Morphine Inhibits Spontaneous and Cytokine-enhanced Natural Killer Cell Cytotoxicity in Volunteers

Abstract

These results suggest that morphine administration, at doses within the range of analgesic use, can cause measurable suppression of some components of the human cellular immune system.

Intrathecal morphine suppresses NK cell activity following abdominal surgery

“…5 1 Chromium-labeled target cells, 5×10 3 , of the human erythroleukemic cell line K-562 were mixed with different concentrations of mononuclear cells from blood samples of the patients, for use as effector cells, to obtain effector to target cell ratios 100:1, 50:1, 25:1 and 12:1. Cell suspensions were incubated for four hours at 37°C in humidified air and carbon dioxide 5%.…”

Perioperative management and oncological outcomes following radical cystectomy for bladder cancer: a matched retrospective cohort study

“…3,[6][7][8] A reduction in systemic opioids has been associated with a reduction in both the recurrence and the progression of cancer in a murine model. 2 Nevertheless, conducting clinical studies that examine the effects of opioid-sparing anesthetic techniques on oncological outcomes is a complex undertaking.…”

“…Specifically, surgical manipulation disseminates malignant cells into the bloodstream, 4 surgical stress promotes metastatic growth by affecting immunosuppression through neuroendocrine pathways, 2,3 and the use of systemic opioids directly inhibits NK cell activity. [5][6][7][8][9] Finally, blood transfusion induces immunosuppression. 10 While systemic morphine reduces the NK cell activity, the addition of spinal blockade to general anesthesia in a murine model attenuated the propagation of metastases by surgery.…”

Paravertebral anesthesia: how substance P and the NK-1 receptor could be involved in regional block and breast cancer recurrence

“…It is known that the stress response induces an inhibition of the immune function (i.e., there is a marked attenuation of natural killer cells, these cells being involved in preventing tumor dissemination) [3]. Paravertebral anesthesia also spares patients from postoperative opioids (e.g., morphine), which inhibit both cellular and humoral immune function [4,5]; in addition, it is known that morphine exerts a proangiogenic effect [6]. In sum, the authors surmised that regional anesthesia and analgesia may help to preserve immune function by attenuating the surgical stress response and diminishing the need for opioids.…”