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Les antagonistes de la cholécystokinine: futurs antalgiques?

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Douleur et Analgésie

Résumé

La cholécystokinine (CCK) est présente dans le cerveau et la moelle épinière où elle agit comme neuromédiateur en activant deux types de récepteurs A et B, ce dernier étant prédominant dans le système nerveux central. Différentes études électrophysiologiques et comportementales plaident en faveur de l'existence d'une interaction entre les systèmes CCK-ergique et opioïde endogènes dans le contrôle de la nociception. Le système CCK-ergique a ainsi été qualifié de système anti-opioïdergique. Expérimentalement, l'administration d'un antagoniste CCK-B potentialise l'effet antinociceptif de la morphine. L'ensemble des données actuelles laisse entrevoir la possibilité d'utiliser des antagonistes CCK-B spécifiques et sélectifs comme analgésiques de complément à la morphine dans le traitement des douleurs postopératories ou chroniques sévères.

Summary

Cholecystokinin (CCK) is located in the brain and the spinal cord. CCK acts as a neuromediator and produces various biological effects that are mediated by two receptors: CCK-A and CCK-B, the predominant form found in the central nervous system. Electrophysiological and behavioural studies suggest the existence of regulatory mechanism between CCK and opioid systems in the control of pain. Thus, it has been proposed that CCK could act as an endogenous opiate and play a role in the development of morphine tolerance. In contrast, administration of a CCK-B receptor antagonist may enhance the antinociceptive effect of morphine. Experimental and clinical studies indicate the possibility for the therapeutic use of selective and specific CCK-B receptor antagonists as co-analgesics with morphine in postoperative period or in patient with intractable pain.

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Mann, C. Les antagonistes de la cholécystokinine: futurs antalgiques?. Doul. et Analg. 10, 127–130 (1997). https://doi.org/10.1007/BF03003146

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  • DOI: https://doi.org/10.1007/BF03003146

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