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IJBCP International Journal of Basic & Clinical Pharmacology Print ISSN 2319-2003 | Online ISSN 2279-0780 IJBCP International Journal of Basic & Clinical Pharmacology doi: 10.5455/2319-2003.ijbcp20150431 Research Article Effect of nalfurafi ne hydrochloride on the basal pressure of the sphincter of Oddi in anesthetized rabbits Ryosuke Kobayashi, Kaoru Nakao*, Kiyoshi Yamada, Yohei Miyamoto, Hidenori Mochizuki Toray Industries, Inc. ABSTRACT Pharmaceutical Research Laboratories, 10-1, Tebiro Background: Opioid analgesics, which are classifi ed as μ-opioid receptor agonists, are 6-chome, Kamakura, known to induce spasms or contraction of the sphincter of Oddi (SO), thereby inducing Kanagawa - 248-8555, Japan or exacerbating biliary diseases such as biliary obstruction, gallbladder dysfunction, cholelithiasis, pancreatitis, biliary dyskinesia, cholangitis, and cholecystitis. However, Received: 09 February 2015 effects of κ-opioid receptor agonists on SO contraction have not been clarifi ed. In the Accepted: 07 March 2015 present study, we investigated the effect of nalfurafi ne hydrochloride (nalfurafi ne), (E)-N-[17-(cyclopropylmethyl)-4,5α-epoxy-3,14-dihydroxymorphinan-6β-yl]-3- *Correspondence to: (furan-3-yl)-N-methylprop-2-enamide monohydrochloride, a selective κ-opioid Kaoru Nakao, receptor agonist, on spontaneous contraction of rabbit SO. Email: Kaoru_Nakao@nts. Methods: SO contraction was measured using manometry in anesthetized rabbits. toray.co.jp Rabbits were anesthetized with intravenous administration of 25 mg/kg sodium pentobarbital. An open tip catheter was inserted into the common bile duct toward Copyright: © the author(s), the SO ampullae. Saline was perfused through the lumen of the open tip catheter at a publisher and licensee Medip constant rate of 6 ml/hr using a syringe pump. Nalfurafi ne, morphine, and pentazocine Academy. This is an open- were intravenously (i.v.) administered and perfusion pressure was recorded. access article distributed under Results: Morphine (0.3 mg/kg, i.v.) and pentazocine (3 mg/kg, i.v.) were found to the terms of the Creative increase SO perfusion pressure, suggesting that these opioid analgesics may cause Commons Attribution Non- SO contraction. In contrast, nalfurafi ne (0.2 μg/kg, i.v.) decreased the perfusion Commercial License, which pressure, indicating that this κ-opioid receptor agonist suppresses SO contraction. permits unrestricted non- Conclusions: These fi ndings suggest that nalfurafi ne is unlikely to induce or commercial use, distribution, exacerbate biliary diseases and may be safely used in patients with these disorders. and reproduction in any medium, provided the original Keywords: Nalfurafi ne hydrochloride, TRK-820, κ-opioid receptor, Sphincter of work is properly cited. Oddi, Biliary disease INTRODUCTION hinan-6β-yl]-3-(furan-3-yl)-N-methylprop-2-enamide monohydrochloride, more commonly known as nalfurafi ne hydrochloride (nalfurafi ne), has been shown to be well- Biliary disease is a generic term for digestive system diseases tolerated and effective in the treatment of pruritus, resistant of the gallbladder, bile duct, pancreas, or pancreatic duct. to existing therapies or treatments in hemodialysis patients.3-6 The sphincter of Oddi (SO) is the smooth muscle of the Nalfurafine was officially approved for clinical use in choledochoduodenal junction that regulates the fl ow of January 2009 by the Ministry of Health, Labour, and Welfare bile and pancreatic juice into the duodenum and prevents of Japan.3,5 In this study, we investigated whether nalfurafi ne duodenobiliary refl ux.1 It is thought that SO contraction affected spontaneous SO contraction in anesthetized rabbits. leads to an increase in common bile duct pressure,2 thereby inducing or exacerbating biliary diseases. In clinical METHODS situations, μ-opioid receptor agonists, such as morphine, buprenorphine, and pentazocine are known to induce SO Animals spasms and exacerbate cholestatic and pancreatic disorders. However, the relationship between κ-opioid receptors and SO function has not yet been clarifi ed. Male New Zealand white rabbits (body weight: 2.0-2.5 kg; Japan SLC Inc., Shizuoka, Japan) were used. All rabbits The selective κ-opioid receptor agonist (E)-N-[17- were individually housed at room temperature (21-25°C), (cyclopropylmethyl)-4,5α-epoxy-3,14-dihydroxymorp with 40-70% humidity and 12 hrs light/dark cycles (lights www.ijbcp.com International Journal of Basic & Clinical Pharmacology | March-April 2015 | Vol 4 | Issue 2 Page 198 Kobayashi R et al. Int J Basic Clin Pharmacol. 2015 Apr;4(2):198-202 on at 7:00 AM) for at least 1-week prior to experimentation. Instruments) using the DX-300 transducer (Nihon Kohden) Rabbits were given free access to food and water ad libitum. and blood pressure amplifi er (AP-641G, Nihon Kohden). All experiments were conducted with the approval of In addition, duodenum motility was monitored by a force the Animal Experimentation Ethics Committee of Basic transducer (F-12IS, Star Medical Inc., Tokyo, Japan) placed Research Laboratories, Toray Industries, Inc. (Tokyo, Japan). on the choledochoduodenal junction, bridge balance box (FB-01, Star Medical Inc., Tokyo, Japan), currier amplifi er (AP-601G, Nihon Kohden), and a PowerLab system (AD Anesthesia Instruments). Rabbits were deprived of food 1-day before testing. On the Test drugs day of testing, rabbits were anesthetized with intravenous (i.v.) administration of 25 mg/kg sodium pentobarbital to an auricular vein. Additional pentobarbital was administered Nalfurafi ne (Code No: TRK-820, Toray Industries, Inc.) was to maintain a certain level of anesthesia throughout the dissolved in 5% mannitol solution; nalfurafi ne was confi rmed experiment. Anesthetized rabbits were placed on a warm mat to be stable in this solution. Morphine hydrochloride hydrate (42°C) in the supine position. Rabbits were intratracheally (morphine; Takeda Pharmaceutical Co., Ltd., Osaka, Japan) intubated with an endotracheal tube (16 Fr; Terumo, Tokyo, and pentazocine hydrochloride (pentazocine; Pentagin Japan), connected to a respirator (SN-480-5; Shinano, injection 30, Daiichi Sankyo Co., Ltd., Tokyo, Japan) were Tokyo, Japan). Ventilation was performed with a 4-6 ml/ diluted with saline. Nalfurafi ne, morphine, and pentazocine kg/ventilation volume range 40-60% ventilation fl ow and were i.v. administered at 1 ml/kg body weight. Sulfated 45-55 rpm/min ventilation rate all of which were adjusted cholecystokinin-octapeptide (CCK-8, Peptide Institute, Inc., to maintain 7.34-7.45 blood pH, 35-45 mmHg PCO2, and Osaka, Japan) was dissolved in saline and i.v. administered 80-105 mmHg PO2 as measured by an I-STAT analyzer (Fuso at 0.1 ml/kg body weight. Pharmaceutical Industries, Ltd., Osaka, Japan). Test schedule Cardiovascular monitoring As shown in Figure 1, after basal perfusion pressure stabilized, A polyethylene tube (PE50; Becton, Dickinson and Co., perfusion pressure was recorded for 3 mins. After the Franklin Lakes, NJ, USA) was inserted and fi xed into a administration of CCK-8, the perfusion pressure of each rabbit jugular vein for infusion of balanced salt solution (vehicle; recorded for 3 mins. Only rabbits showing more than 3 mmHg Solita T-3, Ajinomoto Pharmaceuticals Co., Ltd., Tokyo, increase in maximum perfusion pressure for 3 mins after Japan) and test drug administration. Another tube (PE50), administration of CCK-8 compared with pre-CCK-8 values it was connected to the transducer (DX-300, Nihon Kohden, were used for further experiments. After 30 mins or longer, the Tokyo, Japan), was inserted and fi xed into a carotid artery perfusion pressure of CCK-8-responsive animals was recorded. for measurement of heart rate and blood pressure. Heart Furthermore, the vehicle corresponding to each test drug was rate and blood pressure were measured using a PowerLab administered (60 sec i.v. infusion) and the perfusion pressure system (AD Instruments, Sydney, Australia) through a heart recorded for 3 mins. After 30 mins or longer, the perfusion rate amplifi er (AT-601G, Nihon Kohden, Tokyo, Japan) and pressure of each CCK-8 responsive animal was recorded for blood pressure amplifi er (AP-641G, Nihon Kohden, Tokyo, 3 mins, then test drugs were administered (60 sec i.v. infusion) Japan), respectively. and the perfusion pressure recorded for another 3 mins. Measurement of SO perfusion pressure To monitor the motility of SO, an abdominal incision was made to expose the duodenum and the common bile duct. A small incision was made at the common bile duct, and a tube (PE50) was inserted toward the gallbladder to drain the bile. An open tip catheter, prepared by modifying a 5Fr ATOM feeding catheter (outer diameter, 1.7 mm), was also inserted into the common bile duct toward the SO ampullae. Saline was perfused through the lumen of the open tip catheter at a constant rate of 6 ml/hr (constant pressure perfusion) using a syringe pump (model 55-1111, Harvard Apparatus, MA, USA). Perfusion pressure was used as an indicator of SO Figure 1: Testing schedule for sphincter of Oddi contraction and was recorded using a PowerLab system (AD perfusion pressure recording. International Journal of Basic & Clinical Pharmacology | March-April 2015 | Vol 4 | Issue 2 Page 199 Kobayashi R et al. Int J Basic Clin Pharmacol. 2015 Apr;4(2):198-202 Statistical analysis vehicle administration and 160.96±13.05% (average, +6.49 mmHg) with pentazocine (p=0.0093; Figure 2b). All data were expressed as the mean±standard error Effect of nalfurafi ne on SO perfusion pressure of the means. Statistical analysis was performed using the percentage change in maximum perfusion pressure calculated by dividing post-dosing maximum perfusion Nalfurafi ne (0.2 μg/kg, i.v.) did not increase the perfusion pressure by pre-dosing maximum perfusion pressure. pressure in rabbits (0/11 animals). Instead, the maximum Comparison of vehicle-administration percentage change perfusion pressure significantly decreased after its in maximum perfusion pressure with drug-injection values administration (Figure 3a and b). The percentage change in was performed by paired t-test. The signifi cance level was maximum perfusion pressure was 99.81±2.02% (average, set to p<0.05.
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