|  | General Considerations 
 
 
						
						Over the years, a number of neuropeptides have been 
						identified which play a variety of functional roles in 
						the nervous system. Several have well-known endocrine 
						roles such as ACTH, oxytocin, and vasopressin from the 
						pituitary gland. Also included are the hypothalamic 
						factors which control the release of certain pituitary 
						hormones. These are somatostatin (growth 
						hormone-inhibiting factor), thyrotropin-releasing factor 
						(TRF), and luteinizing hormone-releasing factor (LHRF).
						 
						
						Other neuropeptides appear to function as 
						neurotransmitters. One of these is substance P, found in 
						certain pathways in the brain and in terminal endings of 
						specific primary sensory fibers of spinal nerves. The 
						latter are represented by those fibers which synapse on 
						secondary spinal cord neurons responding most readily to 
						pain. Thus it is hypothesized to operate as a 
						transmitter for painful stimuli from the periphery to 
						the CNS.  
						
						Perhaps the most interesting group of neuropeptides are 
						the enkephalins and endorphins. The morphinelike 
						enkephalins have been found in interneurons in the same 
						regions of the spinal cord where substance P is 
						released. and there is evidence to suggest that they 
						inhibit the release of substance P. Thus, 
						enkephalin-containing neurons may work to suppress the 
						transmission of painful information between primary and 
						secondary neurons. Enkephalins probably operate by 
						presynaptically inhibiting the release of substance P 
						from primary neurons, giving them a modulatory role at 
						these synapses. Enkephalin is also found in several areas of the brain 
						and brainstem, paralleling the distribution of opiate 
						receptors. The highest concentration occurs in the 
						globus pallidus with lesser amounts in the caudate 
						nucleus, hypothalamus, periaqueductal gray matter, and 
						amygdala. The intriguing possibility exists that 
						enkephalins may be naturally occurring analgesics 
						operating as modulating neurotransmitters in various 
						pain-mediating pathways |