Opioids and immunosupression in oncological postoperative patients

Bonilla-García, José Luis; Cortiñas-Sáenz, Manuel; Pozo-Gavilán, Esperanza del

doi:10.1590/1806-9282.63.09.753

Cited by 2 publications

(2 citation statements)

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“…This is probably due to the combination of direct effects on immunocytes and indirect effects in vivo that involve centrally mediated mechanisms as well as the systemic production and release of immunomodulatory mediators. Studies suggest that morphine has the highest immunosuppressive potential, fentanyl ranks medium, while buprenorphine and tramadol show the lowest or no immunosuppressive effect [ 33 ]. Morphine, codeine, and fentanyl suppress NK cell activity [ 3 ].…”

Section: Potential Mechanisms Of Opioid-induced Immunosuppressionmentioning

confidence: 99%

“…Opioids, by activating MOP ( µ ) opioid receptors located on vascular endothelial cells, activate and promote angiogenesis and networking of new blood vessels, which play an important role in the transfer of cancer cells from the primary lesion site to the host cardiovascular system and further to the metastatic lesion sites. This mechanism involves, among other things, the vascular endothelial growth factor (VEGF) [ 33 , 45 ]. Studies by Lennon et al have confirmed that opioids stimulate the migration and proliferation of endothelial cells, including vascular endothelial cells via the vascular endothelial growth factor (VEGF) [ 46 ].…”

Section: How Can Surgery and Perioperative Opioids Contribute To Cmentioning

confidence: 99%

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Perioperative Immunosuppression and Risk of Cancer Progression: The Impact of Opioids on Pain Management

Zajączkowska

Leppert

Mika

et al. 2018

Pain Research and Management

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Opioids comprise an important group of drugs used in cancer pain pharmacotherapy. In recent years, more and more studies have emerged indicating the potentially immunosuppressive effects of opioid analgesics and their serious consequences, including the risk of cancer progression. The identification of these risks has prompted a search for other effective, and most importantly, safer methods of perioperative analgesic management. Regional analgesia techniques, which allow for a significant reduction in opioid dosing and thus diminish the risk of immunosuppression associated with these drugs, seem to offer substantial hope in this respect. A number of studies available in the literature assess the effects of regional analgesia techniques on cancer progression; however, it is often difficult to interpret their results owing to several perioperative factors (such as surgical trauma, inadequate pain and stress relief, and hypothermia) which are also attributed immunosuppressive effects and tend to be implicated in increased risk of cancer progression. Further research is needed to verify the available data on both the potential adverse effects of opioids and the possible protective effects of regional analgesia techniques on cancer patients.

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Section: Potential Mechanisms Of Opioid-induced Immunosuppressionmentioning

confidence: 99%