1
|
Miller NW, Seman BG, Akers SM, Povroznik JM, Brundage K, Fang W, Robinson CM. The impact of opioid exposure during pregnancy on the human neonatal immune profile. Pediatr Res 2022; 92:1566-1574. [PMID: 35288639 PMCID: PMC8920062 DOI: 10.1038/s41390-022-02014-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/19/2022] [Accepted: 02/04/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND The increasing magnitude of the opioid crisis and rising rates of neonatal abstinence syndrome (NAS) diagnoses highlight the need for increased research into how maternal substance use during pregnancy can impact the neonatal immune profile and its functionality. We hypothesized that neonates with opioid exposure would have reduced proportions of some immune cells, an anti-inflammatory cytokine profile, reduced T cell proliferation, and monocyte bacterial killing activity compared to the control population. METHODS The present study compares immune cell populations, inflammatory and anti-inflammatory cytokine and chemokine levels in the serum, and monocyte and T cell functional activity using umbilical cord samples from neonates with known opioid exposure during gestation and from control neonates without known exposure. RESULTS Our findings demonstrated a significant reduction in neutrophils, decreased levels of inflammatory cytokines in the serum, and reduced IL-2 production during in vitro CD4+ T cell proliferation in neonates exposed to opioids compared to controls. The neutrophil findings were supported by retrospective analysis of an extended network of deidentified patient records. CONCLUSIONS This study is the first of its kind to evaluate differences in neonatal immunity as a result of opioid exposure in the human population that will inform continued mechanistic studies. IMPACT The opioid epidemic has become a public health crisis in the United States, and the corresponding incidence of neonatal abstinence syndrome (NAS) have risen accordingly. New research is required to understand the short and long-term health impacts of opioid exposure to the neonate. This is the first human study to investigate the immunologic profile and functionality in neonates with known opioid exposure in utero. The abundance of neutrophils and the ratio of neutrophils to lymphocytes is significantly reduced along with inflammatory cytokines and chemokines following opioid exposure during pregnancy. The immune profile in opioid-exposed neonates may promote susceptibility to infection.
Collapse
Affiliation(s)
- Nicholas W. Miller
- grid.268154.c0000 0001 2156 6140Department of Microbiology, Immunology, & Cell Biology, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Brittany G. Seman
- grid.268154.c0000 0001 2156 6140Department of Microbiology, Immunology, & Cell Biology, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Stephen M. Akers
- grid.268154.c0000 0001 2156 6140Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Jessica M. Povroznik
- grid.268154.c0000 0001 2156 6140Department of Microbiology, Immunology, & Cell Biology, West Virginia University School of Medicine, Morgantown, WV 26506 USA ,grid.268154.c0000 0001 2156 6140Vaccine Development Center at West Virginia University Health Sciences Center, Morgantown, WV 26506 USA
| | - Kathleen Brundage
- grid.268154.c0000 0001 2156 6140Department of Microbiology, Immunology, & Cell Biology, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Wei Fang
- grid.268154.c0000 0001 2156 6140West Virginia Clinical and Translational Science Institute, Morgantown, WV 26506 USA
| | - Cory M. Robinson
- grid.268154.c0000 0001 2156 6140Department of Microbiology, Immunology, & Cell Biology, West Virginia University School of Medicine, Morgantown, WV 26506 USA ,grid.268154.c0000 0001 2156 6140Vaccine Development Center at West Virginia University Health Sciences Center, Morgantown, WV 26506 USA
| |
Collapse
|
2
|
Opioid-Mediated HIV-1 Immunopathogenesis. J Neuroimmune Pharmacol 2020; 15:628-642. [PMID: 33029670 DOI: 10.1007/s11481-020-09960-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023]
Abstract
Despite the ability of combination antiretroviral therapy to dramatically suppress viremia, the brain continues to be a reservoir of HIV-1 low-level replication. Adding further complexity to this is the comorbidity of drug abuse with HIV-1 associated neurocognitive disorders and neuroHIV. Among several abused drugs, the use of opiates is highly prevalent in HIV-1 infected individuals, both as an abused drug as well as for pain management. Opioids and their receptors have attained notable attention owing to their ability to modulate immune functions, in turn, impacting disease progression. Various cell culture, animal and human studies have implicated the role of opioids and their receptors in modulating viral replication and virus-mediated pathology both positively and negatively. Further, the combinatorial effects of HIV-1/HIV-1 proteins and morphine have demonstrated activation of inflammatory signaling in the host system. Herein, we summarized the current knowledge on the role of opioids on peripheral immunopathogenesis, viral immunopathogenesis, epigenetic profiles of the host and viral genome, neuropathogenesis of SIV/SHIV-infected non-human primates, blood-brain-barrier, HIV-1 viral latency, and viral rebound. Overall, this review provides recent insights into the role of opioids in HIV-1 immunopathogenesis. Graphical abstract.
Collapse
|
3
|
Carlesse F, Daudt LE, Seber A, Dutra ÁP, Melo ASDA, Simões B, Macedo CRD, Bonfim C, Benites E, Gregianin L, Batista MV, Abramczyk M, Tostes V, Lederman HM, Lee MLDM, Loggetto S, Galvão de Castro Junior C, Colombo AL. A consensus document for the clinical management of invasive fungal diseases in pediatric patients with hematologic cancer and/or undergoing hematopoietic stem cell transplantation in Brazilian medical centers. Braz J Infect Dis 2019; 23:395-409. [PMID: 31738887 PMCID: PMC9428207 DOI: 10.1016/j.bjid.2019.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 09/10/2019] [Accepted: 09/28/2019] [Indexed: 01/05/2023] Open
Abstract
In the present paper we summarize the suggestions of a multidisciplinary group including experts in pediatric oncology and infectious diseases who reviewed the medical literature to elaborate a consensus document (CD) for the diagnosis and clinical management of invasive fungal diseases (IFDs) in children with hematologic cancer and those who underwent hematopoietic stem-cell transplantation. All major multicenter studies designed to characterize the epidemiology of IFDs in children with cancer, as well as all randomized clinical trials addressing empirical and targeted antifungal therapy were reviewed. In the absence of randomized clinical trials, the best evidence available to support the recommendations were selected. Algorithms for early diagnosis and best clinical management of IFDs are also presented. This document summarizes practical recommendations that will certainly help pediatricians to best treat their patients suffering of invasive fungal diseases.
Collapse
Affiliation(s)
- Fabianne Carlesse
- Instituto de Oncologia Pediátrica, UNIFESP, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina (EPM), UNIFESP, São Paulo, SP, Brazil.
| | - Liane Esteves Daudt
- Universidade do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Adriana Seber
- Hospital Samaritano de São Paulo, São Paulo, SP, Brazil; ABHH, Brazil.
| | | | | | - Belinda Simões
- Hospital das Clínicas de Ribeirão Preto-USP, São Paulo, SP, Brazil.
| | | | - Carmem Bonfim
- Hospital das Clínicas de Curitiba, Paraná, PR, Brazil.
| | | | - Lauro Gregianin
- Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Marjorie Vieira Batista
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil.
| | - Marcelo Abramczyk
- Hospital Infantil Darcy Vargas, Morumbi, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil.
| | - Vivian Tostes
- Pro-Imagem medicina diagnóstica Ribeirão Preto, SP, Brazil.
| | | | - Maria Lúcia de Martino Lee
- Hospital Santa Marcelina TUCA, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | | | - Arnaldo Lopes Colombo
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Infectologia, Brazil.
| |
Collapse
|
4
|
Morphine exposure during early life alters thermal and mechanical thresholds in rats. Int J Dev Neurosci 2016; 60:78-85. [DOI: 10.1016/j.ijdevneu.2016.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/04/2016] [Accepted: 12/29/2016] [Indexed: 12/20/2022] Open
|
5
|
Ankrah AO, Sathekge MM, Dierckx RAJO, Glaudemans AWJM. Imaging fungal infections in children. Clin Transl Imaging 2016; 4:57-72. [PMID: 26913275 PMCID: PMC4752574 DOI: 10.1007/s40336-015-0159-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 12/15/2015] [Indexed: 12/16/2022]
Abstract
Fungal infections in children rarely occur, but continue to have a high morbidity and mortality despite the development of newer antifungal agents. It is essential for these infections to be diagnosed at the earliest possible stage so appropriate treatment can be initiated promptly. The addition of high-resolution computer tomography (HR CT) has helped in early diagnosis making; however, it lacks both sensitivity and specificity. Metabolic changes precede anatomical changes and hybrid imaging with positron emission tomography (PET) integrated with imaging modalities with high anatomical resolution such as CT or magnetic resonance imaging (MRI) is likely to detect these infections at an earlier stage with higher diagnostic accuracy rates. Several authors presented papers highlighting the advantages of PET/CT in imaging fungal infections. These papers, however, usually involve a limited number of patients and mostly adults. Fungal infections behave different in children than in adults, since there are differences in epidemiology, imaging findings, and response to treatment with antifungal drugs. This paper reviews the literature and explores the use of hybrid imaging for diagnosis and therapy decision making in children with fungal infections.
Collapse
Affiliation(s)
- Alfred O Ankrah
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO 9700 RB Groningen, The Netherlands ; Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Mike M Sathekge
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Rudi A J O Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO 9700 RB Groningen, The Netherlands
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO 9700 RB Groningen, The Netherlands
| |
Collapse
|
6
|
Hou W, Li H, Jiang W, Zhang C, McNutt MA, Li G. Simian Immunodeficiency Virus Impacts MicroRNA-16 Mediated Post-Transcriptional Regulation of mu Opioid Receptor in CEM ×174 Cells. J Cell Biochem 2015; 117:84-93. [DOI: 10.1002/jcb.25251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 06/04/2015] [Indexed: 01/09/2023]
Affiliation(s)
- Wenting Hou
- Department of Biochemistry and Molecular Biology; Peking University Health Science Center; Peking University; Beijing 100191 China
| | - Hui Li
- Department of Biochemistry and Molecular Biology; Peking University Health Science Center; Peking University; Beijing 100191 China
| | - Wei Jiang
- Department of Biochemistry and Molecular Biology; Peking University Health Science Center; Peking University; Beijing 100191 China
| | - Chao Zhang
- Department of Biochemistry and Molecular Biology; Peking University Health Science Center; Peking University; Beijing 100191 China
| | - Michael A McNutt
- Department of Pathology; Peking University Health Science Center; Peking University; Beijing 100191 China
| | - Gang Li
- Department of Biochemistry and Molecular Biology; Peking University Health Science Center; Peking University; Beijing 100191 China
| |
Collapse
|
7
|
Neefjes EC, van der Vorst MJ, Boddaert MS, Zuurmond WW, van der Vliet HJ, Beeker A, van den Berg HP, van Groeningen CJ, Vrijaldenhoven S, Verheul HM. Clinical evaluation of the efficacy of methylnaltrexone in resolving constipation induced by different opioid subtypes combined with laboratory analysis of immunomodulatory and antiangiogenic effects of methylnaltrexone. BMC Palliat Care 2014; 13:42. [PMID: 25165428 PMCID: PMC4145161 DOI: 10.1186/1472-684x-13-42] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 08/11/2014] [Indexed: 11/26/2022] Open
Abstract
Background Opioid-induced constipation (OIC) is one of the major symptoms in palliative care with a prevalence of 30-50%. Methylnaltrexone for the treatment of OIC is significantly more effective than placebo, but only in about fifty percent of the patients regardless of dose increase. Dose increases cause increased toxicity without additional efficacy, and are therefore not recommended. While methylnaltrexone is a μ-receptor antagonist, only a few opioids are solely μ-receptor agonists. Therefore, the response to methylnaltrexone may be determined by the receptor-profile of a specific opioid. In addition, methylnaltrexone may also affect the immune system and angiogenesis as was found in pre-clinical studies. Primary aim of this study is to determine differences in the efficacy of methylnaltrexone prescribed to resolve opioid induced constipation between three commonly used opioid subtypes: morphine sulphate, oxycodone and fentanyl. Secondary aim is to explore potential immunomodulatory and antiangiogenic effects of methylnaltrexone. Methods In this multi-center, prospective, parallel group trial we will evaluate the efficacy of methylnaltrexone in resolving OIC occurring as a side effect of the most common opioid subtypes: morphine, oxycodone and fentanyl. In total 195 patients with OIC despite prophylactic laxatives will receive methylnaltrexone every other day up to fourteen days. Patients will report its effect in a laxation diary. Group allocation is based on the opioid type the patient is using. At the start and end of the study period patients complete the Bowel Function Index questionnaire. A subgroup of the patients will donate blood for analysis of immunomodulatory- and anti-angiogenic effects of methylnaltrexone. Discussion In this study we aim to determine the efficacy of methylnaltrexone per opioid subtype to reduce constipation. We expect that the outcome of this study will improve the clinical use of methylnaltraxone. Trial registration This trial is registered at clinicaltrials.gov: NCT01955213 and in the Dutch trial register: NTR4272.
Collapse
Affiliation(s)
- Elisabeth Cw Neefjes
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Maurice Jdl van der Vorst
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | | | - Wouter Wa Zuurmond
- Department of Anesthesiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Hans J van der Vliet
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Aart Beeker
- Department of Internal Medicine, Spaarneziekenhuis, Hoofddorp, The Netherlands
| | | | | | - Suzan Vrijaldenhoven
- Department of Internal Medicine, Medisch Centrum Alkmaar, Alkmaar, The Netherlands
| | - Henk Mw Verheul
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
8
|
Lehrnbecher T, Groll AH. Invasive fungal infections in the pediatric population. Expert Rev Anti Infect Ther 2014; 9:275-8. [DOI: 10.1586/eri.11.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
9
|
Jones HE, Heil SH, Kaltenbach K, Stine SM, Coyle MG, Arria AM, O’Grady KE, Selby P, Martin PR. Comments on: Efficacy versus Effectiveness of Buprenorphine and Methadone Maintenance in Pregnancy. J Addict Dis 2012; 31:321-6; discussion 327-8. [DOI: 10.1080/10550887.2012.736289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hendrée E. Jones
- a RTI International, Research Triangle Park, North Carolina, USA, and The Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University , Baltimore , Maryland , USA
| | - Sarah H. Heil
- b Departments of Psychiatry and Psychology , University of Vermont , Burlington , Vermont , USA
| | - Karol Kaltenbach
- c Departments of Pediatrics, Psychiatry and Human Behavior, Jefferson Medical College , Thomas Jefferson University , Philadelphia , Pennsylvania , USA
| | - Susan M. Stine
- d Department of Psychiatry and Behavioral Neurosciences , Wayne State University School of Medicine , Detroit , Michigan , USA
| | - Mara G. Coyle
- e Department of Pediatrics , The Warren Alpert Medical School of Brown University , Providence , Rhode Island , USA
| | - Amelia M. Arria
- f Center for Young Adult Health and Development , University of Maryland, College Park , College Park , Maryland , USA
| | - Kevin E. O’Grady
- g Department of Psychology , University of Maryland, College Park , College Park , Maryland , USA
| | - Peter Selby
- h Departments of Family and Community Medicine and Psychiatry , University of Toronto , Toronto , Ontario , Canada
| | - Peter R. Martin
- i The Departments of Psychiatry and Pharmacology and Addiction Center , Vanderbilt University School of Medicine , Nashville , Tennessee , USA
| |
Collapse
|
10
|
Hou PC, Yu HR, Kuo HC, Wang L, Lin LY, Sheen JM, Hsu TY, Ou CY, Jheng YJ, Yang KD, Cheng WH. Different modulating effects of adenosine on neonatal and adult polymorphonuclear leukocytes. ScientificWorldJournal 2012; 2012:387923. [PMID: 22919313 PMCID: PMC3415154 DOI: 10.1100/2012/387923] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 05/21/2012] [Indexed: 01/09/2023] Open
Abstract
Polymorphonuclear leukocytes (PMNs) are the major leukocytes in the circulation and play an important role in host defense. Intact PMN functions include adhesion, migration, phagocytosis, and reactive oxygen species (ROS) release. It has been known for a long time that adenosine can function as a modulator of adult PMN functions. Neonatal plasma has a higher adenosine level than that of adults; however, little is known about the modulating effects of adenosine on neonatal PMNs. The aim of this study was to investigate the effects of adenosine on neonatal PMN functions. We found that neonatal PMNs had impaired adhesion, chemotaxis, and ROS production abilities, but not phagocytosis compared to adult PMNs. As with adult PMNs, adenosine could suppress the CD11b expressions of neonatal PMNs, but had no significant suppressive effect on phagocytosis. In contrast to adult PMNs, adenosine did not significantly suppress chemotaxis and ROS production of neonatal PMNs. This may be due to impaired phagocyte reactions and a poor neonatal PMN response to adenosine. Adenosine may not be a good strategy for the treatment of neonatal sepsis because of impaired phagocyte reactions and poor response.
Collapse
Affiliation(s)
- Pei-Chen Hou
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Niao-Sung district, Kaohsiung 833, Taiwan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Chang MC, Fan SZ, Hsiao PN, Cheng WF, Sun WZ. Influence of morphine on host immunity. ACTA ACUST UNITED AC 2011; 49:105-8. [PMID: 21982172 DOI: 10.1016/j.aat.2011.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 08/09/2011] [Accepted: 08/12/2011] [Indexed: 12/24/2022]
Abstract
Morphine is a widely used drug for analgesia and substance abuse. It has been accepted as a safe medication with great analgesic efficacy. Previous studies have reported that morphine is highly associated with the risk of immunosuppressive effects. Although the observed clinical effects suggest that morphine has the immunomodulatory capabilities, the mechanism of its action is still unclear. Here we review morphine on the bench to improve our understanding of the drug on the host immunity at the bedside. Studies of the effects of morphine on the innate and adaptive immune systems as well as immune responses are also discussed.
Collapse
Affiliation(s)
- Ming-Cheng Chang
- Department of Anesthesiology, College of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C
| | | | | | | | | |
Collapse
|
12
|
Roy S, Ninkovic J, Banerjee S, Charboneau RG, Das S, Dutta R, Kirchner VA, Koodie L, Ma J, Meng J, Barke RA. Opioid drug abuse and modulation of immune function: consequences in the susceptibility to opportunistic infections. J Neuroimmune Pharmacol 2011; 6:442-65. [PMID: 21789507 DOI: 10.1007/s11481-011-9292-5] [Citation(s) in RCA: 222] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 06/27/2011] [Indexed: 12/13/2022]
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.
Collapse
Affiliation(s)
- Sabita Roy
- Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Sung L, Phillips R, Lehrnbecher T. Time for paediatric febrile neutropenia guidelines – children are not little adults. Eur J Cancer 2011; 47:811-3. [DOI: 10.1016/j.ejca.2011.01.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022]
|
14
|
Abstract
This paper is the 31st consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2008 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration and thermoregulation (Section 16); and immunological responses (Section 17).
Collapse
Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, 65-30 Kissena Blvd, Flushing, NY 11367, United States.
| |
Collapse
|
15
|
Vien TN, Gleason CA, Hays SL, McPherson RJ, Chavkin C, Juul SE. Effects of neonatal stress and morphine on kappa opioid receptor signaling. Neonatology 2009; 96:235-43. [PMID: 19478529 PMCID: PMC3690293 DOI: 10.1159/000220763] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 10/28/2008] [Indexed: 01/30/2023]
Abstract
BACKGROUND Critically ill neonates experience multiple stressors during hospitalization. Opioids are commonly prescribed to ameliorate their pain and stress. However, the enduring effects of stress and opioids are not understood. The kappa opioid system is important in the mediation of stress in adults, but little is known about its function in neonates. OBJECTIVES To characterize kappa opioid receptor (KOR) distribution in the neonatal mouse brain and test whether neonatal exposure to morphine, stress, or both, change KOR signaling. METHODS Five groups of wild-type C57BL/6 or prodynorphin (Pdyn) knockout mice were tested: (1) untreated control (dam-reared, no handling), (2) saline-injected control, (3) morphine-injected control, (4) stressed with saline injections and (5) stressed with morphine injections. Mice were treated from postnatal day 5 to postnatal day 9, after which their brains were immunolabeled with a phospho-specific KOR antibody (KOR-P), glial fibrillary acidic protein or glutamic acid decarboxylase. RESULTS There were no effects of saline or morphine injection on KOR-P immunoreactivity. Neonatal stress increased KOR-P labeling in wild-type brains (p < 0.05), but not in Pdyn(-/-) animals. Mice exposed to stress and morphine showed region-specific increases in KOR-P immunoreactivity from 38 to 500% (p < 0.05 to p < 0.001), with marked gliosis. In stressed morphine-treated Pdyn(-/-) animals, KOR-P immunoreactivity was absent, but gliosis increased compared to wild-type animals. CONCLUSIONS Neonatal stress increases KOR activation via the dynorphin system. Neonatal stress plus morphine treatment further increased this response and also resulted in hippocampal gliosis. Enhanced gliosis noted in Pdyn(-/-) animals suggests that the endogenous dynorphin may play a role in downregulating this inflammatory response.
Collapse
Affiliation(s)
- Thuy N Vien
- Department of Pediatrics, University of Washington, Seattle, WA 98195-6320, USA.
| | | | | | | | | | | |
Collapse
|
16
|
Stein C, Clark JD, Oh U, Vasko MR, Wilcox GL, Overland AC, Vanderah TW, Spencer RH. Peripheral mechanisms of pain and analgesia. ACTA ACUST UNITED AC 2008; 60:90-113. [PMID: 19150465 DOI: 10.1016/j.brainresrev.2008.12.017] [Citation(s) in RCA: 184] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2008] [Indexed: 12/23/2022]
Abstract
This review summarizes recent findings on peripheral mechanisms underlying the generation and inhibition of pain. The focus is on events occurring in peripheral injured tissues that lead to the sensitization and excitation of primary afferent neurons, and on the modulation of such mechanisms. Primary afferent neurons are of particular interest from a therapeutic perspective because they are the initial generator of noxious impulses traveling towards relay stations in the spinal cord and the brain. Thus, if one finds ways to inhibit the sensitization and/or excitation of peripheral sensory neurons, subsequent central events such as wind-up, sensitization and plasticity may be prevented. Most importantly, if agents are found that selectively modulate primary afferent function and do not cross the blood-brain-barrier, centrally mediated untoward side effects of conventional analgesics (e.g. opioids, anticonvulsants) may be avoided. This article begins with the peripheral actions of opioids, turns to a discussion of the effects of adrenergic co-adjuvants, and then moves on to a discussion of pro-inflammatory mechanisms focusing on TRP channels and nerve growth factor, their signaling pathways and arising therapeutic perspectives.
Collapse
Affiliation(s)
- Christoph Stein
- Department of Anesthesiology and Critical Care Medicine, Charité Campus Benjamin Franklin, Freie Universität Berlin, Germany
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Castro BA. The immunocompromised pediatric patient and surgery. Best Pract Res Clin Anaesthesiol 2008; 22:611-26. [DOI: 10.1016/j.bpa.2008.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|