<p>Which idea is better with regard to immune response? Opioid anesthesia or opioid free anesthesia</p>

Abstract

The stress of surgery is characterized by an inflammatory response with immune suppression resulting from many factors, including the type of surgery and the kind of anesthesia, linked with the drugs that are used and the underlying disease of the patient. The trauma of surgery triggers a cascade of reactions involving the immune response and nociception. As strong analgesics, opioids provide the analgesic component of general anesthesia with bi-directional effect on the immune system. Opioids influence almost all aspects of the immune response in regards to leukocytes, macrophages, mast cells, lymphocytes, and NK cells. The suppressive effect of opioids on the immune system is limiting their use, especially in patients with impaired immune response, so the possibility of using multimodal anesthesia without opioids, known as opioid-free anesthesia (OFA), is gaining more and more sympathizers. The idea of OFA is to eliminate opioid analgesia in the treatment of acute pain and to replace it with drugs from other groups that are assumed to have a comparable analgesic effect without affecting the immune system. Here, we present a review on the impact of anesthesia, with and without the use of opioids, on the immune response to surgical stress.

Gut Microbiota-Derived Inflammation-Related Serum Metabolites as Potential Biomarkers for Major Depressive Disorder

“…The inflammatory response has a close relationship with many diseases. [43][44][45][46] As the important part of immune system, it is viewed as a driving factor causing changes in neurocircuits and neurotransmitters, which are closely related to the onset of depressive symptoms. Mounting evidence has solidified the relationships between depression and inflammation.…”

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“…Initially, our study discovered that H1N1 disrupted blood routine and T lymphocyte subpopulation with the involvement of reduced number of leukocytes, neutrophil and lymphocytes as well as T lymphocytes. As principal components in immune system, leukocytes and lymphocytes deficiency brought about worsening nociception and immune environment in various underlying disorders [21]. Neutrophil represented the most plentiful class of cells in immune system, and they were migrated in lung epithelial cells infected by influenza viruses [22].…”

The immunomodulatory effects of opioids and implications for intensive care unit populations

“…In order to evaluate the immunologic effects of opioids, one must first consider the major opioid receptors: the mu opioid receptor (MOR), kappa opioid receptor (KOR), delta opioid receptor (DOR), and nociceptin/orphanin FQ receptor (NOR). These receptors, particularly MOR, have been found on a multitude of immune cells 12 . Specifically, the MOR is found on macrophages, peripheral blood mononuclear cells (PBMCs), T and B cells, and NK cells.…”

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