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Publication : Morphine acts on spinal dynorphin neurons to cause itch through disinhibition.

First Author  Nguyen E Year  2021
Journal  Sci Transl Med Volume  13
Issue  579 PubMed ID  33536279
Mgi Jnum  J:302044 Mgi Id  MGI:6505939
Doi  10.1126/scitranslmed.abc3774 Citation  Nguyen E, et al. (2021) Morphine acts on spinal dynorphin neurons to cause itch through disinhibition. Sci Transl Med 13(579)
abstractText  Morphine-induced itch is a very common and debilitating side effect that occurs in laboring women who receive epidural analgesia and in patients who receive spinal morphine for relief of perioperative pain. Although antihistamines are still widely prescribed for the treatment of morphine-induced itch, their use is controversial because the cellular basis for morphine-induced itch remains unclear. Here, we used animal models and show that neuraxial morphine causes itch through neurons and not mast cells. In particular, we found that spinal dynorphin (Pdyn) neurons are both necessary and sufficient for morphine-induced itch in mice. Agonism of the kappa-opioid receptor alleviated morphine-induced itch in mice and nonhuman primates. Thus, our findings not only reveal that morphine causes itch through a mechanism of disinhibition but also challenge the long-standing use of antihistamines, thereby informing the treatment of millions worldwide.
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