beta-endorphin and Neoplasms

It is becoming increasingly clear that stressful life events can affect cancer growth and metastasis by modulating nervous, endocrine, and immune systems. The purpose of this review is to briefly describe the process by which stress may potentiate carcinogenesis and how reducing body stress may prevent cancer growth and progression. The opioid peptide β-endorphin plays a critical role in bringing the stress axis to a state of homeostasis. We have recently shown that enhancement of endogenous levels of β-endorphin in the hypothalamus via β-endorphin neuron transplantation suppresses stress response, promotes immune function, and reduces the incidence of cancer in rat models of prostate and breast cancers. The cancer-preventive effect of β-endorphin is mediated through the suppression of sympathetic neuronal function, which results in increased peripheral natural killer cell and macrophage activities, elevated levels of anti-inflammatory cytokines, and reduced levels of inflammatory cytokines. β-endorphin inhibition of tumor progression also involves alteration in the tumor microenvironment, possibly because of suppression of catecholamine and inflammatory cytokine production, which are known to alter DNA repair, cell-matrix attachments, angiogenic process, and epithelial-mesenchymal transition. Thus, β-endorphin cell therapy may offer some therapeutic value in cancer prevention.

Topics: Animals; beta-Endorphin; Cell Transplantation; Disease Progression; Humans; Neoplasms; Neurons; Neurosecretory Systems; Stress, Psychological

The accurate assessment of pain is needed to control cancer pain and its treatment. Pain itself is subjective experience and is difficult to estimate quantitatively. Until now, there is no precise method to quantitate the cancer pain objectively. First, we show the tools to assess cancer pain by patient's description, including visual analogue scales, verval rating scales and numerical rating scales and so on. These scales have been used to evaluate the intensity of clinical pain, however they cannot assess the quality of cancer pain and only McGill Pain Questionnaire (MPQ) has specificity for the qualitative and quantitative properties of clinical pain. Molecular biological approach has been advanced in the neuroscience field to find the candidate of neuropathic pain. In this article, we would like to show the results of the proteomics research for neuropathic pain. We also tried to discuss about the biomarker and its possibility whether it can reflect cancer pain and effect of cancer treatment.

Topics: Animals; beta-Endorphin; Biomarkers; Cholecystokinin; Cytokines; Humans; Neoplasms; Oxidative Stress; Pain; Pain Measurement

Topics: beta-Endorphin; China; Depression; Drugs, Chinese Herbal; Humans; Interleukin-2; Neoplasms; Phytotherapy; Tumor Necrosis Factor-alpha

To observe the clinical efficacy and safety of electroacupuncture (EA) at Neimadian-point for cancer pain.. A total of 140 cancer patients with pain were randomly divided into EA and control groups, with 70 cases in each group. The patients of the EA group received EA at Neimadian-point plus analgesia pump (all prepared with normal saline). The patients of the control group were treated by Sufentanil patient-controlled intravenous analgesia plus sham EA (without stimulation). The treatment was conducted once daily for two days at 8 o'clock every morning. Respectively, in 1 h before treatment (T0), 1 h (T1), 8 h (T2), 24 h (T3) after treatment of the first day, 1 h (T4), 8 h (T5), 24 h (T6) after treatment of the second day, the visual analogue scale (VAS) score of pain, and the plasma levels of norepinephrine, 5-HT, leucine enkephalin, β-endorphin and dynorphin A1-13 were tested. The security level (1-4 grade) was assessed during the treatment.. Compared with their own pre-treatment, in T1 to T6, the VAS scores, and the contents of plasma norepinephrine and 5-HT obviously decreased in both groups （. EA at Neimadian-point can effectively relieve the pain of cancer patients and improve their quality of daily life.

Topics: beta-Endorphin; Cancer Pain; Electroacupuncture; Humans; Neoplasms; Pain; Pain Management

The study aimed to investigate the analgesic effect of a combination of intravenous flurbiprofen axetil and opioids, and evaluate the relationship between refractory pain relief and plasma β-endorphin levels in cancer patients.. A total of 120 cancer patients was randomly divided into two groups, 60 patients took orally morphine sulfate sustained-release tablets in group A, and another 60 patients receiving the combination treatment of intravenous flurbiprofen axetil and opioid drugs in group B. After 7 days, pain relief, quality of life improvement and side effects were evaluated. Furthermore, plasma β-endorphin levels were measured by radioimmunoassay.. With the combination treatment of intravenous intravenous flurbiprofen axetil and opioids, the total effective rate of pain relief rose to 91.4%, as compared to 82.1% when morphine sulfate sustained-release tablet was used alone. Compared with that of group A, the analgesic effect increased in group B (p=0.031). Moreover, satisfactory pain relief was associated with a significant increase in plasma β-endorphin levels. After the treatment, plasma β-endorphin level in group B was 62.4±13.5 pg/ml, which was higher than that in group A (45.8±11.2 pg/ml) (p<0.05).. Our results suggest the combination of intravenous flurbiprofen axetil and opioids can enhance the analgesic effect of opioid drugs by increasing plasma β-endorphin levels, which would offer a selected and reliable strategy for refractory cancer pain treatment.

Topics: Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; beta-Endorphin; Drug Synergism; Drug Therapy, Combination; Female; Flurbiprofen; Follow-Up Studies; Humans; Injections, Intravenous; Male; Middle Aged; Neoplasms; Pain, Intractable; Prognosis; Quality of Life; Radioimmunoassay

A new type of immuno-cell therapy called BRM-activated killer (BAK) therapy using non-MHC-restricted lymphocytes, CD56-positive cells, was devised. Peripheral blood lymphocytes were selected by immobilization with anti-CD3 monoclonal antibody and cultured for 2 weeks in the presence of IL-2. Thereafter, they were reactivated by 1,000 U/ml of IFN-alpha for 15 min. Twenty-six outpatients with cancer whose performance status were over 80% on Karnofsky scale were selected for this study. About 6 x 10(9) BAK cells were returned by intravenous drip infusion, at one month intervals at an outpatient clinic to each of 20 advanced cancer patients in whom many metastatic lesions were found postoperatively, and to 6 patients with no postoperatively detectable metastases. The proportion of CD56-positive cells increased from 20% to 50% with culture. CD56-positive cells have strong cytotoxic activity and produced 20 ng/10(9) cells of beta-endorphin, an intracerebral hormone. During the course of BAK therapy, we adopted the Face scale as a QOL indicator. The QOL of all patients remained satisfactory or improved. Beta-endorphin is thought to make patients feel well and maintains good QOL because of its potent analgesic, sedative activity. From that facts that CD56 is a neural cell adhesion molecule and a member of the Ig superfamily, and that the CD56-positive cell produces beta-endorphin, we concluded that the CD56-positive cell is a multifunctional, integrated NIE (neuro-immune-endocrine) cell. Administration of BAK cells allowed all 20 advanced cancer patients with metastases to survive for over one year. All 6 patients receiving the same therapy for prevention of postoperative metastasis have been recurrence-free for one to five years.

Topics: Aged; beta-Endorphin; Biomarkers, Tumor; CD56 Antigen; Cells, Cultured; Female; Humans; Immunologic Factors; Immunotherapy, Adoptive; Interferon-alpha; Interferon-gamma; Interleukin-2; Killer Cells, Natural; Lymphocyte Activation; Male; Middle Aged; Neoplasms; Prognosis; Quality of Life; Receptors, Antigen, T-Cell, gamma-delta; T-Lymphocyte Subsets

Topics: Analgesia; beta-Endorphin; Humans; Neoplasms; Pain, Intractable; Pain, Postoperative

Tiapride, a substituted benzamide, exerts an antalgic effect in man. To examine the possibility that tiapride analgesia might be related to a mechanism involving a release of endogenous opioids, the acute effects of an intravenous injection of the drug on plasma radioimmunoassayable beta-endorphin were studied in patients with pain from cancer (placebo-tiapride double-blind randomized trial). Seeing that substituted benzamides affect prolactin secretion, the plasmatic levels of prolactin and dopamine, a known factor inhibiting prolactin release, were studied as well. The tiapride infusion produced a slight but significant increase in plasma beta-endorphin level, an early and significant increase in plasma prolactin, and a sudden and highly significant decrease in plasma dopamine. These results are compatible with the hypothesis that tiapride influences the neuroendocrine system.

Topics: Adrenocorticotropic Hormone; Aged; Benzamides; beta-Endorphin; Dopamine; Endorphins; Female; Humans; Male; Neoplasms; Pain; Prolactin; Tiapamil Hydrochloride

β-Endorphin (BEP)-producing neuron in the hypothalamus plays a key role in bringing the stress axis to a state of homeostasis and maintaining body immune defense system. Long-term delivery of BEP to obtain beneficial effect on chemoprevention is challenging, as the peptides rapidly develop tolerance. Using rats as animal models, we show here that transplantation of BEP neurons into the hypothalamus suppressed carcinogens- and hormone-induced cancers in various tissues and prevented growth and metastasis of established tumors via activation of innate immune functions. In addition, we show that intracerebroventricular administration of nanosphere-attached dibutyryl cyclic adenosine monophosphate (dbcAMP) increased the number of BEP neurons in the hypothalamus, reduced the stress response, enhanced the innate immune function, and prevented tumor cell growth, progression, and metastasis. BEP neuronal supplementation did not produce any deleterious effects on general health but was beneficial in suppressing age-induced alterations in physical activity, metabolic, and immune functions. We conclude that the neuroimmune system has significant control over cancer growth and progression, and that activation of the neuroimmune system via BEP neuronal supplementation/induction may have therapeutic value for cancer prevention and improvement of general health.

Topics: Animals; Anticarcinogenic Agents; beta-Endorphin; Bucladesine; Carcinogens; Cell Differentiation; Disease Models, Animal; Female; Glucose Tolerance Test; Hypothalamus; Immune System; Immunohistochemistry; Killer Cells, Natural; Male; Neoplasm Metastasis; Neoplasms; Neurons; Rats; Rats, Inbred F344; Rats, Nude; Rats, Sprague-Dawley

Endothelin-1 (ET-1) produced by various cancers is known to be responsible for inducing pain. While ET-1 binding to ETAR on peripheral nerves clearly mediates nociception, effects from binding to ETBR are less clear. The present study assessed the effects of ETBR activation and the role of endogenous opioid analgesia in carcinoma pain using an orthotopic cancer pain mouse model. mRNA expression analysis showed that ET-1 was nearly doubled while ETBR was significantly down-regulated in a human oral SCC cell line compared to normal oral keratinocytes (NOK). Squamous cell carcinoma (SCC) cell culture treated with an ETBR agonist (10(-4)M, 10(-5)M, and 10(-6) M BQ-3020) significantly increased the production of beta-endorphin without any effects on leu-enkephalin or dynorphin. Cancer inoculated in the hind paw of athymic mice with SCC induced significant pain, as indicated by reduction of paw withdrawal thresholds in response to mechanical stimulation, compared to sham-injected and NOK-injected groups. Intratumor administration of 3mg/kg BQ-3020 attenuated cancer pain by approximately 50% up to 3h post-injection compared to PBS-vehicle and contralateral injection, while intratumor ETBR antagonist BQ-788 treatment (100 and 300microg/kg and 3mg/kg) had no effects. Local naloxone methiodide (500microg/kg) or selective mu-opioid receptor antagonist (CTOP, 500microg/kg) injection reversed ETBR agonist-induced antinociception in cancer animals. We propose that these results demonstrate that peripheral ETBR agonism attenuates carcinoma pain by modulating beta-endorphins released from the SCC to act on peripheral opioid receptors found in the cancer microenvironment.

Topics: Animals; beta-Endorphin; Cell Line, Tumor; Disease Models, Animal; Down-Regulation; Endothelin-1; Endothelins; Humans; Mice; Mice, Nude; Narcotic Antagonists; Neoplasm Transplantation; Neoplasms; Nociceptors; Oligopeptides; Opioid Peptides; Pain; Peptide Fragments; Piperidines; Receptor, Endothelin B; Receptors, Opioid; Sensory Receptor Cells; Up-Regulation

Cancer pain impairs the quality of life of cancer patients, but opioid analgesics can not only cause inhibition of respiratory function, and constipation, but also other significant side effects such as addiction and tolerance that further decrease quality of life. Thus, in the present study, the effects of electro-acupuncture treatment (EA) on mechanical allodynia were examined in cancer pain mouse model. In order to induce neuropathic cancer pain model, S-180 sarcoma cells were inoculated around the sciatic nerve of left legs of Balb/c mice. The mass of S-180 cancer cells embedded around sciatic nerve in a time course was confirmed by Magnetic Resonance Imaging (MRI) scanning. Mechanical allodynia was most consistently induced in mouse sarcoma cell line S-180 (2 x 10(6) sarcoma cells) treated group among all groups. EA stimulation (2Hz) was daily given to ST36 (Zusanli) of S-180 bearing mice for 30 min for 9 days after S-180 inoculation. EA treatment significantly prolonged paw withdrawal latency from 5 days after inoculation as well as shortened cumulative lifting duration from 7 days after inoculation compared with tumor control. In addition, the overexpressions of pain peptide substance P in dorsal horn of spinal cord were significantly decreased in EA treated group compared with tumor control on Day 9 after inoculation. Furthermore, EA treatment effectively increased the concentration of beta endorphin in blood and brain of mice more than tumor control as well as normal group. The concentration of beta-endorphin for EA treatment group increased by 51.457% in blood 12.6% in brain respectively, compared with tumor control group. These findings suggest that S-180 cancer pain model can be a consistent and short time animal model and also EA treatment can be an alternative therapeutic method for cancer pain via decreased substance P and increased beta endorphin.

Topics: Acupuncture Analgesia; Acupuncture Points; Animals; beta-Endorphin; Cell Line, Tumor; Disease Models, Animal; Electroacupuncture; Humans; Male; Mice; Mice, Inbred BALB C; Neoplasms; Pain; Pain Management; Pain Threshold; Substance P

The developments of bio-analytical methods for analyzing bioactive peptides are of paramount importance. Neuropeptides and their bioactive fragments play a vital role in the regulation of many biological processes and diseases. This paper presents the use of matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) mass spectrometry (MS) method for monitoring neuropeptides along with their degradation products in plasma samples from cancer patients. The neuropeptides focused in this study were beta-endrophin, substance P, and bradykinin. The method involves the enzyme digestion of the neuroactive peptides followed by MALDI-MS sample preparation and subsequent acquisition of the MS spectral data. The mass spectral profile identifies most of the C-terminal and N-terminal peptides, and the mass accuracy was in the range of -1.68 to 1.46 Da with the mass spectrometer utilised. Analysis of the neuropeptide degradation patterns from the cancer patients were compared with the controls showed similar results. The study reveals that this approach can be used to identify the enzymatic digestion products of protein.

Topics: beta-Endorphin; Bradykinin; Cathepsin A; CD13 Antigens; Chemistry Techniques, Analytical; Chemistry, Pharmaceutical; Electrophoresis, Capillary; Humans; Mass Spectrometry; Neoplasms; Neuropeptides; Peptides; Protein Structure, Tertiary; Sensitivity and Specificity; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Trypsin

Recently there has been considerable conjecture in the literature concerning a possible relationship between stress, depression and bereavement, and carcinoma. We shall propose a causal model in which the relationship between stress, depression and carcinoma is clarified. This relationship is grounded on dysregulation of the inflammatory cytokines in stress and depression. Stress is associated with increased expression of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha), and reduced expression of IL-2, interferon-gamma (IFN-gamma), major histocompatability complex (MHC) class II molecules and natural killer cell activity (NKA). Depression is associated with elevated IFN-gamma and IL-1 beta, downregulated IL-2, and reduced NKA. Most organ-related carcinomas are associated with elevated TNF-alpha, which inhibits the activity of protein tyrosine phosphatase (PTPase), the enzyme that initiates activation of the MHC class I pathway. Sustained elevation of TNF-alpha inhibits the activity of PTPase which results in diminished expression of the MHC class I antigen on the cell surface and thus, malignant cells escape immune surveillance. Therefore, stress and depression can foster tumor progression by means of inhibiting the expression of MHC class I and II molecules and through the reduction of NKA.

Topics: beta-Endorphin; Cytokines; Depression; Female; Humans; Interferon-gamma; Male; Neoplasms; Stress, Psychological; Tumor Necrosis Factor-alpha

Topics: Adrenocorticotropic Hormone; Animals; beta-Endorphin; Humans; Mammals; Melanocyte-Stimulating Hormones; Neoplasms; Neoplasms, Radiation-Induced; Pro-Opiomelanocortin; Skin; Skin Physiological Phenomena; Sunlight; Ultraviolet Rays

Topics: beta-Endorphin; Flow Cytometry; Hospitalization; Humans; Interleukin-2; Lymphocytes; Neoplasms

The present data report on five bereaved cancer patients with initial progression-free disease in respect to natural killer cell activity, beta-endorphin binding capacity of their peripheral blood lymphocytes, and the psychometrically objective parameter depression during widowhood. In bereaved and severely depressed cancer patients, there is a tendency of an earlier onset of decreased natural killer cell activity and a reduced binding affinity of beta-endorphin to peripheral blood lymphocytes. A second set of data obtained from a cancer patient cohort study shows a correlation between the two variables depression and beta-endorphin, profiles are inversely correlated and cancer patients, doing clinically well, state that physical activities counteract possible day-to-day depressive disorders. Taking together the two sets of data, one might speculate that for a definable subgroup of cancer patients physical activities raise endorphin levels and psychological well-being, both of which might modulate the activity of immune competent cells, which leads to an extended period of progression-free disease.

Topics: Aged; Bereavement; beta-Endorphin; Exercise; Female; Humans; Killer Cells, Natural; Lymphocytes; Male; Middle Aged; Neoplasms; Receptors, Opioid

Beta-endorphin-like immunoreactivity (beta-ELIR) blood levels in control subjects and in patients with different carcinoma and non-Hodgkin's lymphoma tumor types, were found within the same range, with the exception of one carcinoma type. This pertained to a group of patients with small cell lung cancer who had a significantly higher median beta-ELIR level compared to controls. This finding, and the fact that proopiomelanocortin expression is enhanced in tissues of this cancer type, suggest that the latter might secrete elevated beta-ELIR amounts into the blood of the affected patients.

Topics: beta-Endorphin; Female; Humans; Male; Middle Aged; Neoplasms

The endocrine action of medroxyprogesterone acetate (MPA) has been claimed to be of a glucocorticoid-like nature. Upon clinical observation, MPA has been shown to improve life quality and overall well-being in patients with advanced breast cancer, renal carcinoma, prostatic carcinoma, and uterine adenocarcinoma. The authors have evaluated MPA endocrine action by the administration of human corticotropin releasing factor (hCRF) in a 90-minute assay in 15 patients with advanced breast cancer or renal cell carcinoma both, before the initiation of oral high-dose MPA treatment (1000 mg MPA) as well as after at least 10 days of therapy. The curves for corticotropin, beta-endorphin, and cortisol responses to hCRF of tumor patients who were tested before the initiation of MPA treatment were parallel to the curves of a healthy control group of probands tested under equal conditions, although at significantly higher respective hormone levels. In patients with malignant disorders assayed after MPA administration, both basal and peak hormone levels were found to be comparable with values obtained in healthy controls. In conclusion, MPA appeared to act at a suprapituitary level since pituitary responsiveness to hCRF was preserved under MPA treatment. Moreover, it appeared that MPA brought the hormonal stress state found in patients with malignant tumors back to normal.

Topics: Administration, Oral; Adult; Aged; Antineoplastic Agents; beta-Endorphin; Corticotropin-Releasing Hormone; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Male; Medroxyprogesterone; Medroxyprogesterone Acetate; Middle Aged; Neoplasms; Pituitary Gland, Anterior; Pituitary-Adrenal System

Observations of neuropsychiatric changes in patients receiving interleukin-2 (IL-2) led us to examine the effects of IL-2 administration on the stress-related hormones, beta-endorphin, ACTH, cortisol, and CRH. We evaluated 30 cancer patients who received immunotherapy with IL-2 or IL-2 plus lymphokine-activated killer (LAK) cells. Blood samples were taken immediately before and 4 and 8 h after infusion of IL-2 or IL-2 plus LAK cells. IL-2 stimulated increased hormone levels 4 h after infusion compared with those before therapy and with basal levels in normal volunteers at the following magnitudes: beta-endorphin, 10-fold; ACTH, 20-fold; and cortisol, 2-fold. The effect of IL-2 was not altered in patients also receiving LAK cells. An effect of treatment course was noted, with higher stimulated values seen 4 h after IL-2 in the second treatment course compared with those after the first course [change (delta) in beta-endorphin, 101 vs. 11 fmol/mL; delta ACTH, 138 vs. 8 pmol/L; delta cortisol, 414 vs. 218 nmol/L]. We conclude that IL-2 treatment induces the release of neuroendocrine hormones and that a significant increase in hormonal stimulation occurs upon reexposure to IL-2.

Topics: Adrenocorticotropic Hormone; beta-Endorphin; Corticotropin-Releasing Hormone; Dose-Response Relationship, Drug; Female; Humans; Hydrocortisone; Interleukin-2; Killer Cells, Natural; Male; Middle Aged; Neoplasms; Neurosecretory Systems; Recombinant Proteins

Populations eating low-fat or low-fat, high-fiber diets have lower mortality rates for many cancers and coronary heart disease. The importance of nutrient composition in the lumen on absorption and on function of the gastrointestinal tract as a factor in the development of these diseases has not been studied. We investigated the plasma levels of gut-CNS peptide hormones in lean and obese Dutch women fed a high-fat meal and administered cholecystokinin (CCK). After a high-fat meal the increase in plasma CCK was similar in lean and obese women. CCK administration significantly decreased insulin release in lean and obese women, decreased glucagon release in obese women, but caused a rapid increase in plasma glucagon in lean women. Although the CCK response was similar to a fat meal in lean and obese women, differences in the control of peptide hormone release occurred in response to fat meals and CCK administration.

Topics: beta-Endorphin; Cholecystokinin; Cholesterol; Coronary Disease; Diet; Diet, Vegetarian; Dietary Fiber; Female; Gastrins; Glucagon; Humans; Insulin; Lipids; Middle Aged; Neoplasms; Obesity; Risk Factors

Recent studies showed that both the pineal gland and the endogenous opioid system are involved in the modulation of the immune system and in the regulation of tumor growth. Moreover, a relationship between pineal and opioid system has been demonstrated. In order get an overall view of the psychoneuroendocrine interactions in cancer patients, the levels of melatonin, the most important pineal hormone, and of beta-endorphin have been measured on blood samples collected during the morning. The study was carried out on 54 patients, 42 healthy subjects, and in 34 patients having illnesses other than cancer. Breast cancer, lung carcinoma, and colorectum cancer were the three neoplasms detected in the patients investigated. Growth hormone (GH), somatomedin-C and prolactin (PRL) levels were also determined. beta-endorphin levels were found to be substantially within the normal range in patients with cancer, whereas those of melatonin were raised in several cases. The beta-endorphin/melatonin ratio was higher than 2 in normal subjects, in non-neoplastic patients and in most cancer patients without metastases, whereas this ratio was lower than 2 in almost all patients in a metastatic stage of the disease. Neither melatonin levels nor those of beta-endorphin appeared to be significantly correlated with GH, somatomedin-C, and PRL concentrations. The low beta-endorphin/melatonin ratio observed in metastatic patients suggests the presence of an unbalanced relation between the pineal and the opioid system in those subjects. Therefore, an anomalous relationship between pineal function and opioid activity might play a role in the clinical course of neoplastic disease.

Topics: Adult; beta-Endorphin; Breast Neoplasms; Colonic Neoplasms; Endorphins; Female; Growth Hormone; Humans; Insulin-Like Growth Factor I; Lung Neoplasms; Male; Melatonin; Middle Aged; Neoplasms; Pineal Gland; Prolactin; Rectal Neoplasms

Topics: beta-Endorphin; Dose-Response Relationship, Drug; Drug Evaluation; Endorphins; Humans; Hydroxyindoleacetic Acid; Injections, Spinal; Morphine; Neoplasms; Pain Measurement; Pain, Intractable

It has been previously reported that sauna-induced fevers (approximately 39 degrees C) result in rises of beta-endorphins in normal volunteers. This report describes changes in plasma beta-endorphins in cancer patients undergoing whole body hyperthermia (40.5 degrees C to 41.8 degrees C). Results presented show that there is a linear relationship between thermal stress, defined in terms of core temperature and/or duration of hyperthermia, and the quantitative rise in plasma beta-endorphin levels. Data relating to changes in ACTH and cortisol levels are in a single temperature range (41.5 degrees C--41.8 degrees C) are also reported.

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; beta-Endorphin; Colonic Neoplasms; Female; Humans; Hydrocortisone; Hyperthermia, Induced; Male; Melanoma; Middle Aged; Neoplasms; Pancreatic Neoplasms; Sarcoma

It is known that prolonged therapy with cytotoxic drugs may affect the endocrine system. The present study was carried out to establish whether administration of chemotherapeutic drugs acutely influences hypophyseal and pineal activities. Nineteen patients affected by solid tumors were included in the study, 5 of whom were treated with CMF, 4 with FEC, 4 with CEV, and 6 with CDDP. Cytotoxic drugs were intravenously administered. Venous blood samples were collected at zero time and at 30, 60, 120 and 180 min after drug administration. On a separate occasion, venous blood samples were drawn during a saline infusion only. In each sample FSH, LH, GH, PRL, TSH, cortisol, melatonin and beta-endorphin were determined by the RIA method. The only significant changes observed in this study were a rise in PRL and a decrease in beta-endorphin after CDDP administration. Melatonin was enhanced after CDDP and CMF, and cortisol decreased after CMF and FEC, but their variations were not statistically significant with respect to those seen during saline infusion.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; beta-Endorphin; Cisplatin; Cyclophosphamide; Doxorubicin; Endorphins; Epirubicin; Female; Fluorouracil; Humans; Hydrocortisone; Male; Melatonin; Methotrexate; Neoplasms; Pineal Gland; Pituitary Gland, Anterior; Pituitary Hormones, Anterior; Secretory Rate; Vincristine

Endogenous opioid peptides have been shown to be involved in the regulation of tumour growth. At present, however, no data are available about the secretion of opioid peptides in cancer patients. To draw some preliminary conclusions on opioid brain function in human neoplasms, we evaluated hypophyseal hormone responses to the administration of a met-enkephalin analogue, FK 33-824. The study included 14 patients affected by early or advanced neoplastic disease, 12 healthy subjects and 7 patients with a chronic medical illness other than cancer. FK 33-824 was given intravenously at a dose of 0.3 mg. Venous blood samples were collected at zero time, and 30, 60 and 120 min after drug administration. In each sample, PRL, GH, LH, cortisol and beta-endorphin levels were measured by RIA. In all normal subjects and in patients with non-neoplastic chronic illness, FK 33-824 induced a rise in PRL and GH levels, and a decrease in LH, cortisol and beta-endorphin. A normal endocrine response to FK 33-824 was seen in our cancer patient only, while in the other cases with tumour no hormonal changes or a paradoxical response were seen after FK 33-824. Based on the fact that an abnormal endocrine response to FK 33-824 has been described in hypothalamic-pituitary disorders, in which anomalous brain opioid activity has been demonstrated, these results suggest the existence of an altered function of the opioid system in cancer patients, the clinical importance of which remains to be determined.

Topics: Adult; beta-Endorphin; D-Ala(2),MePhe(4),Met(0)-ol-enkephalin; Female; Growth Hormone; Humans; Hydrocortisone; Luteinizing Hormone; Male; Middle Aged; Neoplasms; Pituitary Gland; Prolactin; Stimulation, Chemical; Time Factors

Surgical hypophysectomy performed in 18 cases with hormone-dependent carcinoma resulted in tumour regression in 38.8% of the cases, and pain relief in 88%. Neuroadenolysis performed 170 times on 130 cases resulted in pain relief in 94% with hormone-dependent carcinoma, and 70% with non-dependent carcinoma. The clinical investigations, following performance of neuroadenolysis, indicate suppressed pituitary function, significant increase of ACTH, thyrotropin-releasing hormone and vasopressin in the cerebrospinal fluid (CSF), delay of long latencies in somatosensory evoked potential and increased pain threshold of C-fibres. Increase of beta-endorphin in CSF was very brief. Though the exact physiological activity in pain sensation of those peptides other than endorphins still remains obscure, increase of the peptides which are mainly synthesized in the hypothalamopituitary axis, along with suppressed pituitary function, is considered to exert a long-lasting suppressive effect on the mediation and perception of cancer pain through C-fibres and the central nervous system.

Topics: beta-Endorphin; Endorphins; Ethanol; Evoked Potentials, Somatosensory; Female; Humans; Hypophysectomy; Male; Neoplasms; Neoplasms, Hormone-Dependent; Pain Measurement; Palliative Care; Pituitary Gland, Anterior; Pituitary Hormones; Thyrotropin-Releasing Hormone

Topics: beta-Endorphin; Endorphins; Female; Humans; Injections, Spinal; Middle Aged; Neoplasms; Pain, Intractable

We studied the cerebrospinal fluid (CSF) and plasma concentration-time profiles of morphine, methadone, and beta-endorphin after lumbar epidural or intrathecal injection in 17 patients with cancer. After epidural injection, all three drugs reached peak levels in lumbar CSF within 34 minutes that were 50 to 1300 times higher than free drug concentrations in plasma. The rate of decline of CSF levels correlated with drug lipid solubility (methadone [t1/2 = 73 minutes] greater than morphine [126 minutes] greater than beta-endorphin [317 minutes]). Plasma levels were comparable with those after intragluteal injection of the same dose. In four patients given intrathecal morphine or methadone, CSF at the C1-2 level contained high levels of morphine as early as 1 hour after injection, but levels of methadone were lower or undetectable. Three of 17 patients reported improved analgesia initially, but none were improved at 2 weeks after chronic therapy. We conclude that analgesia induced by intrathecal or epidural morphine injections is caused by drug acting at both spinal and supraspinal sites. The use of spinal opiates such as morphine is of limited value in patients whose pain is not adequately managed by high systemic doses of morphine-like drugs.

Topics: Adult; Aged; beta-Endorphin; Drug Evaluation; Endorphins; Epidural Space; Female; Half-Life; Humans; Injections, Spinal; Kinetics; Male; Methadone; Middle Aged; Morphine; Neoplasms; Pain, Intractable; Palliative Care

Plasma beta-endorphin levels were found to be significantly lower in patients suffering from chronic pain of malignant etiology than in a control group. After a bilateral stereotactic cryothalamotomy in Centrum Medianum and Parafascicularis nuclei, a good clinical result and a significant increase in plasma beta-endorphin levels were obtained.

Topics: Adult; Aged; beta-Endorphin; Cryosurgery; Endorphins; Female; Humans; Male; Neoplasms; Pain, Intractable; Stereotaxic Techniques; Thalamic Nuclei

Seven cases of chronic pain were treated by intrathecal administration of 30 micrograms of beta-endorphin and dynorphin-(1-13). Compared with saline, both peptides were able to suppress pain for periods up to 4.5 and 7 hours on the average, respectively. No significant side reactions were noticed during the entire investigation.

Topics: Adult; Aged; beta-Endorphin; Cerebral Infarction; Dynorphins; Endorphins; Female; Herpes Zoster; Humans; Injections, Spinal; Male; Middle Aged; Neoplasms; Pain, Intractable; Peptide Fragments; Wounds, Gunshot

A patient with a disseminated malignancy received 3 mg of synthetic beta-endorphin administered intrathecally by lumbar puncture. A marked behavioral syndrome characterized by confusion, hypomanic/manic behavior, and psychosis followed drug administration and persisted for more than 2 days.

Topics: beta-Endorphin; Bipolar Disorder; Confusion; Endorphins; Female; Humans; Injections, Spinal; Middle Aged; Neoplasms; Palliative Care; Psychoses, Substance-Induced

Chronic implantation of a stimulating electrode in the thalamic relay nucleus (11 cases), in the periaqueductal gray (1 case) and in the internal capsule (2 cases) was performed in fourteen cases which suffered from intractable pain. All these cases could get pain relief at least initial two months. Ventricular fluids were collected before and after stimulation with optimal combination of parameters, and measurements of beta-endorphin were performed by radio-immunoassay. Intrathecal morphine (1mg) injection was performed in eight cases. Cerebrospinal fluids were collected by lumbar tap before and 24 hours after morphine injection. beta-endorphin immunoreactivity was measured by the same method. Pain relief was judged to be excellent if the patient so claimed, and if he discontinued analgesics. Pain relief was thought to be good when it was not completely controllable by stimulation but was sufficiently improved that the patient could do without analgesics. It was thought to be fair when patient could not discontinue analgesics, and poor when patient could not get pain relief. We usually attempt to prevent the stimulation-tolerance by administration of the monoamine precursors , i.e., 1-dopa and 1-tryptophan, on the basis of the experimental observation reported previously. In somatogenic pain patients, the thalamic relay nucleus stimulation was performed in 7 cases (excellent; 3, good; 1, fair; 3) and the periaqueductal gray stimulation in one case (good).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; beta-Endorphin; Electrodes, Implanted; Electronarcosis; Endorphins; Female; Humans; Male; Middle Aged; Neoplasms; Pain, Intractable; Thalamic Nuclei

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

Immunoreactive beta-endorphin (beta-EP) in the ventricular fluid of six carcinomatous patients was measured using a specific radioimmunoassay. The subjects were undergoing a surgical procedure for relief of chronic intractable pain. This procedure involved the focal stimulation and coagulation of the posteromedial hypothalamus. Samples of ventricular fluid were collected before and after the stimulation and serially after the coagulation. Prior to stimulation, beta-EP-like immunoreactivity (beta-EP-LI) was below 200 pg/ml. In all of the six patients with pain relief, electrical stimulation led to a marked increase in immunoreactive beta-EP. In three patients beta-EP levels remained high after electrical coagulation for 6-24 hrs. These results suggest that beta-EP-like material, released into the ventricular fluid, may contribute to the initial pain blockade that results from stimulation and coagulation of the posteromedial hypothalamus.

Topics: Adult; beta-Endorphin; Chromatography, Gel; Electric Stimulation Therapy; Endorphins; Female; Humans; Hypothalamus; Hypothalamus, Posterior; Male; Middle Aged; Neoplasms; Pain, Intractable; Radioimmunoassay; Time Factors

Epidural administration of 3 mg of synthetic beta-endorphin produced analgesia in 10 patients with intractable pain due to disseminated cancer. Mean onset of relief of pain was 24 +/- 3 minutes and the mean duration of analgesia was 19 +/- 3 hours. The onset of analgesia produced by the epidural injection of beta-endorphin was slower and the duration less than those observed after intrathecal injection.

Topics: Adult; Aged; beta-Endorphin; Endorphins; Epidural Space; Female; Humans; Injections; Male; Middle Aged; Neoplasms; Pain

Topics: Acupuncture Therapy; Adrenocorticotropic Hormone; beta-Endorphin; beta-Lipotropin; Brain Chemistry; Endorphins; Enkephalin, Methionine; Enkephalins; Humans; Melanocyte-Stimulating Hormones; Neoplasms; Radioimmunoassay