@article {Butelman155, author = {Eduardo R. Butelman and Todd J. Harris and Mary Jeanne Kreek}, title = {Antiallodynic Effects of Loperamide and Fentanyl against Topical Capsaicin-Induced Allodynia in Unanesthetized Primates}, volume = {311}, number = {1}, pages = {155--163}, year = {2004}, doi = {10.1124/jpet.104.068411}, publisher = {American Society for Pharmacology and Experimental Therapeutics}, abstract = {Capsaicin produces thermal allodynia in animals and humans by acting as an agonist at vanilloid receptor subtype 1 [VR1; also known as transient receptor potential vanilloid type 1 (TRPV1)]. VR1 receptors are widely distributed in the periphery (e.g., on primary afferent neurons). These studies examined the ability of loperamide (0.1{\textendash}1 mg/kg s.c.; a μ-opioid agonist that is peripherally selective after systemic administration), in preventing and reversing thermal allodynia caused by topical capsaicin (0.004 M) in rhesus monkeys, within a tail withdrawal assay (n = 4; 38{\textdegree}C and 42{\textdegree}C; normally non-noxious thermal stimuli). The effects of loperamide were compared with those of the centrally penetrating μ-agonist, fentanyl (0.0032{\textendash}0.032 mg/kg s.c.). We also characterized the allodynic effects of the endogenous VR1 agonist ({\textquotedblleft}endovanilloid{\textquotedblright}), N-oleoyldopamine (OLDA; 0.0013{\textendash}0.004 M). In this model, loperamide and fentanyl produced dose-dependent prevention of capsaicin-induced allodynia, whereas only fentanyl produced robust reversal of ongoing allodynia. Antagonism experiments with naltrexone (0.1 mg/kg s.c.) or its analog, methylnaltrexone (0.32 mg/kg s.c.), which does not readily cross the blood-brain barrier, suggest that the antiallodynic effects of loperamide and fentanyl were predominantly mediated by peripherally and centrally located μ-receptors, respectively. Loperamide and fentanyl (1 mg/kg and 0.032 mg/kg, respectively) also prevented OLDA (0.004 M)-induced allodynia. Up to the largest dose studied, loperamide was devoid of thermal antinociceptive effects at 48{\textdegree}C (a noxious thermal stimulus, in the absence of capsaicin). By contrast, fentanyl (0.01{\textendash}0.032 mg/kg) caused dose-dependent antinociception in this sensitive thermal antinociceptive assay (a presumed centrally mediated effect). These studies show that loperamide, acting as a peripherally selective μ-agonist after systemic administration, can prevent capsaicin-induced thermal allodynia in primates in vivo, in the absence of thermal antinociceptive effects. The American Society for Pharmacology and Experimental Therapeutics}, issn = {0022-3565}, URL = {https://jpet.aspetjournals.org/content/311/1/155}, eprint = {https://jpet.aspetjournals.org/content/311/1/155.full.pdf}, journal = {Journal of Pharmacology and Experimental Therapeutics} }