Objective and Design: On the basis that endogenous opioids play a role in the physiological response to inflammation, this
study tests the antiarthritic effects of a μ-opioid agonist, morphine and the partial μ-agonist, buprenorphine.
Material: Male Lewis rats were used.
Treatment: Rats were innoculated subcutaneously with 0.05 ml of Freund's complete adjuvant (5 mg/ml) into the right hind paw
to produce adjuvant arthritis. Morphine (either 10 to 60 mg/kg/day s.c. bolus or 60 mg/kg/day s.c. infusion) and buprenorphine
(0.65±0.06 mg/kg/day, orally), respectively, were administered for 3 days during the primary inflammatory phase of adjuvant
arthritis.
Methods: The progression of adjuvant arthritis was monitored every three days by body weight change and hind limb oedema (ipsilateral
and contralateral). On day 21 the animals were sacrificed and histology and radiography of the contralateral limb were performed.
In rats receiving Freund's adjuvant and no drug treatment, the incidence of arthritis was 89%. Effect was expressed as the
pooled severity index (PSI) derived from the arithmetic average of the volume, histology and radiography scores in the contralateral
hind limb.
Results: Buprenorphine had no effect on experimental arthritis (PSI control vs treated: 242±28 vs 253±28%). In contrast, morphine
by subcutaneous injection twice daily (10 to 60 mg/kg/day) but not by subcutaneous infusion (60 mg/kg/day) was found to attenuate
the progression of adjuvant arthritis in a dose-dependent manner. This indicates that the anti-arthritic effects of morphine
are opioid receptor mediated (ED50, 58±9 mg/kg) and suggests that the local concentration reached effective levels only after subcutaneous injection. It is
also possible that the high doses of morphine were anti-inflammatory through effects at the kappa receptor. However, these
high doses of morphine produced death in one third of the rats, the calculated lethal dose (LD50, 63±2 mg/kg) being close to the effective dose.
Conclusion: Anti-arthritic effects of morphine are opioid receptor mediated but morphine use for this indication is restricted
by its adverse effects.
Key words Opioids - Morphine - Buprenorphine - Adjuvant arthritis
accepted by M. J. Parnham