Chapter 4 - Neuropeptides in shock and traumatic injury: sites and mechanisms of action

Abstract

This chapter describes the neuropeptides in shock and traumatic injury along with its sites and mechanisms of action. One area that has been particularly rewarding is the characterization of a pathophysiological role for endogenous opioid systems in circulatory shock and spinal injury. This accomplishment has provided important clues to the etiology of these syndromes. Indeed, the successful treatment of shock and trauma with opioid antagonists suggests that endogenous opioids are fundamental to these disease states. Since the initial discovery of the enkephalins and β -endorphin, at least ten different peptides have been isolated from biological tissues and demonstrated to have opiate-like actions in vitro and in vivo . Many of these opioid peptides share structural homologies at their amino terminus, although the amino acid sequences of kyotorphin, dermorphin, and β -casomorphin are unrelated to the enkephalin structure shared by the other peptides.