ABSTRACT
Since endorphins are released in response to stress and injection of exogenous and endogenous opiates mimics the cardiovascular responses seen in shock, it is reasonable to assume that endorphins might contribute to the pathophysiology of the cardiovascular depression seen in shock. The Koch-Dale criteria for implication of a particular agent in disease are: presence in disease, absence in health, eliciting disease by exogenous administration, and blocking the effect by an antagonist thus preventing the disease. Studies using isolated systems were specifically excluded since extrapolation of that kind of information to the clinically relevant setting is difficult. Also excluded were reviews of endorphins in shock. The major criteria was whether the elevation in endorphins and the cardiovascular or other manifestation of the shock state were related temporally. The endorphin elevation could result from the shock state and could make the shock state worse.
