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. 1981 Oct 10;283(6297):937–939. doi: 10.1136/bmj.283.6297.937

Chlorpropamide alcohol flush and circulating met-enkephalin: a positive link.

S Medbak, J A Wass, V Clement-Jones, E D Cooke, S A Bowcock, A G Cudworth, L H Rees
PMCID: PMC1507233  PMID: 6269688

Abstract

Chlorpropamide-alcohol flushing may be due to sensitivity to endogenous opiates. To investigate this possibility the plasma met-enkephalin and beta-endorphin responses to sherry with and without chlorpropamide were studied in six patients with non-insulin dependent diabetes and in six normal subjects. After chlorpropamide all patients showed a rise in met-enkephalin concentrations from a basal level of 50 +/- 7.2 ng/l to a peak of 75 +/- 8.1 ng/l (p less than 0.001). In contrast, before chlorpropamide treatment was started met-enkephalin values did not change after alcohol. No significant changes in beta-endorphin values were observed. In six normal subjects pretreated with chlorpropamide the met-enkephalin concentration also rose from a basal level of 72 +/- 15 ng/l to a peak of 103 +/- 9.4 ng/l (p less than 0.002). Again, the met-enkephalin rise was not observed after placebo. Neither beta-endorphin concentrations nor facial temperature changed significantly. These data suggest that endogenous opiates may be implicated in CPAF. Furthermore, this is the first study in which a significant change in circulating met-enkephalin values has occurred.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnett A. H., Pyke D. A. Chlorpropamide-alcohol flushing and large-vessel disease in non-insulin-dependent diabetes. Br Med J. 1980 Jul 26;281(6235):261–262. doi: 10.1136/bmj.281.6235.261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Barnett A. H., Spiliopoulos A. J., Pyke D. A. Blockade of chlorpropamide-alcohol flushing by indomethacin suggests an association between prostaglandins and diabetic vascular complications. Lancet. 1980 Jul 26;2(8187):164–166. doi: 10.1016/s0140-6736(80)90058-6. [DOI] [PubMed] [Google Scholar]
  3. Clement-Jones V., Lowry P. J., Rees L. H., Besser G. M. Development of a specific extracted radioimmunoassay for methionine enkephalin in human plasma and cerebrospinal fluid. J Endocrinol. 1980 Aug;86(2):231–243. doi: 10.1677/joe.0.0860231. [DOI] [PubMed] [Google Scholar]
  4. Clement-Jones V., Lowry P. J., Rees L. H., Besser G. M. Met-enkephalin circulates in human plasma. Nature. 1980 Jan 17;283(5744):295–297. doi: 10.1038/283295a0. [DOI] [PubMed] [Google Scholar]
  5. Jeffcoate W. J., Rees L. H., McLoughlin L., Ratter S. J., Hope J., Lowry P. J., Besser G. M. beta-Endorphin in human cerebrospinal fluid. Lancet. 1978 Jul 15;2(8081):119–121. doi: 10.1016/s0140-6736(78)91506-4. [DOI] [PubMed] [Google Scholar]
  6. Jeffreys D. B., Strakosch C. R., Keen H. Facial flushing in diabetes. Lancet. 1979 Dec 1;2(8153):1195–1195. doi: 10.1016/s0140-6736(79)92426-7. [DOI] [PubMed] [Google Scholar]
  7. Köbberling J., Bengsch N., Brüggeboes B., Schwarck H., Tillil H., Weber M. The chlorpropamide alcohol flush. Lack of specificity for familial non-insulin dependent diabetes. Diabetologia. 1980 Oct;19(4):359–363. doi: 10.1007/BF00280521. [DOI] [PubMed] [Google Scholar]
  8. Leslie R. D., Barnett A. H., Pyke D. A. Chlorpropamide alcohol flushing and diabetic retinopathy. Lancet. 1979 May 12;1(8124):997–999. doi: 10.1016/s0140-6736(79)92753-3. [DOI] [PubMed] [Google Scholar]
  9. Leslie R. D., Pyke D. A. Chlorpropamide-alcohol flushing: a dominantly inherited trait associated with diabetes. Br Med J. 1978 Dec 2;2(6151):1519–1521. doi: 10.1136/bmj.2.6151.1519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Leslie R. D., Pyke D. A., Stubbs W. A. Sensitivity to enkephalin as a cause of non-insulin dependent diabetes. Lancet. 1979 Feb 17;1(8112):341–343. doi: 10.1016/s0140-6736(79)92887-3. [DOI] [PubMed] [Google Scholar]
  11. McLoughlin L., Lowry P. J., Ratter S., Besser G. M., Rees L. H. beta-Endorphin and beta-MSH in human plasma. Clin Endocrinol (Oxf) 1980 Mar;12(3):287–292. doi: 10.1111/j.1365-2265.1980.tb02712.x. [DOI] [PubMed] [Google Scholar]
  12. Monnier L. H., Blotman M. J., Colette C., Monnier M. P., Mirouze J. Effects of dietary fibre supplementation in stable and labile insulin-dependent diabetics. Diabetologia. 1981;20(1):12–17. doi: 10.1007/BF00253810. [DOI] [PubMed] [Google Scholar]
  13. Podgainy H., Bressler R. Biochemical basis of the sulfonylurea-induced antabuse syndrome. Diabetes. 1968 Nov;17(11):679–683. doi: 10.2337/diab.17.11.679. [DOI] [PubMed] [Google Scholar]
  14. Pyke D. A., Leslie R. D. Chlorpropamide-alcohol flushing: a definition of its relation to non-insulin-dependent diabetes. Br Med J. 1978 Dec 2;2(6151):1521–1522. doi: 10.1136/bmj.2.6151.1521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Strakosch C. R., Jefferys D. B., Keen H. Blockade of chlorpropamide alcohol flush by aspirin. Lancet. 1980 Feb 23;1(8165):394–396. doi: 10.1016/s0140-6736(80)90945-9. [DOI] [PubMed] [Google Scholar]
  16. deSilva N. E., Tunbridge W. M., Alberti K. G. Low incidence of chlorpropamide-alcohol flushing in diet-treated, non-insulin-dependent diabetes. Lancet. 1981 Jan 17;1(8212):128–131. doi: 10.1016/s0140-6736(81)90711-x. [DOI] [PubMed] [Google Scholar]

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