Immunosuppression by opioids: Mechanisms of action on innate and adaptive immunity

Sun, Qinmei; Li, Zhonghao; Wang, Zijing; Wang, Qisheng; Qin, Fenfen; Pan, Hongqiu; Li, Weixin; Mu, Xinru; Wang, Yuxuan; Jiang, Yongwei; Lu, Zhigang

doi:10.1016/j.bcp.2023.115417

Cited by 18 publications

(6 citation statements)

References 138 publications

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“…Extended exposure to high doses of morphine can impede the proliferation of natural killer cells, T and B lymphocytes, and diminish the production of cytokines, including IL-2, IL-4, and IL-6. 43 , 44 …”

Section: Discussionmentioning

confidence: 99%

Bibliometric Analysis of Anesthetic Drugs’ Effects on Immune Function- Current Knowledge, Hotspots and Future Perspectives

Wang,

Sun,

et al. 2023

DDDT

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The objective of this study is to conduct a bibliometric analysis of the present status, areas of focus, and upcoming developments in the research of anesthetic drugs and their impact on immune function, along with other related research domains. Methods: From January 1, 2008 to June 9, 2023, A thorough exploration of anesthetic drug-related literature pertaining to immune function was carried out through the utilization of the Web of Science. The bibliometric analysis was predominantly executed by means of CiteSpace, GraphPad Prism 8.0, and the acquisition of data regarding the country, institution, author, journal, and keywords associated with each publication. Results: This study analyzed a comprehensive total of 318 publications, consisting of 228 articles and 90 reviews, to determine the publication output of anesthetic drugs on immune function. Notably, China exhibited the highest publication output with (109, 34.28%) articles. Among the institutions analyzed, Harvard University was found to be the most productive with (12, 3.77%) publications. The study findings indicate that Buggy, Donal J (5, 1.57%) and Yuki, Koichi (5, 1.57%) had the highest publication records. Anesthesiology was the most frequently cited journal with a total of (206) citations. The results also revealed that "surgery" was the most frequently used keyword, appearing (48 times), followed by "general anesthesia" (41 times) and "breast cancer" (37 times). The study has identified several current areas of interest, with a particular emphasis on "metastasis", "inflammation", "recurrence", "anesthesia technique", and "induction". It is anticipated that forthcoming research endeavors will concentrate on exploring the impacts of isoflurane, sevoflurane, and ketamine on immune function. Conclusion:This study provided a thorough analysis of the research trends and developments in investigating the impact of anesthetic drugs on immune function, incorporating pertinent research and collaborative entities such as authors, institutions, and countries.

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Section: Discussionmentioning

confidence: 99%

Bibliometric Analysis of Anesthetic Drugs’ Effects on Immune Function- Current Knowledge, Hotspots and Future Perspectives

Wang,

Sun,

et al. 2023

DDDT

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“… 13 The uncertainty of the I 2 has been quantified using 95% CIs, and in a previous study of 385 meta-analyses with I 2 =0, the 95% CI of I 2 exceeded 50% in 81% of meta-analyses. 14 Finally, although key sources of clinical heterogeneity were identified, other potential sources associated with ESIs and patient-level factors include use of intralaminar vs transforaminal ESIs, steroid type and dose, administration of multiple ESIs during the preoperative period, the potential immunosuppressive effects of comorbid long-term opioid therapy, 35 , 36 status of diabetes management, and body mass index.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Epidural Steroid Injections and Postoperative Infections After Lumbar or Cervical Spine Surgery: A Systematic Review and Meta-Analysis

Hooten,

Eberhart,

Cao

et al. 2023

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…There is no trial evidence for the risk of infection with opioid analgesics for cancer pain. Nevertheless, there is emerging evidence from preclinical studies and retrospective cohort studies in humans highlighting the immunomodulatory effects of opioid analgesics and potential implications for clinical practice 239 . A 2022 review that included preclinical studies suggests that morphine, fentanyl, methadone, and buprenorphine can suppress key cells of the innate immune system, including macrophages, neutrophils, mast cells, natural killer cells, and dendritic cells, but have diverse effects on adaptive immunity 240 .…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, there is emerging evidence from preclinical studies and retrospective cohort studies in humans highlighting the immunomodulatory effects of opioid analgesics and potential implications for clinical practice. 239 A 2022 review that included preclinical studies suggests that morphine, fentanyl, methadone, and buprenorphine can suppress key cells of the innate immune system, including macrophages, neutrophils, mast cells, natural killer cells, and dendritic cells, but have diverse effects on adaptive immunity. 240 Morphine and methadone appear to augment interleukin-4 production, which is involved with humoral immunity, but can also suppress T-cell and B-cell proliferation.…”

Section: Immunomodulatory Effects Of Common Opioid Analgesicsmentioning

confidence: 99%

Opioid analgesics for nociceptive cancer pain: A comprehensive review

Abdel Shaheed,

Hayes,

Maher

et al. 2023

CA A Cancer J Clinicians

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Pain is one of the most burdensome symptoms in people with cancer, and opioid analgesics are considered the mainstay of cancer pain management. For this review, the authors evaluated the efficacy and toxicities of opioid analgesics compared with placebo, other opioids, nonopioid analgesics, and nonpharmacologic treatments for background cancer pain (continuous and relatively constant pain present at rest), and breakthrough cancer pain (transient exacerbation of pain despite stable and adequately controlled background pain). They found a paucity of placebo‐controlled trials for background cancer pain, although tapentadol or codeine may be more efficacious than placebo (moderate‐certainty to low‐certainty evidence). Nonsteroidal anti‐inflammatory drugs including aspirin, piroxicam, diclofenac, ketorolac, and the antidepressant medicine imipramine, may be at least as efficacious as opioids for moderate‐to‐severe background cancer pain. For breakthrough cancer pain, oral transmucosal, buccal, sublingual, or intranasal fentanyl preparations were identified as more efficacious than placebo but were more commonly associated with toxicities, including constipation and nausea. Despite being recommended worldwide for the treatment of cancer pain, morphine was generally not superior to other opioids, nor did it have a more favorable toxicity profile. The interpretation of study results, however, was complicated by the heterogeneity in the study populations evaluated. Given the limited quality and quantity of research, there is a need to reappraise the clinical utility of opioids in people with cancer pain, particularly those who are not at the end of life, and to further explore the effects of opioids on immune system function and quality of life in these individuals.

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Immunosuppression by opioids: Mechanisms of action on innate and adaptive immunity

Cited by 18 publications

References 138 publications

Bibliometric Analysis of Anesthetic Drugs’ Effects on Immune Function- Current Knowledge, Hotspots and Future Perspectives

Bibliometric Analysis of Anesthetic Drugs’ Effects on Immune Function- Current Knowledge, Hotspots and Future Perspectives

Preoperative Epidural Steroid Injections and Postoperative Infections After Lumbar or Cervical Spine Surgery: A Systematic Review and Meta-Analysis

Opioid analgesics for nociceptive cancer pain: A comprehensive review

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