Prospects for Creation of Cardioprotective and Antiarrhythmic Drugs Based on Opioid Receptor Agonists

• Published in: Medicinal research reviews Vol. 36; no. 5; pp. 871 - 923
• Main Authors: Maslov, Leonid N, Khaliulin, Igor, Oeltgen, Peter R., Naryzhnaya, Natalia V., Pei, Jian-Ming, Brown, Stephen A., Lishmanov, Yury B., Downey, James M.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.09.2016; Wiley Subscription Services, Inc; John Wiley and Sons Inc
• Subjects: Analgesics, Opioid - chemistry; Analgesics, Opioid - pharmacology; Animals; Anti-Arrhythmia Agents - chemistry; Anti-Arrhythmia Agents - pharmacology; cardioprotection; Cardiotonic Agents - chemistry; Cardiotonic Agents - pharmacology; Drug Discovery; heart; Humans; ischemia/reperfusion injury; opioids; Receptors, Opioid - agonists; Review; signal transduction; cardioprotection; ischemia/reperfusion injury; signal transduction; heart; opioids
• ISSN: 0198-6325; 1098-1128; 1098-1128
• DOI: 10.1002/med.21395

It has now been demonstrated that the μ, δ1, δ2, and κ1 opioid receptor (OR) agonists represent the most promising group of opioids for the creation of drugs enhancing cardiac tolerance to the detrimental effects of ischemia/reperfusion (I/R). Opioids are able to prevent necrosis and apoptosis of cardiomyocytes during I/R and improve cardiac contractility in the reperfusion period. The OR agonists exert an infarct‐reducing effect with prophylactic administration and prevent reperfusion‐induced cardiomyocyte death when ischemic injury of heart has already occurred; that is, opioids can mimic preconditioning and postconditioning phenomena. Furthermore, opioids are also effective in preventing ischemia‐induced arrhythmias.