Opioids and immune system

Sacerdote, Paola; Franchi, Silvia

doi:10.1016/s1734-1140(11)70427-3

Cited by 90 publications

(129 citation statements)

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“…The reason for this increase in tumour size was unclear, but it was perceivable that morphine could have had secondary effects on the immune system that supported tumour progression (21). Alternatively, the increases in tumour size could simply have been due to a direct effect of morphine that resulted in enhanced cellular proliferation in the tumours or reduced cell death.…”

Section: Discussionmentioning

confidence: 99%

Naltrexone at low doses upregulates a unique gene expression not seen with normal doses: Implications for its use in cancer therapy

Liu

Scott

Dennis

et al. 2016

International Journal of Oncology

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Abstract. It has been reported that lower doses of the opioid antagonist naltrexone are able to reduce tumour growth by interfering with cell signalling as well as by modifying the immune system. We have evaluated the gene expression profile of a cancer cell line after treatment with low-dose naltrexone (LDN), and assessed the effect that adapting treatment schedules with LDN may have on enhancing efficacy. LDN had a selective impact on genes involved with cell cycle regulation and immune modulation. Similarly, the pro-apoptotic genes BAD and BIK1 were increased only after LDN. Continuous treatment with LDN had little effect on growth in different cell lines; however, altering the treatment schedule to include a phase of culture in the absence of drug following an initial round of LDN treatment, resulted in enhanced cell killing. Furthermore, cells pre-treated with LDN were more sensitive to the cytotoxic effects of a number of common chemotherapy agents. For example, priming HCT116 with LDN before treatment with oxaliplatin significantly increased cell killing to 49±7.0 vs. 14±2.4% in cultures where priming was not used. Interestingly, priming with NTX before oxaliplatin resulted in just 32±1.8% cell killing. Our data support further the idea that LDN possesses anticancer activity, which can be improved by modifying the treatment schedule.

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Section: Discussionmentioning

confidence: 99%

Naltrexone at low doses upregulates a unique gene expression not seen with normal doses: Implications for its use in cancer therapy

Liu

Scott

Dennis

et al. 2016

International Journal of Oncology

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“…High-dose and long-term opioid therapy in cancer patients is becoming a concern, given observed risks such as poly-endocrinopathy, osteoporosis, and immunosuppression 88 . Preclinical studies have demonstrated that certain opioids-such as codeine, morphine, methadone, and remifentanil-are associated with increased morbidity and mortality attributable to worsening of cancer and infections 88 .…”

Section: Cannabinoid Therapies As a Harm Reduction Strategymentioning

confidence: 99%

A User’s Guide to Cannabinoid Therapies in Oncology

Maida

Daeninck

2016

Current Oncology

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ABSTRACT"Cannabinoid" is the collective term for a group of chemical compounds that either are derived from the Cannabis plant, are synthetic analogues, or occur endogenously. Although cannabinoids interact mostly at the level of the currently recognized cannabinoid receptors, they might have cross reactivity, such as at opioid receptors.Patients with malignant disease represent a cohort within health care that have some of the greatest unmet needs despite the availability of a plethora of guideline-driven disease-modulating treatments and pain and symptom management options. Cannabinoid therapies are varied and versatile, and can be offered as pharmaceuticals (nabilone, dronabinol, and nabiximols), dried botanical material, and edible organic oils infused with cannabis extracts. Cannabinoid therapy regimens can be creative, involving combinations of all of the aforementioned modalities. Patients with malignant disease, at all points of their disease trajectory, could be candidates for cannabinoid therapies whether as monotherapies or as adjuvants.The most studied and established roles for cannabinoid therapies include pain, chemotherapy-induced nausea and vomiting, and anorexia. Moreover, given their breadth of activity, cannabinoids could be used to concurrently optimize the management of multiple symptoms, thereby reducing overall polypharmacy. The use of cannabinoid therapies could be effective in improving quality of life and possibly modifying malignancy by virtue of direct effects and in improving compliance or adherence with disease-modulating treatments such as chemotherapy and radiation therapy.

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“…Currently, there is a growing interest in elucidating the possible influences of opioid use in the management of patients with pain. 2,12 Traditionally, as documented since the 9 th century, there has been an increase in the incidence and severity of infections among opiate users. The potential target of the immunosuppressive effect of opiates is not fully understood, but different investigations appear to indicate bidirectional connections between the neural, endocrine and immune systems, placing it peripherally based on the expression of the MOP receptor on immune cells with implications at the central nervous system level.…”

Section: Introductionmentioning

confidence: 99%

“…The potential target of the immunosuppressive effect of opiates is not fully understood, but different investigations appear to indicate bidirectional connections between the neural, endocrine and immune systems, placing it peripherally based on the expression of the MOP receptor on immune cells with implications at the central nervous system level. 12,13 The administration of opioids affects the immune system in different degrees and manners. 2 The clinical relevance of this immunological role is not well-known.…”

Section: Introductionmentioning

confidence: 99%

“…14 In vivo investigations seem to relate changes in the downregulation of protein C, somatostatin and nitric oxide with a decline in NK cell function, suppression of inflammatory cytokines with a sympathetic nervous system activation that promotes high levels of norepinephrine and which could be related with immune suppression. 2,12,15 There is a close relation between cancer, inflammation, sepsis and immunity. 16 This relationship is based on the interaction that is produced between the inflammatory cells in the presence of several cytokines.…”

Section: Introductionmentioning

confidence: 99%

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