title: Intravenous fentanyl increases natural killer cell cytotoxicity and circulating CD16(+) lymphocytes in humans.
abstract: Opioids, including fentanyl, are often administered to patients who may be at risk for the consequences of impaired immune function. We performed a clinical study to test the effects of the synthetic opioid fentanyl on human immune function. Participants received an IV fentanyl initial dose of 3 microg/kg followed by a 2-h IV infusion of 1.2 microg x kg(-1) x h(-1). Peripheral blood was drawn before and after fentanyl administration to test for neutrophil phagocytic function, neutrophil antibody-dependent cell cytotoxicity, natural killer cell cytotoxicity, percentage of lymphocyte populations, T-lymphocyte proliferative response, and in vivo antibody response to a pneumococcal vaccine inoculation given at the end of the fentanyl infusion. Fentanyl exposure under the conditions of this study caused a rapid and significant increase in natural killer cell cytotoxicity, which was coincident with an increase in the percentage of CD16(+) and CD8(+) cells in peripheral blood. Fentanyl did not significantly affect any of the other immune measurements.
  
  
  CONCLUSIONS
  Many previous studies have suggested that opioid drugs can impair immune resistance in patients who may be at risk for infection. This study suggests that the opioid fentanyl, when given to healthy humans without coexisting diseases, does not suppress immune resistance. On the basis of these results, the use of fentanyl should not be restricted because of concerns that it may suppress immune function.
authors.affiliation: Department of Anesthesiology, Dartmouth Medical School, Hanover, New Hampshire 03756, USA. mark.p.yeager@hitchcock.org
authors.forename: Mark P
authors.initials: MP
authors.lastname: Yeager
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Procopio
authors.forename: Joyce A
authors.initials: JA
authors.lastname: DeLeo
authors.forename: Janice L
authors.initials: JL
authors.lastname: Arruda
authors.forename: Laurie
authors.initials: L
authors.lastname: Hildebrandt
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Howell
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D000917:Antibody Formation; D000920:Antibody-Dependent Cell Cytotoxicity / Q000187:drug effects; D003602:Cytotoxicity, Immunologic / Q000187:drug effects; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006801:Humans; D007694:Killer Cells, Natural / Q000187:drug effects / Q000276:immunology*; D008213:Lymphocyte Activation; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D010587:Phagocytosis; D022242:Pneumococcal Vaccines / Q000276:immunology; D017452:Receptors, IgG / Q000032:analysis*; D013296:Streptococcus pneumoniae / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D022242:Pneumococcal Vaccines; D017452:Receptors, IgG; D005283:Fentanyl