title: Opioid drug abuse and modulation of immune function: consequences in the susceptibility to opportunistic infections.
abstract: Infection rate among intravenous drug users (IDU) is higher than the general public, and is the major cause of morbidity and hospitalization in the IDU population. Epidemiologic studies provide data on increased prevalence of opportunistic bacterial infections such as TB and pneumonia, and viral infections such as HIV-1 and hepatitis in the IDU population. An important component in the intravenous drug abuse population and in patients receiving medically indicated chronic opioid treatment is opioid withdrawal. Data on bacterial virulence in the context of opioid withdrawal suggest that mice undergoing withdrawal had shortened survival and increased bacterial load in response to Salmonella infection. As the body of evidence in support of opioid dependency and its immunosuppressive effects is growing, it is imperative to understand the mechanisms by which opioids exert these effects and identify the populations at risk that would benefit the most from the interventions to counteract opioid immunosuppressive effects. Thus, it is important to refine the existing animal model to closely match human conditions and to cross-validate these findings through carefully controlled human studies. Better understanding of the mechanisms will facilitate the search for new therapeutic modalities to counteract adverse effects including increased infection rates. This review will summarize the effects of morphine on innate and adaptive immunity, identify the role of the mu opioid receptor in these functions and the signal transduction activated in the process. The role of opioid withdrawal in immunosuppression and the clinical relevance of these findings will also be discussed.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA. royxx002@umn.edu
authors.forename: Sabita
authors.initials: S
authors.lastname: Roy
authors.forename: Jana
authors.initials: J
authors.lastname: Ninkovic
authors.forename: Santanu
authors.initials: S
authors.lastname: Banerjee
authors.forename: Richard Gene
authors.initials: RG
authors.lastname: Charboneau
authors.forename: Subhas
authors.initials: S
authors.lastname: Das
authors.forename: Raini
authors.initials: R
authors.lastname: Dutta
authors.forename: Varvara A
authors.initials: VA
authors.lastname: Kirchner
authors.forename: Lisa
authors.initials: L
authors.lastname: Koodie
authors.forename: Jing
authors.initials: J
authors.lastname: Ma
authors.forename: Jingjing
authors.initials: J
authors.lastname: Meng
authors.forename: Roderick A
authors.initials: RA
authors.lastname: Barke
mesh_terms: D000701:Analgesics, Opioid / Q000276:immunology* / Q000494:pharmacology; D000818:Animals; D006801:Humans; D007107:Immune System / Q000187:drug effects*; D009020:Morphine / Q000494:pharmacology; D009021:Morphine Dependence / Q000276:immunology / Q000382:microbiology; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000276:immunology* / Q000378:metabolism; D017450:Receptors, Opioid, mu / Q000378:metabolism; D013375:Substance Withdrawal Syndrome / Q000276:immunology / Q000378:metabolism; D019966:Substance-Related Disorders / Q000276:immunology* / Q000378:metabolism
chemical_list: D000701:Analgesics, Opioid; D017450:Receptors, Opioid, mu; D009020:Morphine