Opioids and the Immune System: Clinical Relevance

Garcia, João Batista Santos; Cardoso, Mirlane Guimarães de Melo; Dos-Santos, Maria Cristina

doi:10.1016/s0034-7094(12)70169-1

Cited by 24 publications

(27 citation statements)

References 47 publications

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“…Opioids are known to restrict the body’s natural defenses against aspiration and lung infection or inflammation, via cough suppression and bronchoconstriction . Although clinically significant human studies have largely been limited, animal and cellular studies have also shown increases in rejection‐specific immunologic markers, and signs of immunosuppression after opioid exposure . Finally, chronic pain can be a symptom of rejection, suggesting that chronic opioid use is a marker for rejection associated pain.…”

Section: Discussionmentioning

confidence: 99%

“…Lung function may also be adversely affected by respiratory depression and bronchoconstriction caused by opioids . Finally, opioids have been shown to increase autoimmunity factors, while decreasing the body’s ability to fight infection in animal and cellular models . Limited studies of short‐term opioid use effects on immunity in humans have revealed mixed results regarding clinical outcomes .…”

Section: Introductionmentioning

confidence: 99%

“…9 Finally, opioids have been shown to increase autoimmunity factors, while decreasing the body's ability to fight infection in animal and cellular models. [9][10][11][12][13][14] Limited studies of short-term opioid use effects on immunity in humans have revealed mixed results regarding clinical outcomes. 10,11 To assess the association of long-term chronic opioid use with clinical outcomes among LTx recipients, we performed a single-center retrospective cohort study to investigate the effect of chronic opioid use among adolescent and young adult patients followed by our LTx program.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Drees

Tumin

Miller

et al. 2018

Clinical Respiratory J

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Drees

Tumin

Miller

et al. 2018

Clinical Respiratory J

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“…Recently much attention has been emphasised on opioids and its impact on the immune system 13,14 . Opioids have been shown to modulate immune function by direct effects on cells of the immune system and indirectly via centrally mediated neuronal mechanisms 6 .…”

Section: Discussionmentioning

confidence: 99%

Acute Immunomodulatory Effects of Fentanyl and its Three New Analogues in Swiss Albino Mice

Yadav

Bhattacharya

2017

Def. Life. Sc. Jl.

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Fentanyl is a potent synthetic opioid analgesic. However, due to its several limitations, new analogues are being synthesised for better pain management. We have earlier reported the synthesis and bio-efficacy of fentanyl and its eight new analogues (1-8) in mice. Among eight analogues tested, N- (1-(2-phenoxyethyl)-4-piperidinyl) propionanilide (2), N-isopropyl-3-(4-(N-phenylpropionamido)piperidin-1-yl)propanamide (5), and N-t-butyl-3-(4-(N-phenylpropionamido)piperidin-1-yl)propanamide (6) were found to be more effective and less toxic compared to fentanyl. Therapeutic efficacy of fentanyl and its analogues are known to be compromised due to many adverse effects, including alterations in the immune system. Therefore, the present study was undertaken to assess the acute effect of fentanyl and its three analogues (2, 5, and 6) on plasma levels of different pro-inflammatory cytokines such as interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), and anti-inflammatory cytokines such as interleukin-10 (IL-10) at different time points. Mice were intraperitoneally treated with 0.50 LD 50 of the compounds and cytokines were measured 1 h, 2 h, 4 h, and 24 h post-exposure. Compared to control, none of the treatments produced any change in TNF-α and IL-1β levels. However, IL-6 levels were significantly elevated between 1 h to 2 h post-exposure in fentanyl and analogue 2 treated groups. Further, IL-10 levels were found to be significantly increased in fentanyl, analogue 2, and 6 treated groups at 1 h and 2 h post-exposure. Pretreatment of naltrexone (opioid receptor antagonist) blocked the effects of fentanyl, confirming that its effects were opioid receptor-dependent. However, effect of naltrexone on analogue 2 and 6 was not conclusively evidenced, indicating that immunomodulatory changes caused by the analogues could have some additional implications as well. The present study reveals undesirable effects of fentanyl and its new analogues on cytokines homeostasis, thereby limiting their use in pain management.

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“…In fact some study suggests that while heroin negatively affects both innate and acquired immunity, patients on long-term methadone treatment seem to have preserved immune functioning [20]. The clinical relevance of this immunomodulation remains uncertain [21]. …”

Section: Introductionmentioning

confidence: 99%

Active opioid use does not attenuate the humoral responses to inactivated influenza vaccine

Мороз

Albrecht

Aden

et al. 2016

Vaccine

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Background Influenza vaccination is recommended for vulnerable individuals, including active drug users, to prevent influenza complications and decrease influenza spread. Recent studies suggest that opioids negatively regulate immune responses in experimental models, but the extent to which opioid use will affect the humoral responses to influenza vaccine in humans is unknown. This information is critical in maximizing vaccination efforts. Objective To determine whether there is a difference in antibody response after influenza vaccination in heroin or methadone users compared to control subjects. Methods We studied active heroin users, subjects on methadone maintenance treatment (MMT) and subjects that did not use any drugs before and 1 and 4 weeks after vaccination with trivalent influenza vaccine (TIV). We measured hemagglutination inhibition and microneutralization titers, and we compared geometric mean titers (GMT), and rates of seroprotection and seroconversion for each of the vaccine strains among the 3 groups of subjects. Results Heroin users, subjects on MMT and non-user controls mount a similarly robust serologic response to TIV. GMT and rates of seroprotection and seroconversion were not significantly different among groups. Conclusion Our results suggest that opioid use do not significantly alter antibody responses to influenza vaccine supporting the vaccination effort in these populations.

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Opioids and the Immune System: Clinical Relevance

Cited by 24 publications

References 47 publications

Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Acute Immunomodulatory Effects of Fentanyl and its Three New Analogues in Swiss Albino Mice

Active opioid use does not attenuate the humoral responses to inactivated influenza vaccine

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