Morphine and other opioids remain the most frequently prescribed drugs for the treatment of moderate to severe pain, including pain due to cancer or surgery. The overall goal of this study is to elucidate the mechanisms of morphine and other opioid-induced tolerance in the ileum and brain but not in the colon which leads to constipation and limits the chronic use of these excellent pain relievers in man. This proposal represents a collaboration of two senior laboratories, one with expertise in gastrointestinal physiology and the other with extensive experience in studying the acute and chronic effects of morphine and other opioids, utilizing molecular, cellular and whole animal approaches. The main hypothesis to be tested is that differences in the cellular signaling properties between the colon and ileum result in morphine-induced tolerance in the ileum but not the colon. We further propose that the ratio of tolerance to various opioids is the same across these tissues. Our preliminary data demonstrate that as marked tolerance develops to the antinociceptive effects of morphine following chronic administration in mice, tolerance does not develop to its constipating effects. The major objective of the work proposed in year 1 is to elucidate whether this difference in tolerance in different tissues observed for morphine is the same for other opioids both in vivo and in vitro. In the second year we propose to further evaluate our interesting finding that nicotinamide, an endogenous CD-38 inhibitor, induces tolerance to morphine in the colon, a phenomenon not previously reported. We will test the hypothesis that the CD-38 pathway prevents tolerance development in the colon and that its blockade by either chemical means or genetically in knock out animals allows tolerance to occur. We propose to investigate whether CD38 in other tissues such as the ileum or brain causes a regulatory effect on the development of tolerance in these tissues as well. Further, we will investigate whether additional steps in the signal transduction process such as the phosphorylation of mu opioid receptors, the activity of protein kinase C and A, GRK alter opioid tolerance development similarly or differently in various tissues. Our preliminary data demonstrate that inhibition of the CD38 pathway by either nicotinamide or 8-bromo cyclic ADPribose results in the induction of tolerance to morphine in the colon. We will test the effects of nictoinamide, ryanodine and cADPribose on tolerance development and on dependence to morphine in the isolated colonic muscle strips and determine if inhibition of the CD38 pathways results in changes in mu receptor phosphorylation in enteric neurons. The long-term major public health implication of this research is the use of this information to develop medications to treat chronic pain that are devoid of constipation. These studies will also increase our understanding of the potential mechanisms in the development of tolerance and ultimately physical dependence to opioids in the brain.

Public Health Relevance

implication of this research is the use of the information to develop medications to treat chronic pain that are devoid of constipation. A second benefit is the utilization of this information regarding the mechanism of tolerance to opioids in some tissues such as the brain and the ileum and the lack of tolerance in the colon, to increasing our understanding of the mechanism(s) of tolerance in the brain and ultimately physical dependence to opioids.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA024009-01A1
Application #
7525435
Study Section
Clinical and Integrative Gastrointestinal Pathobiology Study Section (CIGP)
Program Officer
Rapaka, Rao
Project Start
2009-08-01
Project End
2011-07-31
Budget Start
2009-08-01
Budget End
2010-07-31
Support Year
1
Fiscal Year
2009
Total Cost
$299,000
Indirect Cost
Name
Virginia Commonwealth University
Department
Pharmacology
Type
Schools of Medicine
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
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Bhave, Sukhada; Gade, Aravind; Kang, Minho et al. (2017) Connexin-purinergic signaling in enteric glia mediates the prolonged effect of morphine on constipation. FASEB J 31:2649-2660
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Kang, Minho; Hashimoto, Atsushi; Gade, Aravind et al. (2015) Interaction between hydrogen sulfide-induced sulfhydration and tyrosine nitration in the KATP channel complex. Am J Physiol Gastrointest Liver Physiol 308:G532-9
Akbarali, Hamid I; Kang, Minho (2015) Postranslational Modification of Ion Channels in Colonic Inflammation. Curr Neuropharmacol 13:234-8
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