• Peptides · Apr 2004

    Opioid peptide response to spinal cord stimulation in chronic critical limb ischemia.

    • Fiorella Fontana, Pasquale Bernardi, Giuseppina Lanfranchi, Santi Spampinato, Rosanna Di Toro, Eleonora Conti, Francesca Bonafè, and Sergio Coccheri.
    • Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Ospedale S. Orsola, Via Massarenti 9, 40138 Bologna, Italy.
    • Peptides. 2004 Apr 1;25(4):571-5.

    AbstractTwelve patients with chronic critical limb ischemia in whom a spinal cord stimulation (SCS) system had been implanted for at least one year had increased microvascular flow and achieved healing of trophic acral lesions. After switching off the system, the clinical improvement persisted for 10 days and the neurohormonal pattern showed high plasma values of beta-endorphin and Met-enkephalin, normal dynorphin B, endothelin-1 and catecholamines, and low nitric oxide. Met-enkephalin levels were further increased (P < 0.01) immediately after switching on the electrical stimulation again. The persistence of high plasma opioid levels after switching off the spinal cord stimulation explains the absence of subjective complaints and suggests an involvement of opioids in the regulation and improvement of the microcirculation.Copyright 2004 Elsevier Inc.

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