Opioid peptide response to spinal cord stimulation in chronic critical limb ischemia

Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Ospedale S. Orsola, Via Massarenti 9, 40138 Bologna, Italy.
Peptides (Impact Factor: 2.62). 04/2004; 25(4):571-5. DOI: 10.1016/j.peptides.2004.01.007
Source: PubMed


Twelve patients with chronic critical limb ischemia in whom a spinal cord stimulation (SCS) system had been implanted for at least one year had increased microvascular flow and achieved healing of trophic acral lesions. After switching off the system, the clinical improvement persisted for 10 days and the neurohormonal pattern showed high plasma values of beta-endorphin and Met-enkephalin, normal dynorphin B, endothelin-1 and catecholamines, and low nitric oxide. Met-enkephalin levels were further increased (P < 0.01) immediately after switching on the electrical stimulation again. The persistence of high plasma opioid levels after switching off the spinal cord stimulation explains the absence of subjective complaints and suggests an involvement of opioids in the regulation and improvement of the microcirculation.

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    • "Results from a clinical study show that opioid peptides are released during SCS. In that study, plasma Met-enkephalin increased during SCS, indicating an involvement of opioids in the regulation and improvement of the microcirculation by SCS (Fontana et al, 2004). However, clinically there is little or no evidence that opioids are involved in the SCS effects (Eliasson et al., 1998; Meyerson and Linderoth, 2000) "
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