Does Prolonged Oral Treatment with Sustained-Release Morphine Tablets Influence Immune Function?

Palm, Sebastian; Lehzen, Stephan; Mignat, Christian; Steinmann, Joerg; Leimenstoll, G.; Maier, Christoph

doi:10.1213/00000539-199801000-00033

Cited by 31 publications

(14 citation statements)

References 17 publications

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“…In contrast, no immune alterations were detected for buprenorphine-treated animals. Palm et al (1998) addressed the issue of whether prolonged oral treatment with sustainedrelease morphine tablets influenced immune function in patients with pain syndromes. Treatment with oral, sustainedrelease morphine did not have a suppressive effect on overall peripheral mononuclear cell (PMC) function.…”

Section: Opioidsmentioning

confidence: 99%

“…Immunosuppressive effects caused by burn injury, alone or in combination with the administration of morphine sulfate, were not observed in the presence of naloxone as measured by DTH response, also implying the involvement of the endogenous opioid system. Palm et al (1998) addressed whether prolonged oral treatment with sustained-release morphine tablets influenced immune function, because opioids such as morphine are the mainstay of acute and chronic pain treatment. Treatment of patients with chronic pain syndromes with oral, sustained-release morphine did not have a suppressive effect on overall peripheral MNC function.…”

Section: Opioidsmentioning

confidence: 99%

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Drugs of Abuse, Immune Modulation, and AIDS

Cabral

2006

Jrnl Neuroimmune Pharm

112

100

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Illicit drugs such as amphetamines, cocaine, marijuana, and opiates alter immune function and decrease host resistance to microbes in vitro and in experimental animal models. Effects on the immune system may be mediated indirectly as a result of drug interactions in the central nervous system (CNS) or directly through activation of cognate receptors on various immune cell types. For marijuana and opioids, seven-transmembranal G protein-coupled receptors have been identified in the CNS and in the immune system that may play a functionally relevant role in immune modulation. There is accumulating evidence that sigma(1) receptors play a comparable role in cocaine-mediated alteration of immune responses. A mode by which these exogenously introduced substances affects immunity and host resistance may be by perturbing the balance of Th(1) proinflammatory versus Th(2) anti-inflammatory cytokines and lipid bioeffectors. However, while illicit drugs have been documented to alter immune functions in vitro and in animal models, there is a paucity of controlled longitudinal epidemiological studies that definitively correlate immunosuppressive effects with increased incidence of infections or immune disorders in humans, including infection with the human immunodeficiency virus (HIV) or disease progression to AIDS.

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Section: Opioidsmentioning

confidence: 99%

Section: Opioidsmentioning

confidence: 99%

Drugs of Abuse, Immune Modulation, and AIDS

Cabral

2006

Jrnl Neuroimmune Pharm

112

100

View full text Add to dashboard Cite

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“…Prolonged treatment of rats with morphine resulted in a decreased resistance to T. Spiralis infection even though specific antibody responses were not affected [26]. Some studies report a decreased humoral immune function in humans treated with morphine [27]. A study focusing on the antibody response to a hepatitis B vaccination in intravenous drug addicts revealed remarkably lower antibody titres in drug addicts compared to healthy controls [28].…”

Section: A S S E S S I N G I M M U N O T O X I C I T Y O F P H a R M mentioning

confidence: 99%

Assessing immunotoxicity: guidelines

Putman

Laan

Loveren

2003

Fundamemntal Clinical Pharma

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Over the last couple of years the assessment of immunotoxic potential of human pharmaceuticals has drawn considerable attention worldwide. Regulatory agencies entrusted with the registration of pharmaceuticals (or other compounds) found an increased need for guidance on this issue. This has resulted in the release of guidance documents on immunotoxicity in Europe, USA and Japan in close succession. In Europe the CPMP has released their immunotoxicity guidance documents that are now in force. The FDA and the Japanese Authorities are in the process of doing so, and will shortly enforce them. Immune suppression and stimulation, hypersensitivity, photosensitivity, drug-induced autoimmunity and developmental immunotoxicity are the focus of regulatory testing. This review discusses these kinds of immunotoxicity and their clinical implications. The three regional guidelines and screening tools for detection are discussed. Additionally, the scientific background on which these guidelines are based is briefly highlighted.

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“…In einer Studie an 10 Patienten mit Schmerzsyndromen unterschiedlicher Genese wurden vor sowie 1, 4, und 12 Wochen nach Ansetzen einer oralen Morphintherapie zelluläre und humorale Immunreaktionen analysiert [63]. Während sich die Verteilung der Lymphozytensubpopulation sowie die TZell-Proliferation nicht veränderte, stieg die Interleukin-2-Produktion nach 4-wöchiger Morphinbehandlung signifikant an.…”

Section: Schmerztherapieunclassified

Opioide und Immunsuppression

Welters¹

2003

Der Anaesthesist

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First observations that opioids may have disadvantageous effects on the immune response have been made more than 100 years ago. Today the immunosuppressive effect of morphine is well established.Drug-induced immunomodulation is of growing importance in modern anesthetic concepts. The reduced stress response observed after morphine application contributes to this effect as well as direct impairment of immune effector cells such as bactericidal activity, intracellular killing,proliferative response or cytokine synthesis. Opioid-induced immunomodulation is mediated by opioid receptors found on immunocytes and in the central nervous system.A negative feedback mechanism via the hypothalamo-pituitary-adrenal axis may potentiate the direct inhibitory effect of morphine on the immune response.A final statement regarding the clinical relevance of opioid-induced immunosuppression cannot be made at this point, since the existing clinical data are preliminary and inconclusive.Therefore, further clinical studies are mandatory to elucidate the influence of opioid treatment on immune regulation in different clinical settings in anesthesia, critical care, pain therapy and emergency medicine. Further investigations may help to not only provide sufficient analgesia by application of opioids, but also to assess advantages and disadvantages on immune function.

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Does Prolonged Oral Treatment with Sustained-Release Morphine Tablets Influence Immune Function?

Cited by 31 publications

References 17 publications

Drugs of Abuse, Immune Modulation, and AIDS

Drugs of Abuse, Immune Modulation, and AIDS

Assessing immunotoxicity: guidelines

Opioide und Immunsuppression

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