Enhanced lithogenicity of bile following chronic morphine administration to female guinea pigs.

Acute and chronic opiate exposure impairs the emptying of bile from the gallbladder. In this study, the effects of a 4-day morphine regimen on bile composition were examined. Bile acids and phospholipids concentration of bile obtained from the gallbladder of female morphine-treated (MT) guinea pigs were reduced by 60% and 80% respectively, resulting in a highly lithogenic bile. Concentrations of bile acids and phospholipids of spontaneously secreted bile were not reduced. However, the lithogenicity of the hepatic bile in MT animals was still increased because of a 10 fold elevation in cholesterol concentration. Ratios of solute concentrations of stored and freshly secreted bile indicated that morphine also impaired the ability of the gallbladder to concentrate bile. Thus chronic morphine exposure increased bile lithogenicity by increasing cholesterol content and also by diluting the bile in the gallbladder. These alterations and the previously described biliary stasis indicates that chronic opiate and endogenous opioid exposure should facilitate gallstone formation.

Stress- and morphine-induced elevations of plasma and tissue cholesterol in mice: reversal by naltrexone.

Our earlier studies indicated that stress-induced facilitation of gallstone formation could be prevented by the opiate antagonist naltrexone. In view of the possible link between gallstone formation and atherosclerosis, the present study examined the possibility that endogenous opioids might also mediate stress-induced hypercholesterolemia. A 28-day immobilization stress schedule was used to induce increases in plasma, aortic and liver cholesterol of mice maintained on a high cholesterol diet. These stress-induced increases in plasma, hepatic and aortic cholesterol were reversed by pretreatment with the opiate antagonist, naltrexone (1 mg/kg). Exposure of mice to morphine (0.1% in the drinking water for 28 days) resulted in elevations of plasma, liver, and aortic cholesterol levels, similar to those observed following immobilization. In contrast, chronic exposure to the peripherally restricted opiate agonist, loperamide (0.1% in the drinking water for 28 days), was ineffective. The antagonism by naltrexone and duplication by morphine but not loperamide suggest that stress-induced hypercholesterolemia may require the activation of central endogenous opioid systems.

Modification of drug action by hyperammonemia.

Pretreatment with ammonium acetate (NH4Ac) (6 mmol/kg s.c.) approximately doubled the time morphine-treated mice remained on a hot surface and similarly increased muscular incoordination by diazepam, but NH4Ac treatment alone had no effect. Thus, hyperammonemia is capable of altering drug action and must be considered along with impaired drug metabolism in enhanced drug responses associated with liver disease. Experiments in vitro showed that acetylcholine-induced catecholamine release from bovine adrenal medulla is depressed as much as 50% by 0.3 mM NH4Ac and KCl-induced contractions of guinea-pig ileum were inhibited 20% by 5 mM NH4Ac. Addition of excess calcium reversed the depression in both tissues, but calcium-independent catecholamine release by acetaldehyde was not blocked by NH4Ac. These results suggested that ammonia blocks calcium channels. Parallels in the actions of NH4Ac and the calcium channel blocker verapamil support this concept. Both verapamil (10 mg/kg i.p.) and NH4Ac pretreatment enhanced morphine analgesia- and diazepam-induced muscular incoordination and antagonized amphetamine-induced motor activity, and neither verapamil nor NH4Ac affected the convulsant action of metrazol. The data suggest that hyperammonemia exerts a calcium channel blocking action which enhances the effects of central nervous system depressants and certain opioid analgesics.

Stress, endogenous opioids and salt intake.

The effect of stress on NaCl intake was examined in mice given a choice of water and 1.5% NaCl to drink. Immobilization of mice for 15-min and 24-h food deprivation resulted in a 2.5- and 5-fold increases in NaCl intake, respectively, without affecting water intake. Naloxone treatment (0.01, 0.1 and 1.0 mg/kg) produced a dose-dependent decrease in the stress-induced NaCl intake, as did captopril treatment (5, 10 and 50 mg/kg). Intraventricular injection of angiotensin II in mice resulted in an increase in 1.5% NaCl intake, which was blocked by naloxone. Morphine (10 mg/kg) increased the preference of mice for a normally aversive 3.0% NaCl solution, but not for preferred, less concentrated, solutions of NaCl. The results suggest that both endogenous opioids and angiotensin II contribute to stress-induced NaCl intake, and that endogenous opioids may also mediate the increase in NaCl intake, observed with angiotensin II.