title: Effects of morphine, fentanyl and tramadol on human immune response.
abstract: Morphine has been reported to suppress human immune response. We aimed to observe the effects of morphine, fentanyl and tramadol on NF-kappa B and IL-2 from both laboratory and clinical perspective. Jurkat cells were incubated with ten times clinically relevant concentrations of morphine, fentanyl and tramadol before being stimulated with PMA. NF-kappa B binding activity and IL-2 levels were measured. In the clinical study, 150 consenting patients were randomized into 3 groups according to the analgesics used in them, namely, group morphine (M), group fentanyl (F) and group tramadol (T). IL-2 was measured preoperatively and 1, 3 and 24 h after operation. Consequently, NF-kappa B activation was suppressed by morphine and fentanyl but not by tramadol. IL-2 was significantly decreased by morphine and fentanyl but not by tramadol in vitro. In the PCA patients, IL-2 was decreased in group M and increased in group F postoperatively. Whereas in group T, IL-2 was unchanged 1 h after operation but was significantly elevated 3 and 24 h after operation. Our results showed that the inhibition of morphine on IL-2 was most probably related to its suppression on NF-kappa B. Fentanyl had different effects on human immune response in vitro and in vivo. Tramadol may have immune enhancing effect.
authors.affiliation: Department of Anesthesiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: Zhihen
authors.initials: Z
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Yuke
authors.initials: Y
authors.lastname: Tian
mesh_terms: D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007109:Immunity / Q000187:drug effects*; D007376:Interleukin-2 / Q000032:analysis / Q000097:blood; D019169:Jurkat Cells; D008297:Male; D009020:Morphine / Q000494:pharmacology / Q000627:therapeutic use*; D052002:NF-kappa B p50 Subunit / Q000032:analysis / Q000097:blood; D010149:Postoperative Pain / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D014147:Tramadol / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D007376:Interleukin-2; D052002:NF-kappa B p50 Subunit; C489548:NFKB1 protein, human; D014147:Tramadol; D009020:Morphine; D005283:Fentanyl