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New insights in the mechanisms of opioid analgesia and tolerance: Ultramicronized palmitoylethanolamide down-modulates vascular endothelial growth factor-A in the nervous system

Laura Micheli, Stefania Nobili, Elena Lucarini, Alessandra Toti, Francesco Margiotta, Clara Ciampi, Daniel Venturi, Lorenzo Di Cesare Mannelli, Carla Ghelardini. Pharmacol Res. 2024 Nov:209:107472.

Laboratory studyOther animalsWith morphine

This study tested palmitoylethanolamide together with morphine. Its results cannot be assigned to palmitoylethanolamide alone. More combination studies.

Design
Laboratory study
Subjects
Animal model of morphine tolerance
Dose used in the study
Not stated in the abstract
Duration
Not stated in the abstract
What was measured
Onset of morphine tolerance; morphine analgesic activity; VEGF-A levels in the nervous system; comparison with anti-VEGF-A antibody bevacizumab; soluble VEGF receptor 1 (sFLT-1) and pain-related gene expression (Serpina3n, Eaat2) in dorsal root ganglia and spinal cord.

What the authors reported

The study found:

  • Ultramicronised PEA, given before and with morphine, delayed morphine tolerance and boosted morphine's analgesic effect while countering morphine-induced VEGF-A increases in the nervous system, similar to bevacizumab, which also had an analgesic effect on its own.
  • PEA lowered VEGF-A in dorsal root ganglia and spinal cord and lowered soluble VEGF receptor 1 in plasma versus morphine alone at equal analgesic doses.
  • PEA also counteracted a more than 3-fold morphine-induced rise in Serpina3n and Eaat2 gene expression.

Limits of this study

An animal study; it cannot show effect in people taking morphine for pain. Carla Ghelardini and Lorenzo Di Cesare Mannelli received a grant from Epitech (Padua, Italy), which makes ultramicronised PEA.

Source

PubMed 39448045 · doi:10.1016/j.phrs.2024.107472

Entry checked against the abstract on PubMed on 2026-09-22. The dose shown is the dose the researchers used. It is not a recommendation. How to read this page.