Despite its peptidic nature, upon systemic administration, metkefamide rapidly penetrates the blood-brain-barrier and disperses into the central nervous system where it produces potent, centrally-mediated analgesic effects,[9] of which have been shown to be dependent on activity at both the μ- and δ-opioid receptors.[6][10] In addition, on account of modifications to the N- and C-terminals, metkefamide is highly stable against proteolytic degradation relative to many other opioid peptides.[3][11] As an example, while its parent peptide, [Met]enkephalin, has an in vivohalf-life of merely seconds, metkefamide has a half-life of nearly 60 minutes, and upon intramuscular administration, has been shown to provide pain relief that lasts for hours.[3]
Likely on account of its δ-opioid activity, clinical trials have found metkefamide to possess less of a tendency for producing many of the undesirable side effects usually associated with conventional opioids such as respiratory depression, tolerance, and physical dependence.[6][12] However, it has been shown to cause some additional side effects that are considered unusual for standard opioid analgesics like sensations of heaviness in the extremities and nasal congestion—though these were not considered to be particularly distressing[9]—and it has also been shown to raise the seizure threshold in animals.[13] In any case, clinical development was not further pursued after phase I clinical studies and metkefamide never reached the pharmaceutical market.[14][15][16]
^ abcFrederickson RC, Smithwick EL, Shuman R, Bemis KG (February 1981). "Metkephamid, a systemically active analog of methionine enkephalin with potent opioid alpha-receptor activity". Science. 211 (4482): 603–605. doi:10.1126/science.6256856. PMID6256856.
^Lehrman SR (31 August 1990). "Protein Structure". In Stein S (ed.). Fundamentals of Protein Biotechnology. CRC Press. p. 17. ISBN978-0-8247-8346-4. Retrieved 27 April 2012.
^Tortella FC, Robles LE, Holaday JW, Cowan A (1983). "A selective role for delta-receptors in the regulation of opioid-induced changes in seizure threshold". Life Sciences. 33 (Suppl 1): 603–606. doi:10.1016/0024-3205(83)90575-1. PMID6319916.
^Embrey ML, Hartel CR (1 August 1999). "Treatment Research". Drug Abuse and Drug Abuse Research (1991): The Third Triennial Report to Congress from the Secretary, Department of Health and Human Services. DIANE Publishing. p. 51. ISBN978-0-7881-8196-2. Retrieved 27 April 2012.