Effects of Chronic Intrathecal Infusion of a Opioid Agonist in Dogs

2 ,DPen 5 )enkephalin (DPDPE), adult beagles were prepared with chronic lumbar intrathecal cath- eters. Groups of dogs received intrathecal infusions (100 l/h) of saline (vehicle), DPDPE 3 mg/ml or 6 mg/ml for 28 days. Over the 28-day period, saline or 3 mg/ml showed minimal changes in neurological function, whereas in the 6 mg/ml animals, prominent hind limb dysfunction evolved over the 28-day interval. Histopa- thology in control animals displayed a modest pericatheter reac- tion considered normal for this model. Dogs receiving DPDPE (three of four at 6 mg/ml and one of four at 3 mg/ml) but not saline (zero of four) developed large inflammatory masses (granulomas) in the intrathecal space located proximal to the catheter tip. In these masses, severe chronic inflammatory changes in combination with necrosis and fibrosis was detected. Occasional focal destruc- tion of neuropil was detected also in the adjacent spinal cord parenchyma. These masses contained extensive accumulation of mouse antihuman macrophages (MAC)-positive inflammatory cells expressing tumor necrosis factor- (TNF-), revealing infil- tration of macrophages, granulocytes, and monocytes. In separate animals, prepared with dual intrathecal catheters, lumbar CSF was sampled at specified time points following intrathecal bolus (3 mg/ml) and 24 h DPDPE infusion (3 mg/ml and 6 mg/ml). Steady- state cerebrospinal fluid (CSF) DPDPE levels were 18.6 1.0 and 22.6 4.0 g/ml for 3 mg/ml and 6 mg/ml infusions respectively. These results indicate that this opioid agonist DPDPE produces a concentration and time-dependent formation of an intrathecal inflammatory mass.