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Respiratory effects of thyrotropin-releasing hormone and its analogue taltirelin on opioid-induced respiratory depression
Opioid-induced respiratory depression (OIRD) is a serious complication of opioid use. It is related to activation of μ-opioid receptors, expressed on neurones in brainstem respiratory networks. Reversal of OIRD by naloxone restores breathing activity but drawbacks include difficulty in reversing high-affinity or high-dose opioids, short duration of action, pain and withdrawal symptoms, and inability to reverse non-opioid-induced respiratory depression. Hence, there is an unmet need for respiratory stimulants that will reverse respiratory depression from any drug without these drawbacks. One possible strategy is treatment of OIRD with the hypothalamic hormone thyrotropin-releasing hormone (TRH). TRH is widely distributed throughout the neuraxis and apart from effects within the hypothalamic–hypophysial neuroendocrine system, it has functions within the limbic/cortical and brainstem/midbrain systems. TRH acts by binding to the G protein-coupled receptors, TRHR1 and TRHR2.
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Show moreOpioid-induced respiratory depression (OIRD) is a serious complication of opioid use. It is related to activation of μ-opioid receptors, expressed on neurones in brainstem respiratory networks. Reversal of OIRD by naloxone restores breathing activity but drawbacks include difficulty in reversing high-affinity or high-dose opioids, short duration of action, pain and withdrawal symptoms, and inability to reverse non-opioid-induced respiratory depression. Hence, there is an unmet need for respiratory stimulants that will reverse respiratory depression from any drug without these drawbacks. One possible strategy is treatment of OIRD with the hypothalamic hormone thyrotropin-releasing hormone (TRH). TRH is widely distributed throughout the neuraxis and apart from effects within the hypothalamic–hypophysial neuroendocrine system, it has functions within the limbic/cortical and brainstem/midbrain systems. TRH acts by binding to the G protein-coupled receptors, TRHR1 and TRHR2.
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TRHR2 modulates non-endocrine functions such as the antiepileptic and respiratory effects of TRH
Show less- All authors
- Algera, M.H.; Cotten, J.F.; Velzen, M. van; Niesters, M.; Boon, M.; Shoham, D.S.; Dandrea, K.E.; Schrier, R. van der; Dahan, A.
- Date
- 2022-04-19
- Journal
- British Journal of Anaesthesia
- Volume
- 129
- Issue
- 1
- Pages
- E4 - E6
- Link
- https://www.bjanaesthesia.org.uk/article/S0007-0912(22)00147-7/fulltext