PSD (306 +/- 23, P < 0.01) with epithelization in some wounds. There was still strong expression of beta-endorphin on 7 and 14 PSD. Complete epithelization was observed in scald group on 21 PSD, with nerve terminal approaching the boundary between the dermis and epidermis, and collagen began to arrange in good order. The expression of P-endorphin in scald group (31 +/-24)was similar to that in control group(30 +/- 18) on 21 PSD, but the expression of MOR (56 +/- 16) was still higher than that in control group (28 +/- 15 ).. The expression of MOR and P-endorphin exhibits chronobiological nature during the process of wound healing,

Topics: Animals; beta-Endorphin; Burns; Disease Models, Animal; Male; Random Allocation; Rats; Rats, Wistar; Receptors, Opioid, mu; Wound Healing

To investigate the changes and significance of serum gastrin (GAS), beta-endorphin (beta-EP) and plasma motilin (MTL) in patients with severe burns.. Blood samples were gotten according to different timepoints from 32 admitted burned patients, and then serum GAS, beta-EP and plasma MTL were determined by radio-immuno assay (RIA).. In patients with severe burns, serum GAS decreased significantly in early period. And at the timepoint of 8 h, it reached the lowest level. But during 9-24 h it elevated for a while, and then it reached a relatively stable level. MTL reached the highest level at the timepoint of 2 h after burning. Then at the shock stage, it was comparatively lower. And at the timepoint of 8 h after burning, it reached the lowest level, then raised persistently after reabsorption, but still lower than the normal level. At the early stage after burning, beta-EP raised, then reached the highest level at 8 h after burning. GAS and MTL decreased and beta-EP increased significantly with the increase of the burned area. However, when the burned area was over 70% of the total body surface area, there was no relationship between them.. Blood GAS, MTL and beta-EP have represented regular changes in patients with severe burns at the early stage after burning. And the pain-stimulus and shock are effective factors.

Topics: Adolescent; Adult; beta-Endorphin; Burns; Female; Gastrins; Humans; Male; Middle Aged; Motilin; Radioimmunoassay; Time Factors

To determine separately the effect of corticotropin-releasing hormone (CRH) on analgesia and on inflammation, rats were assigned to receive CRH 60 microg/kg, CRH 300 microg/kg, morphine 4 mg/kg, or normal saline intravenously 15 min before a burn injury. Two mesh chambers that allowed collection of fluid had been previously implanted subdermally in each rat. The skin overlying the right chamber was subject to thermal injury. The left chamber served as a control. We assessed systemic analgesia, and levels of beta-endorphin and corticosterone in plasma and in chamber fluid before, 1, 4 and 24 h after drug administration. The CRH groups exhibited longer tail flick latencies than the control group (P=0.0001) although the increase in latency was of smaller magnitude than in the morphine group. We did not observe a CRH dose response for analgesia. Plasma corticosterone levels were higher in the CRH 300 microg/kg group than in the normal saline group at 4 h (P=0.03). Levels of beta-endorphin in plasma as well as the levels of corticosterone and beta-endorphin in chambers were similar in the CRH 300 microg/kg group and in the normal saline group (all P values>0.1). Thus, systemically administered CRH produces analgesia in thermal injury independent of its effect on these two markers of local or systemic inflammation.

Topics: Analgesia; Animals; beta-Endorphin; Burns; Corticosterone; Corticotropin-Releasing Hormone; Diffusion Chambers, Culture; Disease Models, Animal; Dose-Response Relationship, Drug; Hot Temperature; Male; Pain Measurement; Rats; Rats, Wistar; Time Factors

To investigate the postburn change in hypothalamic paraventricular beta-endorphin and the roles of delta-receptor in scalded rats.. Male Sprague-Dawley (SD) rats were randomly divided into 3 groups, i.e. ICI174864, DPDPE and control groups. The rats were inflicted with 20% TBSA of III degree scalding on the back by boiling (100 degrees ) water. The postburn change in the tissue content of the hypothalamic paraventricular beta-endorphin was determined by radioimmuno assay (RIA). The effects of delta-receptor in scalded shock rats were investigated by observing the change of the rats'survival time and cardiac indices after the micro-injection of delta-receptor agonist DPDPE or antagonist ICI174864 into the hypothalamic paraventricle.. (1) The tissue content of the hypothalamic paraventricular beta-endorphin increased significantly (P < 0.01) at 1, 2 and 4 postburn hours (PBHs) in the scalded rats. (2) When compared with that of control group, the ratio of the cardiovascular parameters [mean arterial pressure (MAP), dp/dt(max) and HR] were obviously increased at different time points in rats with pre-injection of ICI174864 whereas the ratio was decreased when DPDPE was used. Nevertheless, the change in the heart rate ratio was not obvious whether ICI174864 or DPDPE was used. (3) The average animal survival time in ICI174864 group was much longer than that in DPDPE group.. An excessive increase in hypothalamic paraventricular beta-endorphin was one of the factors leading to the aggravation of burn shock and earlier death. delta-receptor located in the tissue might have played important roles in the mediation of the action of hypothalamic paraventricular beta-endorphin. It is beneficial to antagonize the action of delta-receptor for the correction of burn shock and for the prolongation of the of life of animals.

Topics: Analgesics, Opioid; Animals; beta-Endorphin; Blood Pressure; Burns; Enkephalin, D-Penicillamine (2,5)-; Enkephalin, Leucine; Heart Rate; Male; Narcotic Antagonists; Paraventricular Hypothalamic Nucleus; Rats; Rats, Sprague-Dawley; Receptors, Opioid, delta; Survival Analysis

Dynamic changes of immunoreactive beta-endorphin (ir-beta-EP) in perfusates collected from hypothalamic paraventricular nuclei at different times after burn, and the effects of intrahypothalamic paraventricular microinjection of beta-endorphin or its antiserum on various cardiac indices (MAP, dP/dtmax, Lvsp and HR) and survival time, were observed in anesthetized SD rats after third degree burn of 20% total body surface area. The results showed a significant increase of ir-beta-endorphin contents in the perfusate with the appearance of two peaks. According to the cardiac indices and mean survival time, the condition of the burned animals were improved by injection of anti-beta-endorphin serum, while injection of beta-endorphin did the reverse. The above results suggest that massive accumulation of beta-endorphin in the paraventricular nucleus appears to be one of the important factors detrimental to burn shock.

Topics: Animals; beta-Endorphin; Blood Pressure; Burns; Heart Rate; Immune Sera; Male; Microinjections; Paraventricular Hypothalamic Nucleus; Rats; Rats, Sprague-Dawley; Shock, Traumatic

The study of immunosuppression after thermal injury has aroused great interest. The present study is an investigation of changes of plasma ir-beta EP in patients and their effect on lymphocyte responses to PHA following thermal injury, in order to establish a relationship between the immune and neuroendocrine system. Plasma ir-beta EP in eighteen burn patients was determined using the radioimmunoassay. At the same time, autoplasma and the autoplasma treated with anti-beta EP serum had been both tested for their effect on lymphocyte responses to PHA. The levels of plasma ir-beta EP were found to be elevated significantly in every phases during the first three days postburn (P < 0.0005-P < 0.001), and then declined to the normal level on the fourth or fifth day postburn. The lymphocytes cultured with autoplasma showed their inhibited responses to PHA during the first three days postburn and returned to normal on the fourth or fifth day postburn, while the autoplasma treated with anti-beta EP serum had an effect to improve the lymphocyte responses to PHA. The findings suggest that burn stress is a strong stimulation which may elevate plasma ir-beta EP and which in turn decrease the lymphocyte response to PHA. We assume that increased plasma ir-beta EP may be one of the main causes of immunosuppression after thermal injury.

Topics: Adolescent; Adult; Aged; beta-Endorphin; Burns; Female; Humans; Immunosuppression Therapy; Lymphocyte Activation; Male; Middle Aged; Phytohemagglutinins; Radioimmunoassay

The changes in beta-endorphin receptor on the peripheral T lymphocytes were assayed in 30 burned patients (average burn area 38.1 +/- 30.0% of TBSA) and 20 healthy volunteers with radioactive ligand I-beta-endorphin. Results showed that the binding sites of beta-endorphin receptor on T lymphocytes were significantly decreased in various degrees, while kd values were increased, in patients major burns. In patients with smaller burns, the above parameters showed no significant difference from the normal. There were also decreased binding sites when complications such as infection occurred.

Topics: Adult; beta-Endorphin; Burns; Humans; Male; Middle Aged; Radioligand Assay; Receptors, Opioid; T-Lymphocytes

The plasma immunoreactive beta-endorphin (ir-beta-EP) contents in 20 healthy volunteers and 30 burned patients (average age: 36 years, average burn area: 38.1% +/- 30.0% of TBSA) were determined by radioimmunoassay (RIA). Results showed that there were significant increases of plasma ir-beta-EP in burned patients, which correlated to the extents of the burn areas positively (r = 0.576). Raised ir-beta-EP contents were also observed in the complications of operation, wound infection, septicaemic shock, heart failure and brain edema, which reached as high as 3,000pg/ml before death. The above findings suggested that the determination of plasma beta-EP might be helpful in understanding injury extent and evaluating prognosis.

Topics: Adult; beta-Endorphin; Burns; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Radioimmunoassay

Intraventricular injections of anti-beta-endorphin serum (8 microliters) at 0, 1, 2, 3 h after burn shock (20% body surface area, 100 degrees C, 20 s) in different group rats prolonged the survival time, delayed the decrease of mean arterial pressure (MAP) and heart rate, and postponed the abnormal changes of ECG. The effect was most prominent at 1 h and little at 3 h after burn.

Topics: Animals; beta-Endorphin; Blood Pressure; Burns; Electrocardiography; Heart Rate; Immune Sera; Injections, Intraventricular; Male; Rats; Rats, Inbred Strains; Shock, Traumatic; Time Factors

Dose-response curves of three receptor-selective opioids were established in a group of nonburned and a group of burned rats. Morphine (mu-agonist), biphalin (mu- and delta-agonist), and U50488H (kappa-agonist) were administered to each group, and analgesia was measured by tail flick latency testing. Each opioid had a significant increase in potency (i.e., a decrease in ED50 values) in the burned (15% body surface area) compared with the nonburned groups. Moderate doses of each drug (i.e., ED50 doses estimated from nonburned group data) in each case augmented stress-induced analgesia in the burned group. Analgesic doses failed to prevent a significant increase in plasma beta-endorphin and corticosterone after larger surface area (25%) burns. Regardless of receptor specificity, opioid analgesic potency is increased acutely after burn injuries.

Topics: 3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cyclohexyl)-benzeneacetamide, (trans)-Isomer; Analgesia; Analgesics; Animals; beta-Endorphin; Burns; Corticosterone; Dose-Response Relationship, Drug; Enkephalins; Injections, Intravenous; Male; Morphine; Pyrrolidines; Rats; Rats, Inbred Strains

To examine whether an acute pituitary-adrenal response to stress may occur in vivo in the absence of hypothalamic-pituitary connections, we measured plasma beta-endorphin (beta-EP) and corticosterone (C) in rats after acute thermal injury. beta-EP rose significantly after thermal injury in normal rats and rats bearing pituitary-to-kidney autotransplants but not in animals with pituitary aspiration without reimplantation. Corticosterone responses paralleled beta-EP but were significant only in normal controls. Propranolol pretreatment did not reduce postburn beta-EP and C rises in autotransplanted animals. Therefore, since circulating factors contribute in vivo to pituitary-adrenal responses, the widespread practice of using "stress hormone" responses to quantitate perioperative stress or pain may in some circumstances be flawed.

Topics: Animals; beta-Endorphin; Burns; Corticosterone; Corticotropin-Releasing Hormone; Hypophysectomy; Hypothalamo-Hypophyseal System; Male; Pituitary Gland; Pituitary-Adrenal System; Propranolol; Rats; Rats, Inbred Strains; Stress, Physiological

To investigate the role of opioids in the acquired immune dysfunctional state that occurs after burns or trauma, plasma beta-endorphin levels were measured serially in nine severely burned patients, and the effect of four different opioids on normal neutrophil and lymphocyte function was quantitated. The rationale for these studies is that the neuroendocrine system appears capable of interacting with and modulating immune function. The plasma levels of beta-endorphin increased to higher than normal during the first 36 hours after burn (15 versus 3.4 pmol/L, p less than 0.05) but quickly returned toward normal. Morphine had the most profound effect on in vitro neutrophil function; it decreased neutrophil chemotaxis but increased neutrophil bactericidal activity for Staphylococcus aureus, as well as resting and zymosan-stimulated oxygen consumption. Other opioids (naloxone, met-enkephalin, and beta-endorphin) had no direct effect on neutrophil chemotaxis or bactericidal activity. Both naloxone and met-enkephalin increased neutrophil oxygen consumption in a dose-dependent fashion, whereas beta-endorphin impaired neutrophil oxygen consumption. None of the opioids altered resting lymphocyte blastogenesis. The only opioid that impaired the ability of normal lymphocytes to respond to mitogen stimulation at physiologically relevant doses was beta-endorphin. These results, documenting that beta-endorphin levels are altered after thermal injury and that opioids can modulate normal neutrophil and lymphocyte function in vitro, support the concept that changes in neuroendocrine activity may occur and potentially alter immune function.

Topics: beta-Endorphin; Blood Bactericidal Activity; Burns; Chemotaxis, Leukocyte; Humans; In Vitro Techniques; Lymphocyte Activation; Lymphocytes; Narcotics; Neutrophils; Oxygen Consumption

In children with burn injuries we found, in earlier studies, an inverse association of plasma beta-endorphin immunoactivity (iB-EP) and pain levels. To further explore the effects of burn trauma on the peripheral release of beta-endorphin and the occurrence of centrally mediated stress analgesia, plasma iB-EP levels and tail flick latency (TFL) were measured in rats subjected (while anesthetized) to scald injury. In comparison to sham burn (dip in tepid water), burn injury increased plasma iB-EP and TFL; both the duration and magnitude of these effects were directly proportional to the extent of burns. In rats receiving no treatment, TFLs were unchanged throughout the time of the burn experiments. At 2 days post-burn TFLs were invariably back to pre-burn levels. Administration of the long-acting opioid antagonist naltrexone prior to burn injury prevented the rise in TFL. Thus the trauma of burns appeared to bring about a stress-induced analgesia (SIA). The marked increase in iB-EP during this SIA and its antagonism by naltrexone suggest that it was opioid and hormonal in character.

Topics: Analgesia; Animals; beta-Endorphin; Burns; Endorphins; Male; Pain; Rats; Rats, Inbred Strains; Stress, Physiological

There is recent evidence that circulating opioid peptides, or 'endorphins', act as chemical messengers responsible for the induction of the complex cardiovascular changes leading to hypotension in septicaemic shock. The pilot study of an investigation of opioid peptides in septicaemia in burned patients is presented. Serial measurements of plasma beta-endorphin and metenkephalin were performed throughout the recovery of six patients with large burns (20-70 per cent BSA). Our preliminary findings concur with previous evidence that opioid peptides may play a role in the hypotension of septicaemic shock.

Topics: Adolescent; Adult; beta-Endorphin; Burns; Endorphins; Enkephalin, Methionine; Female; Humans; Male; Middle Aged; Radioimmunoassay; Shock, Septic

The need for better analgesia during burn dressing changes (BDCs) in acutely burned children led us to assess pain during BDC with a large 0-10 thermometer-like scale which was well accepted and appeared to reflect the varying degrees of pain that patients experienced. Pain scores were obtained at least once each minute throughout 33 BDCs in 15 patients of 8-17 years. Plasma levels of beta-endorphin immunoactivity (iB-EP) were measured at 5 intervals before and after BDC; mean values (+/- S.E.M.) ranged from 30.5 +/- 4.63 pg/ml (before BDC and analgesic) to 19.2 +/- 3.02 pg/ml (immediately following BDC). The mean pain score (MPS) for each BDC was inversely related to the iB-EP levels of that day (P less than 0.001 with 4 of the 5 iB-EP determinations). The MPS varied directly with the extent of burn injury and inversely with weight; the 2 variables together predicted MPS as well as the iB-EP alone (r2 = 43 and 36% respectively).

Topics: Administration, Topical; Adolescent; Analgesics; Bandages; beta-Endorphin; Burns; Child; Debridement; Endorphins; Humans; Pain; Silver Nitrate

Topics: Adult; Aged; Analgesia; Animals; Anxiety; beta-Endorphin; Burns; Endorphins; Female; Humans; Hypnotics and Sedatives; Male; Middle Aged; Narcotics; Neural Pathways; Neurotransmitter Agents; Pain; Receptors, Opioid; Receptors, Opioid, mu; Respiration, Artificial; Resuscitation; Sensory Thresholds; Stress, Physiological; Stress, Psychological; Time Factors

Decapeptide ceruletide (CRL), chemically related to cholecystokinin and gastrin, proved to have remarkable analgesic properties when administered to a group of 22 burned patients, 15 patients with acute myocardial infarction, and 8 patients suffering from pain caused by malignant tumours with metastases. Its effect was such, that many of the patients required no other analgesics (opiates) even after a prolonged administration (up to 10 days) of CRL. In some of the patients a marked euphoria developed. There were no substantial changes in EEG records during CRL administration in 15 controls, among them 4 epileptics. It is probable that CRL helps to activate the internal analgesic system. In the burned patients cortisol, testosterone, renin, prolactin and tri-iodothyronine (T3) levels in serum (plasma) were measured (radio-immunoassays). CRL did not block the stress response (no drop of increased cortisol levels, no increase in low T3 levels), but it modified (influenced) it (drop of the high renin levels, and a tendency to increase the very low testosterone levels). CRL appears to act as an endorphin releaser, as evidenced by the plasma levels of beta-endorphins (quotations). CRL and similar drugs may represent a new, more physiological and probably safer approach to the management of pain.

Topics: beta-Endorphin; Burns; Ceruletide; Endorphins; Humans; Male; Myocardial Infarction; Neoplasm Metastasis; Neoplasms; Pain