Differential effects of beta-endorphin on cAMP levels in human peripheral blood mononuclear cells

Acute and chronic stress induced changes in sensitivity of peripheral inflammatory pathways to the signals of multiple stress systems --2011 Curt Richter Award Winner

Exposure to psychosocial stress has been associated with increasing rates of morbidity in humans and in animal models, but the underlying mechanisms are not completely understood. Major stress responsive systems, such as the hypothalamus-pituitary adrenal (HPA) axis and the autonomic nervous system (ANS) are under investigation as underlying pathways, but although acute stress reliably activates these systems, findings of long-term alternations in baseline activity are inconsistent at present. Emerging evidence suggests that stress-related changes in the sensitivity of target systems toward glucocorticoid (GC) regulation, i.e. development of GC resistance, might help explain inflammatory disinhibition and development of disease related to inflammation. More recent findings further show that the autonomic nervous system might play an important role in the regulatory control of the inflammatory cascade. The major argument put forward in this manuscript is that target tissues for stress system modulation, such as the inflammatory cascade, vary in their ability to respond to stress system signaling, and that assessing alterations in this stress signal sensitivity which can be caused by stress or disease processes, might be necessary to understand and explain stress effects on health. This review focuses on the inflammatory system in particular, because anti-inflammatory effects of most stress systems have been documented, but the general assumption might have to be generalized to other target systems. The main conclusion to be made is that reduction in glucocorticoid sensitivity of target tissues is the most consistent finding at present, and that assessing such changes in glucocorticoid sensitivity might be necessary to understand many stress-related changes in physiology.

β-Endorphin inhibits phagocytic activity of lizard splenic phagocytes through μ receptor-coupled adenylate cyclase-protein kinase A signaling pathway

The receptor-coupled intracellular signaling mechanism of endogenous opioid peptide β-endorphin (β-end) is explored for the first time in ectothermic vertebrates using wall lizard as a model. β-End inhibited the percentage phagocytosis and phagocytic index of lizard splenic phagocytes in a dose-dependent manner. The inhibitory effect of β-end on phagocytosis was completely antagonized by non-selective opioid receptor antagonist naltrexone and also by selective μ-receptor antagonist CTAP. However, selective antagonists for other opioid receptors like NTI for δ-receptor and NorBNI for κ-receptor did not alter the effect of β-end on phagocytosis. This suggests that β-end mediated its inhibitory effect on phagocytic activity of splenic phagocytes exclusively through μ opioid receptors. The μ opioid receptor-coupled downstream signaling cascade was subsequently explored using inhibitors of adenylate cyclase (SQ 22536) and protein kinase A (H-89). Both SQ 22536 and H-89 abolished the inhibitory effect of β-end on phagocytosis in a concentration-related manner. Implication of cAMP as second messenger was corroborated by cAMP assay where an increase in intracellular cAMP level was observed in response to β-end treatment. It can be concluded that β-end downregulated the phagocytic activity of lizard splenic phagocytes through μ opioid receptor-coupled adenylate cyclase-cAMP-protein kinase A pathway.

Variability in stress system regulatory control of inflammation: a critical factor mediating health effects of stress

Chronic stress has been associated with disease but the biological pathways are not completely understood. Stress systems such as the hypothalamus-pituitary-adrenal axis and the autonomic nervous system are prime candidates but alterations in their baseline activity are not consistently found in chronic stress. Evidence suggests that stress-related changes in the sensitivity of inflammatory pathways towards glucocorticoid regulation, that is, the development of glucocorticoid resistance, might help explain inflammatory disinhibition and the subsequent development of disease. Recent data show a similarly important role for sympathetic and parasympathetic modulation of the inflammatory cascade for the maintenance of health. This article argues that variation of target tissue sensitivity towards anti-inflammatory effects of the hypothalamus-pituitary-adrenal axis, as well as sympathetic and parasympathetic signaling, might be involved in the development of low-grade inflammation under chronic psychosocial stress.

Neuropeptides as signal molecules in common with leukocytes and the hypothalamic-pituitary-adrenal axis

There exists a bidirectional regulatory circuit between the nervous and immune systems. This regulation has been shown to be mediated in part through neuroendocrine hormones and cytokines. Both systems have receptors for both types of signal molecules. The nervous system has receptors for cytokines and it also synthesizes cytokines. The immune system synthesizes and responds to cytokines. So, it is not too far-fetched to believe that neuroendocrine peptide hormones could bind to leukocytes and modulate immune functions. However, it is not widely known that the immune system also synthesizes functional, neuropeptide hormones. This will be discussed in this paper citing a plethora of evidence. The aim of this paper is to summarize this evidence by using three neuropeptides that are synthesized by leukocytes and modulate immune functions as examples; corticotropin (ACTH), endorphin (END), and corticotropin releasing factor (CRF). The production and action of these three neuropeptides in the immune system will be explained. Finally, the potential physiological role of leukocyte-derived ACTH, END, and CRF in inflammation as a localized hypothalamic-pituitary-like axis is discussed.

Receptor regulation in neuroendocrine-immune communication: current knowledge and future perspectives

Immune cells express receptors for every hormone or neurotransmitter we know so far. The neuroendocrine system signals to the immune system via the release of hormones and neurotransmitters that regulate cellular activity via these receptors. Much attention has been focused on the effect of glucocorticoids and catecholamines on the immune system. Glucocorticoids communicate with immune cells via glucocorticoid receptors of which the activity itself changes during immune activation. Many neuroendocrine mediators are ligands for G-protein coupled receptors on immune cells. Cytokines, oxygen-radicals, and catecholamines can influence the responsiveness of G-protein coupled receptors via decreasing the intracellular level of so-called G-protein coupled receptor kinases, of which the subtype GRK2 is highly expressed in immune cells. Therefore, changes in only one kinase can modulate the sensitivity of many receptors. We describe here that sensitivity of neuroendocrine receptors on immune cells is constantly regulated by inflammatory processes or chronic stress, which implies that not only the activity of the neuroendocrine system determines communication but that the sensitivity of receptors is a major factor in determining the final immune response. Finally, consequences of alterations in GRK2 during (neuro)-inflammatory diseases are discussed.

Sympathetic nervous system and neurotransmitters: their possible role in neuroimmunomodulation of multiple sclerosis and some other autoimmune diseases

Multiple sclerosis is still a disease without a cure. Although intensive research efforts have led to the development of drugs that modify the activity of the disease, most of them have various side effects and are expensive. At the same time it is becoming apparent that some remedies usually used to treat somatic and psychic disorders also have immunomodulating properties, and may help manage multiple sclerosis and other autoimmune diseases. We describe here the role of the sympathetic nervous system in the neuro-immune interaction in multiple sclerosis and other immune diseases with increased cellular immunity as well as neurochemical disturbances that take place in these disorders.

Relations of plasma ACTH and cortisol levels with the distribution and function of peripheral blood cells in response to a behavioral challenge in breast cancer: an empirical exploration by means of statistical modeling

This study explores by means of statistical modeling the relations between adrenocorticotrophin hormone (ACTH) and cortisol levels and distribution and function of peripheral blood cells in response to an acute stressor consisting of a standardized speech task in breast cancer patients with axillary lymph node metastases and distant metastases. As a control group age-matched women participated in this study. The preliminary findings show that the effect of ACTH on immunoreactivity is related to the health of the doctor. In node-positive breast cancer patients and healthy women, ACTH has a modest positive effect on T lymphocyte percentages and on pokeweed-induced proliferation at baseline and in response to the speech task. In contrast, in breast cancer patients with distant metastases, ACTH has a negative effect on T lymphocyte and function at baseline and in response to the stressor. Interestingly, neither ACTH nor cortisol levels were related to natural killer (NK) cell percentages and natural killer cell activity (NKCA). In addition, it appeared that cortisol had a positive effect on CD3 cell percentages when the health of the donor was taken into account. This effect was most distinct on CD3 cells measured at baseline. If replicated on a larger scale, these findings may indicate that the hypothalamic pituitary adrenal axis plays a role in the adaptation of the host defenses in reaction to acute stress, particularly those involving T lymphocytes. Moreover, these findings may suggest that the health of the donor may be an important effect modification factor in the relations between neuroendocrines and immunoreactivity.

The peptide molecular links between the central nervous and the immune systems

The central nervous system (CNS) and the immune system were for many years considered as two autonomous systems. Now, the reciprocal connections between them are generally recognized and very well documented. The links are realized mainly by various immuno- and neuropeptides. In the review the influence of the following immunopeptides on CNS is presented: tuftsin, thymulin, thymopoietin and thymopentin, thymosins, and thymic humoral factor. On the other side, the activity in the immune system of such neuropeptides as substance P, neurotensin, some neurokinins, enkephalins, and endorphins is discussed.

Effects of general anaesthesia on inflammation

General anaesthesia accompanied by surgical stress may influence the inflammatory responses that are essential for maintaining the homeostatic state during the postoperative course. Severe dysregulation of the inflammatory process may provoke or aggravate postoperative complications, e.g. increased susceptibility to infections, inadequate stress reactions and hypercatabolism. Anaesthetics have been suspected of impairing various functions of the immune system either directly, by disturbing the functions of immune-competent cells, or indirectly by modulating the stress response. In the past, conflicting data on the possible immunological side effects of anaesthetics have been published. Potential reasons for these controversial findings include heterogeneous patient study groups with diverse pre-existing diseases, lack of standardisation of surgical procedures, major differences in the length and severity of surgical tissue injury and a small number of randomised studies. Although the immunological effects are of minor consequence in subjects with normal immune functions, the suppression of cellular and humoral immunity following surgery and general anaesthesia may be relevant in patients with pre-existing immune disorders.

Plasma levels of interleukin-6 and interleukin-10 are affected by ketorolac as an adjunct to patient-controlled morphine after abdominal hysterectomy

OBJECTIVE

Because morphine affects various immune functions, patient-controlled analgesia with morphine may further deteriorate the immune mechanisms after surgery. Therefore, the purpose of this study was to determine differences between morphine patient-controlled analgesia and a combination of morphine and ketorolac in interleukin-6 and interleukin-10 responses, and in analgesia and morphine-related side effects.

DESIGN

Prospective study.

PATIENTS

Twenty-two patients who underwent abdominal hysterectomy were classified randomly into two groups: (1) patient-controlled analgesia with morphine; and (2) patient-controlled analgesia with a combination of morphine and ketorolac. Blood samples to measure cytokines were collected at preoperatively, immediately postoperatively, and 2 hours, 4 hours, and 24 hours postoperatively.

OUTCOME MEASURES

Plasma was separated and frozen until the analysis of cytokines using enzyme-linked immunosorbent assays. Postoperative pain was assessed using a visual analog score. Sedation was checked based on a protocol developed at the Samsung Medical Center.

RESULTS

In the two groups, interleukin-6 increased immediately postoperatively, and it remained consistent for 24 hours. Interleukin-10 concentrations peaked at 2 hours postoperatively and progressively decreased. Cytokine concentrations between the two groups were significantly different for interleukin-6 24 hours postoperatively (p = 0.026) and for interleukin-10 4 hours postoperatively (p = 0.045). Total analgesic use was not different, but morphine consumption was significantly different (p = 0.037 at 4 hours postoperatively, p = 0.015 at 24 hours postoperatively). Pain scores, sedation, and side effects were unaffected by the patient-controlled analgesia regimen.

CONCLUSIONS

The authors conclude that supplementation using ketorolac plus administration of morphine modifies cytokine responses and may contribute to immune augmentations during postoperative periods.

Involvement of granzyme B expression in the enhancement of natural killer activity by beta-endorphin

Beta-Endorphin has been reported to enhance natural killer (NK) activity in vitro. However, few studies have examined the precise regulation of the cytolytic stage of NK cells. We therefore investigated the regulation by beta-endorphin of cytotoxicity-associated molecules such as granzyme B, perforin, and Fas ligand (FasL) in human CD16(+) NK cells. On semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) assay, the granzyme B mRNA level apparently increased in CD16(+) NK cells from high responding subjects having ratios >1.5 for the LU(30) ratio. An increase in intracellular granzyme B molecules was also detected in CD16(+) NK cells by flow cytometry. On the other hand, perforin and FasL appeared not to be involved in regulation by beta-endorphin. These findings suggest that up-regulation of granzyme B expression may be involved in the enhancement of NK activity by beta-endorphin.

Enkephalin receptors and receptor-mediated signal transduction in cultured human lymphocytes

Enkephalins are opioid peptides that bridge the neuroendocrine and immune systems. Using flow cytometry and a fluorescein conjugate of the endogenous pentapeptide methionine-enkephalin (ME), we have identified enkephalin receptors on cultured human lymphocytes. Cell surface recognition sites that bound ME with high affinity and specificity were detected for NALM 6 (pre-B acute lymphoblastic leukemia) and Jurkat (T lymphoma) cells. Brain-like enkephalin receptors were measured for these lymphocytes using conventional radioligand-receptor assays and the highly delta opioid receptor-selective enkephalin analog [3H]DPDPE. Upon activation, the lymphocyte enkephalin receptors transmitted signals that enhanced the accumulation of intracellular cAMP. These studies provide evidence that cultured human lymphocytes of the B (NALM 6 cells) and T (Jurkat cells) lineages express functional enkephalin receptors and suggest that such receptors may be instrumental in the lymphocyte response to opioid peptides and alkaloids.

Leucine enkephalin degradation in allergopathic versus normal human plasma

The enzyme hydrolysis of labelled leu-enkephalin in the presence of plasma enzymes was studied by kinetic and chromatographic techniques in a group of allergopathic patients in the acute and quiescent stage; data obtained have been compared with those obtained with normal controls. Results shown indicate that in the quiescent stage substrate degradation is reduced, and that the pattern of the hydrolysis by-products is modified with respect to the controls. In the acute as compared to the quiescent stage, enkephalin hydrolysis is further reduced, and the pattern of hydrolysis by-products is further modified. ANOVA analysis of these data indicates that the dependency of hydrolysis reduction upon the grouping of subjects (i.e., controls, quiescent and acute stage) is statistically very significant. Reduced substrate hydrolysis, and modified hydrolysis pattern, appears to be associated with decreased activity of the enzymes involved and more significantly with increased activity of the low molecular weight plasma inhibitors. The combination of these two factors appears to define a hydrolysis pattern characteristic of the allergopathic subjects, similar in the quiescent and acute phase, and different from that observed in the controls.

Effectiveness of a short-term group psychotherapy program on endocrine and immune function in breast cancer patients: an exploratory study

Cancer patients who had been treated for early stage breast cancer and were diagnosed with either positive axillary lymph nodes or distant metastases were randomly assigned to either a 13-week experiential-existential group psychotherapy (EEGP) program or a waiting list control (WLC) condition. Endocrine and immune measures were obtained before and after the intervention period. The findings of this study are that, after the 13 weeks of the experiment, patients in the EEGP group showed lower levels of plasma cortisol and lower levels of prolactin as well as lower percentages of natural killer cells, CD8 cells, and CD4 cells in addition to a lower proliferative response to pokeweed mitogen than patients in the WLC group. Importantly, this was only found in those breast cancer patients presenting relatively high endocrine and immune baseline levels, suggesting that the patients' profile with regard to endocrine and immune function at the start of a program can have an important effect. If replicated on a larger scale, the current results may be relevant for the treatment of breast cancer.

The effect of cortisol suppression on interleukin-6 and white blood cell responses to surgery

BACKGROUND

The endocrine and immune changes associated with surgery are well documented, but the interaction between them has not been fully evaluated. Cortisol production during surgery can be suppressed by etomidate and we have used this to investigate the relationship between the cortisol response and immune changes in the perioperative period.

METHODS

We have measured the cortisol, interleukin-6 and white cell responses to elective abdominal hysterectomy in 8 healthy female patients, who received etomidate 0.3 mg kg-1 for induction of anaesthesia. A control group of 8 subjects received thiopentone. Both groups of patients received vecuronium and fentanyl 2 micrograms kg-1 and anaesthesia was maintained with nitrous oxide in oxygen and isoflurane 0.5-1.0%. Venous blood samples were collected before and during surgery and up to 24 h in the postoperative period.

RESULTS

Serum interleukin-6 values were significantly greater at 6 and 12 h (P < 0.05) in those patients who received etomidate. Inhibition of the serum cortisol response to surgery in the etomidate group was also associated with less marked lymphopenia at 4 h (P < 0.05). There was no significant difference in neutrophil granulocyte counts between the two groups.

CONCLUSION

In conclusion, endogenous corticosteroids modulate the interleukin-6 response to surgery.

An investigation of the effects of heparin, low molecular weight heparin, protamine, and fentanyl on the balance of pro- and anti-inflammatory cytokines in in-vitro monocyte cultures

We report a study conducted to determine if drugs given peri-operatively during cardiac surgery could themselves modulate the balance of pro- and anti-inflammatory cytokines. We determined the cytokine response of 10 separate in vitro monocyte cultures to the administration of drugs at concentrations used during cardiac 'surgery:fentanyl (25 ng.ml-1), heparin 2.5 i.u.ml-1, heparin with an equal concentration of protamine, and enoxaparin 2.5 i.u.ml-1. Fentanyl, heparin and low molecular weight heparin (enoxaparin) led to increased tumour necrosis factor alpha but this did not reach statistical significance. Tumour necrosis factor soluble receptor 1 and 2 was not elevated. Interleukin-1 beta was increased by heparin (p < 0.05), whereas interleukin-1 receptor antagonist was increased by fentanyl (p < 0.05). Protamine blocked the heparin-induced increase in tumour necrosis factor alpha and interleukin-1 beta. These data raise the possibility that endogenous and exogenously administered opioids may be partly contributing to the interleukin-1 receptor antagonist response seen during major surgery.

Immunomodulation: an important concept in modern anaesthesia

This review summarises evidence for immunomodulatory effect of drugs administered peri-operatively. The clinical significance of the balance of pro- and anti-inflammatory cytokines may be seen in certain disease states, for example, meningococcal meningitis and Lyme arthritis. This balance may be altered peri-operatively. Traditionally, these changes are considered to be due to the stress response of surgery, the response to cardiopulmonary bypass, or endotoxaemia. This review presents in vitro evidence suggesting that drugs modulating this cytokine balance include non-steroidal anti-inflammatory agents, phosphodiesterase inhibitors and opioids, acting through effects on intracellular cyclic nucleotide messenger systems. An important consequence of the pro-inflammatory cytokine activity is increased adhesion of neutrophils. Aspects of this process may be inhibited by avoiding low blood flow states, by reducing adhesion molecule expression (for example by use of pentoxifylline), or by use of negatively charged anions such as heparin. Neutrophil activity is generally depressed by intravenous anaesthetic induction agents, but is enhanced by opioids. Natural killer cell activity, which is involved in immunity against tumour cells and virally infected cells is transiently depressed by volatile anaesthetic agents and opioids. In contrast catecholamines enhance natural killer cell activity. Whereas decrease in immunoglobulin levels occur peri-operatively, this is not thought to be as a result of drugs at clinically used concentrations but rather due to haemodilution.

Pretreatment of human peripheral blood lymphocytes with interleukin-2 or dexamethasone does not alter their response to Met-Enkephalin in a NK-cytotoxic assay

The effect of Met-Enkephalin (MENK; 10(-12) - 10(-8) M) on NK-activity of peripheral blood lymphocytes (PBL) after in vitro treatment (18 h, 37 degrees C) was examined in 30 young, healthy male donors. In the group as a whole (n = 30), no significant effect of MENK was detected. At the individual level, 18 of 30 donors (60%) responded to MENK either by mild enhancement (up to 8%, 8 responders), or by mild attenuation (up to 12%, 10 responders) of the basal NK-activity. The effect of MENK was donor-related regarding the dose-response, E/T ratio, and direction of MENK action. The influence of pretreatment of PBL (1 h) with either graded doses of interleukin-2 (IL-2; 3, 25, 50 U/ml) or dexamethasone (Dex; 2.5 x 10(-9), 2.5 x 10(-8), 2.5 x 10(-7) M), on the effect of MENK was also tested. The idea was that pretreatment of PBL would result in predictable, and/or stronger response to MENK. In the group as a whole again no significant effect of MENK was detected on the NK-activity of PBL prestimulated by IL-2 (n = 16), or inhibited by Dex (n = 12). Further, pretreatment of PBL with IL-2/Dex did not significantly alter the intensity of modulation by MENK, which was generally mild. The data obtained have shown that pretreatment of PBL with IL-2 or Dex, regardless of their concentrations, did not significantly alter the frequency of responders to MENK being 50%, 62.5% and 64.3% with 3, 25 or 50 U/ml IL-2, respectively, and 50% with all concentration of Dex used, as compared to that observed with resting PBL (60%). However, at the individual level physiological concentrations of MENK (10(-12) - 10(-9) M) induced enhancement or/and attenuation of the NK-activity pretreated with IL-2/Dex, respectively. The effect of MENK at the individual level was donor-related regarding the dose-response, E/T ratio, and direction of MENK action. Thus, pretreatment of PBL with graded concentrations of IL-2/Dex did not alter the effect of MENK on NK-activity, regarding the frequency and intensity, as well as the direction of modulation: it remained bidirectional, of low intensity, and independent of the grade of PBL preactivation/inhibition, therefore unpredictable.

Positive and negative immunomodulation by opioid peptides

The data that follow review part of the existing evidence concerning the neuroimmune functions mediated by opioid peptides, with particular regard to dual immunomodulatory effects. Limited references to substances other than opioid peptides are included, mainly to emphasize the possible similarities in the mediation of neuroimmune interactions by different informational substances, while the interactions directed from the immune to the nervous system have deliberately been omitted.

Increase of interleukin-6 plasma levels after elective craniotomy: influence of interleukin-10 and catecholamines

Accidental and operative trauma are able to induce a systemic reaction of the organism characterized by fever, leukocytosis, catabolism, and an activation of the coagulation system. Interleukin-6 (IL-6) has been found to be an important mediator of this acute-phase response. In this study the influence of elective craniotomy on IL-6 plasma levels was evaluated. Blood samples were obtained from 20 patients undergoing elective craniotomy for vascular or tumorous diseases of the brain. IL-6 increased significantly (p < 0.05) from the pre-operative (0(0-5.4) pg/ml) to the intraoperative (180 min after beginning of surgery) time-point (10.6 (0-18.5) pg/ml). The maximum was reached on the first postoperative morning (13.9(4.3-45.0) pg/ml). Interleukin-10 (IL-10) is an anti-inflammatory cytokine which suppresses IL-6 synthesis in vitro in various cell lines. IL-10 plasma concentrations showed no alterations throughout the study period. Epinephrine plasma concentrations increased significantly from pre-operative values (15 (0-74) pg/ml) to the postoperative time-point (57(9-459) pg/ml). A 4.5-fold increase (p < 0.05) of norepinephrine plasma concentrations was found when comparing the data obtained 60 min after beginning of surgery with the data of the first postoperative morning. In monocytes, which are a major source of plasma IL-6, an elevation of intracellular cAMP stimulates the IL-6 synthesis. The postoperative maximum of IL-6 in plasma could be due to a release of catecholamines. In conclusion this study demonstrated an elevation of IL-6 plasma concentrations during and after elective craniotomy. Increased plasma catecholamine concentrations as well as a damage in the blood-brain barrier due to the surgical trauma with a spill-over of IL-6 from brain tissue into plasma could have contributed to this result.

Beta-endorphin and the immune system--possible role in autoimmune diseases

The immune system and the neuroendocrine system are closely interconnected having such means of bidirectional communication and regulation. In this review, a hypothesis is put forward regarding the possible role of beta-endorphins in the pathogenesis of autoimmune diseases: It is suggested that the increased cytokine production in immunoinflammatory disorders induces production of beta-endorphins from the pituitary and the lymphocytes; the enhanced level of beta-endorphin causes inhibition of human T helper cell function, which potentially down-regulate the antibody production. Also the beta-endorphin-induced enhancement of the natural killer cell activity may suppress the B cell function. In addition, beta-endorphin also exerts a direct inhibitory effect on the antibody production. Thus, in autoimmune disorders the enhanced cytokine level may via stimulation of the production of beta-endorphins exert a negative feed back on the antibody production and potentially so on the production of autoantibodies.

The in vivo effects of opioid peptides on the murine immune response

We have previously reported that met-enkephalin has dual immunomodulatory properties in vitro. We have continued this investigation using an in vivo system. In this study, Alzet miniosmotic pumps were loaded with either met-enkephalin, DTLET or FK 33-824 and were surgically implanted into BAF1/J mice. Twenty-four hours after pump implantation, mice were challenged with sub-optimal, optimal or supraoptimal immunizing doses of antigen. The immune response was assessed 4 or 5 days after primary immunization. FK 33-824, a met-enkephalin analogue, had no effect on the response of mice challenged with a suboptimal antigen dose. However, FK 33-824, at a pump concentration of 10(-3) M, suppressed the response against optimal challenge doses of antigen. At a pump concentration of 10(-8) M, FK 33-824 suppressed, enhanced or had no effect on the supraoptimal antigen dose-induced immune response. The suppressive effect of FK 33-824 in mice immunized with either optimal or supraoptimal doses of antigen was blocked by naloxone. Met-enkephalin and its delta opioid receptor specific analogue, DTLET, had no effect on the immune response to optimal antigen immunization. These results indicate that FK 33-824 has in vivo immunomodulatory activity and provide evidence that opioid peptides may either upregulate or downregulate the in vivo immune response depending on the strength of the response.

Beta-endorphin modulates calcium channel activity in human neutrophils

10(-6) M n-formyl-methionyl-leucyl-phenylalanine (FMLP) stimulated Ca2+ flux in human neutrophils is characterized by a profile composed of two peaks of different amplitude and breadth. beta-Endorphin inhibited the magnitude and modulated the kinetics of the second peak in a manner which was dose-dependent and could reflect either negative cooperativity or heterogeneity of binding sites. The second peak arises from calcium channel activity since in the presence of nifedipine or EGTA it was not evident while the first peak was reduced about 24%. Similarly, at 15 degrees C, where we were unable to detect any channel activity, the first peak was diminished by 35% and beta-endorphin had no detectable effect on this peak. These results led us to conclude that the first peak is chiefly composed of Ca2+ recruited from cytosolic stores which are relatively insensitive to the above treatments and a smaller fraction of calcium originating in calcium channel activity. Hence, we reason that beta-endorphin modulates only the calcium ion flux arising from calcium channel function.

Leu-enkephalin modulates the migration inhibition of mouse splenocytes induced by cAMP-elevating agents

The ability of Leu-enkephalin (LENK) to alter random migration of mouse spleen cells was tested in vitro and in vivo. Incubation of the cells with LENK (10(-14) M-10(-7) M) for 1 h at 37 degrees C suppressed the migration. The dose-response was irregular, showing two peaks in the physiological concentration range: 10(-10) M, and 10(-13)-10(-14) M. Intraperitoneal (i.p.) injection of LENK (7.5 mg/kg body wt) depressed the migratory capacity of the splenocytes harvested 2 and 24 h later. In contrast to the inhibitory effect of LENK on the migration of native cells, its effect on cells pretreated with the cAMP-elevating agents theophylline, 3-isobutyl-1-methyl-xanthine (IBMX) and forskolin was predominantly a stimulatory one. The addition of LENK resulted in attenuation or even full reversion of the migration-inhibition caused by those agents. Occasionally, potentiation of the suppression was also observed. There was no discrimination between the phosphodiesterase (PDE) inhibitors IBMX and theophylline, and the adenylate cyclase activator forskolin. Specificity of LENK effects was tested by using naloxone (10(-6) M), an opioid-receptor antagonist. Migration-inhibition induced by LENK was reversed in about two-thirds of the experiments. In contrast, migration-inhibition induced by cAMP-elevating agents, could not be reversed by naloxone. Naloxone itself was not inert, usually suppressing the locomotor ability of splenocytes. The data suggest that LENK-induced modulation of cell migration is (at least partly) mediated via opioid receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Naloxone modulates NK-cell activity of human peripheral blood lymphocytes like an opioid agonist

Naloxone at concentrations 10(-6) M to 10(-10) M modulated endogenous NK-activity in 11 of 14 samples of human peripheral blood lymphocytes after 18-hour incubation. The dose response usually showed two peaks, which varied with the donor. Enhancement was obtained in 6, suppression in 4, and both effects (depending on naloxone concentration) in 1 example; 3 donors were nonresponders. However, the overall effect of naloxone on endogenous NK activity was not statistically significant in the population as a whole. IL-2-stimulated NK-activity, was also altered by naloxone. The direction of the alteration depended on the degree of IL-2-induced NK-stimulation, and was donor-dependent. For example, naloxone enhanced NK-activity that had been stimulated by low IL-2 concentration (3 U/ml), but decreased NK-activity which had been stimulated by high (50 U/ml) IL-2 concentration. Naloxone 10(-7) M significantly reversed medium stimulation of NK activity, induced by 25 U/ml, in a group as a whole. Naloxone (10(-7) M to 10(-12) M) also modulated NK-activity stimulated by exogenous IFN alpha, as well as by endogenous, Poly-I.C-induced IFN. Decrease, or enhancement, depended on the degree of baseline NK-stimulation and varied with the donor. Short (2-hours) incubation with naloxone also resulted in the modulation of basal and IFN-stimulated NK-activity. Again, the effect varied with the donor and with the degree of lymphocyte activation. Thus, naloxone, the opioid receptor antagonist, modulated the NK-cell activity like opioid peptides, i.e. resembled an opioid agonist, in an individual, donor dependent fashion.

Regulation of NK cell activity and the level of the intracellular cAMP in human peripheral blood lymphocytes by Met-enkephalin

The effect of Met-enkephalin on natural killer (NK) activity and on intracellular cyclic adenosine monophosphate (cAMP) level in human peripheral blood lymphocytes was measured 1/4, 1, 2, and 24 h after incubation. Concentrations of Met-enkephalin ranged from 10(-12) to 10(-8) M. Cyclic changes in NK activity and in the intracellular cAMP level after treatment with Met-enkephalin were observed. Kinetics of changes caused by high (10(-9), 10(-8) M) and low concentrations (10(-12), 10(-11), 10(-10) M) of Met-enkephalin differed from each other. Early, nearly threefold increase in the level of intracellular cAMP was found 15 min after treating peripheral blood lymphocytes with 10(-12) M Met-enkephalin. By contrast, a nearly 75% decrease of intracellular cAMP level was found 2 h after treatment with 10(-9) M Met-enkephalin. Generally, early intensive changes in the cAMP level in peripheral blood lymphocytes, induced by Met-enkephalin, were followed by delayed, subtle changes in NK cell activity in the opposite direction.

Beta-endorphin blunts phosphatidylinositol formation during in vitro activation of isolated human lymphocytes: preliminary report

We have previously described the regulatory effect of beta-endorphin on three human cytotoxic cell populations. We confirmed the variable nature of these effects on human natural killer cell (NK) activity, showed mixed effects on the generation of cytotoxic T lymphocyte (CTL) activity, and demonstrated the reproducible suppression of lymphokine-activated killer cell (LAK) activity. We and others also observed mixed effects of beta-endorphin on the proliferative response to mitogens and in mixed leukocyte reactions. In the study reported here, we test the effects of beta-endorphin on the formation of phosphatidylinositol during cell activation. 32P-radiolabeled peripheral blood mononuclear cells obtained from normal adult donors and CD2-depleted subpopulations were activated with phytohemagglutinin or in a NK, LAK, or CTL protocol in the absence or presence of recombinant beta-endorphin. The total lipidic extract was analyzed by thin-layer chromatography and autoradiography. The results of these studies indicate that beta-endorphin blunts the formation of phosphatidylinositol by about 20% in the four systems studied and in all the donors tested. This effect is dose-dependent and is blocked in part by the opioid antagonist, naltrexone, suggesting involvement of the opioid receptor.

Effect of morphine and beta-endorphin on human Fc receptor-dependent and natural killer cell functions

Interactions between opiates and the human immune system have important clinical implications. To further evaluate these interactions, we studied in vitro and in vivo effects of morphine sulfate (morphine) and beta-endorphin (Bend) on antibody-dependent cell cytotoxicity (ADCC), natural killer cell cytotoxicity (NKCC), and effector cell expression of antibody Fc receptors. Morphine and Bend had no potent in vivo or in vitro effect on FcR expression nor did they have a significant in vitro effect on ADCC by monocytes or polymorphonuclear cells. Bend enhancement of NKCC in vitro was inhibited by coincubation of effector cells with morphine. After taking 90 to 150 mg of oral morphine, study volunteers demonstrated a significant decrease in ADCC by peripheral blood mononuclear cells. The same individuals demonstrated a consistent increase in NKCC and no change in the expression of Fc receptors. Effector cells from these individuals responded normally to in vitro incubation with interferon-gamma (IFN-gamma).

Effect of enkephalins on bone marrow cells

Mouse bone marrow cells were incubated with methionine- or leucine-enkephalin (10(-15)-10(-6) M) before seeding into soft agar cultures. In marrow samples harvested at different times, enkephalins decreased GM colony count on average by 30-40%. In individual experiments, however, the same concentration of enkephalins caused even stimulation, or at other times had effect. In view of the circadian periodicity of neuroendocrine functions and hematopoietic activity, the enkephalin effect on bone marrow cells was tested on marrow samples harvested at fixed time points (6 am, 6 pm), using enkephalin concentrations in the physiological range (10(-12)-10(-9) M). The seeding efficiency of the 6-pm cell population was on average 50% above that of the 6-am population. The 6-pm cell population was also more susceptible to the inhibitory effect of the enkephalins (35% inhibition) than the 6-am population (15% inhibition), and the variability in response was considerably reduced. With progenitor cell-enriched population, obtained by fluorescence-activated cell sorting (FACS) of 6-am bone marrow samples, in 3 out of 6 experiments Met- and Leu-enkephalin showed 30-35% inhibition of GM colony formation over a wide range of concentrations (10(-15)-10(-6)). In the other 3 experiments, suppression as well as stimulation or no alteration in colony count were observed. This variability probably reflected quality (purity) of the progenitor cell population, and may indicate that the enkephalins affected hematopoietic cells via a population of accessory cells.