Morphine: double-faced roles in the regulation of tumor development

AbstractMorphine, a highly potent analgesic, is one of the most effective drugs for the treatment of severe pain associated with cancer. It directly acts on the central nervous system to relieve pain, but also cause secondary complications, such as addiction, respiratory depression and constipation due to its activities on peripheral tissues. Besides pain relief, morphine is of great importance on cancer management with its effect on tumor development being the subject of debate for many years with some contradictory findings. Morphine has shown both tumor growth-promoting and growth-inhibiting effects in many published research studies. And various signaling pathways have been suggested to be involved in these effects of morphine. Based on a thorough literature review, we summarized the double-faced effects of morphine in tumor development, including tumor cell growth and apoptosis, metastasis, angiogenesis, immunomodulation and inflammation. And we attempted to optimize morphine administration in cancer patients to attenuate its tumor growth-promoting effects.
Source: Clinical and Translational Oncology - Category: Cancer & Oncology Source Type: research

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Buprenorphine is widely used as a treatment for patients with opioid use disorders, but has also been shown to be an effective treatment for cancer and neuropathic pain, with unique pharmacologic properties that give it several advantages over traditional opioids. Buprenorphine is associated with less analgesic tolerance, and is less likely to cause respiratory depression and constipation than other opioids. Buprenorphine also does not cause immunosuppression, sphincter of Oddi dysfunction, or hypogonadism like traditional opioids.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Abstract There is unmet need to design an analgesic with fewer side effects for severe pain management. Although traditional opioids are the most effective painkillers, they are accompanied by severe adverse responses, such as respiratory depression, constipation symptoms, tolerance, withdrawal, and addiction. We indicated BPR1M97 as a dual mu opioid receptor (MOP)/nociceptin-orphanin FQ peptide (NOP) receptor full agonist and investigated the pharmacology of BPR1M97 in multiple animal models. In vitro studies on BPR1M97 were assessed using cyclic-adenosine monophosphate production, β-arrestin, internalizatio...
Source: Neuropharmacology - Category: Drugs & Pharmacology Authors: Tags: Neuropharmacology Source Type: research
CONCLUSION: The epidemic of opioid misuse has shown that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that conflicts of interest and validity of models must be more intensively considered in the context of drug development and that novel analgesics with less addictive potential are urgently needed. Currently, the most promising perspectives appear to be augmenting endogenous opioid actions and the selective activation of peripheral opioid receptors. PMID: 31222410 [PubMed - as supplied by publisher]
Source: Schmerz - Category: Anesthesiology Authors: Tags: Schmerz Source Type: research
This article reviews pharmacological principles and research strategies aiming at novel opioids with reduced side effects. Basic mechanisms underlying pain, opioid analgesia and other opioid actions are outlined. To illustrate the clinical situation and medical needs, plasticity of opioid receptors, intracellular signaling pathways, endogenous and exogenous opioid receptor ligands, central and peripheral sites of analgesic and side effects are discussed. Expert opinion: The epidemic of opioid misuse has taught us that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that co...
Source: Expert Opinion on Investigational Drugs - Category: Drugs & Pharmacology Tags: Expert Opin Investig Drugs Source Type: research
Conclusion: PCIA provided timely, safe, and satisfactory analgesia for advanced cancer patients with pain and may be useful for titration of opioids, management of severe breakthrough pain, and conversion to oral analgesia. There was no significant difference of analgesic effect and side effect among the hydromorphone, sufentanil, and oxycodone. PMID: 29849846 [PubMed - in process]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
  RX PAD With the death of the entertainer Prince attributed to a fentanyl overdose, and new FDA warnings, opioids have been making headlines. Since the most common reason patients visit the emergency department is for pain, it is not surprising that emergency physicians prescribe and administer medications such as oxycodone on a daily basis. Here are some of the basics about how oxycodone works, and also the reason why chronic users may be at even higher risk of unexpected respiratory depression. HOW IT WORKS: Oxycodone is a semi-synthetic opioid with analgesic properties. Oxycodone binds to mu, kappa, and delta opio...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news
Follow me at @mallikamarshall If your doctor told you that she was giving you a placebo and that it would help you, would you believe her? As it turns out, based on new research, maybe you should. Placebos are often considered “fake” treatments. You may have heard them described as “sugar pills.” They usually take the form of pills, injections, or even entire procedures that are used in clinical trials to test “real” treatments. For example, one group of study participants is given an active drug and another group is given a placebo, which looks exactly like the active medication but is ...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Complementary and alternative medicine Pain Management Source Type: news
It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management. The “balancing act” of managing chronic pain Here is the problem: For people with chronic pain, the pain affects nearly all aspects of their lives. But at the same time, treatments to relieve chronic pain also have the potential to influence many aspects of a person’s life. Our best pain-relieving drugs have lots of unpleasant side effects. E...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Health Addiction Arthritis Back Pain Cancer Migraines Pain Management Behavioral Health chronic pain managing pain Source Type: news
Chronic pain is a major public health problem, which is estimated to affect more than 100 million people in the United States and about 20–30% of the population worldwide. The prevalence of persistent pain is expected to rise in the near future as the incidence of associated diseases (including diabetes, obesity, cardiovascular disorders, arthritis, and cancer) increases in the aging U.S. population. Opioids are powerful analgesics that are commonly used and found to be effective for many types of pain. However, opioids can produce significant side effects, including constipation, nausea, mental clouding, and respira...
Source: Psychology of Pain - Category: Psychiatrists and Psychologists Source Type: blogs
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