Effect of the morphine/heroin vaccine on opioid and non-opioid drug-induced antinociception in mice

Pain is a common symptom in patients with opioid use disorder (OUD), which increases synthetic and illicit synthetic opioid abuse and even fatalities due to opioid overdose. Many FDA-approved drugs are available for the treatment of OUD, however, the use of these medications is limited, mainly due to the development of various side effects. Active vaccination is a new therapeutic approach but the resulting antibodies may compromise the use and efficiency of opioid and non-opioid drugs. In this study, we evaluated whether the antibodies produced by the morphine/heroin vaccine (M-TT) would alter the antinociceptive effects of opioid and non-opioid drugs. Female Balb-c mice were immunized with the M-TT vaccine. A solid-phase antibody-capture ELISA was used for monitoring antibody titer responses after each booster dose in vaccinated animals, followed by tail-flick testing. This study found that the M-TT vaccine did not affect the antinociception induced by different doses of morphine or the ability of non-opioid and synthetic opioid drugs to decrease thermal pain. Moreover, the combination of vaccination and naloxone increased the time-course of morphine antagonism relative to either vaccination or naloxone alone. These results suggest that the antibody titers generated by the M-TT vaccine 1) are capable of reducing morphine-induced antinociception and 2) are selective enough not to alter antinociception induced by non-opioid or synthetic drugs. These characteristics support its potential as a treatment agent for patients with symptoms of pain comorbid to OUD.

Morphine withdrawal lowers host defense to enteric bacteria: spontaneous sepsis and increased sensitivity to oral Salmonella enterica serovar Typhimurium infection

Understanding the consequences of drug withdrawal on immune function and host defense to infection is important. We, and others, previously demonstrated that morphine withdrawal results in immunosuppression and sensitizes to lipopolysaccharide-induced septic shock. In the present study, the effect of morphine withdrawal on spontaneous sepsis and on oral infection with Salmonella enterica serovar Typhimurium was examined. Mice were chronically exposed to morphine for 96 h by implantation of a slow-release morphine pellet. Abrupt withdrawal was induced by removal of the pellet. In the sepsis model, bacterial colonization was examined and bacterial species were identified by necropsy of various tissues. It was found that at 48 h postwithdrawal, morphine-treated mice had enteric bacteria that were detected in the Peyer's patches (4/5), mesenteric lymph nodes (4/5), spleens (4/10), livers (6/10), and peritoneal cavities (8/10). In placebo pellet-withdrawn mice, only 2/40 cultures were positive. The most frequently detected organisms in tissues of morphine-withdrawn mice were Enterococcus faecium followed by Klebsiella pneumoniae. Both organisms are part of the normal gastrointestinal flora. In the infection model, mice were orally inoculated with S. enterica 24 h post-initiation of abrupt withdrawal from morphine. Withdrawal significantly decreased the mean survival time and significantly increased the Salmonella burden in various tissues of infected mice compared to placebo-withdrawn animals. Elevated levels of the proinflammatory cytokines were observed in spleens of morphine-withdrawn mice, compared to placebo-withdrawn mice. These findings demonstrate that morphine withdrawal sensitizes to oral infection with a bacterial pathogen and predisposes mice to bacterial sepsis.

Neuropeptide Y Y1 receptors mediate morphine-induced reductions of natural killer cell activity

Morphine suppresses a number of immune parameters, such as natural killer (NK) cell activity and lymphocyte proliferation, by acting through mu-opioid receptors in the central nervous system. Prior studies have implicated the sympathetic nervous system in mediating the immunomodulatory effects of acute morphine treatment. However, the peripheral mechanism whereby morphine inhibits NK cell activity is not fully understood. The aim of the present study was to investigate the role of the sympathetic transmitter neuropeptide Y (NPY) in mediating morphine-induced immune alterations. The results showed that administration of the selective NPY Y1 receptor antagonist BIBP3226 blocked morphine's effect on splenic NK activity but did not attenuate the suppression splenocyte proliferative responses to Con-A or LPS. Furthermore, intravenous NPY administration produced a dose-dependent inhibition of splenic NK activity but did not suppress lymphocyte proliferation. Recent studies from our laboratory have demonstrated that morphine modulates NK activity through a central mechanism that requires the activation of dopamine D1 receptors in the nucleus accumbens. Results from the present study showed that microinjection of the D1 receptor agonist SKF-38393 into the nucleus accumbens shell induced a suppression of NK activity that was reversed by BIBP3226. Collectively, these findings demonstrate that NPY Y1 receptors mediate morphine's suppressive effect on NK activity and further suggest that opioid-induced increases in nucleus accumbens D1 receptor activation inhibit splenic NK activity via NPY released from the sympathetic nervous system.

Morphine withdrawal dramatically reduces lymphocytes in morphine-dependent macaques

The immune effects of chronic opiate exposure and/or opiate withdrawal are not well understood. The results of human studies with opiate abusers are variable and may not be able to control for important factors such as subjects' drug histories, health and nutritional status. Nonhuman primate models are necessary to control these important factors. A model of opiate dependence in macaques was developed to study the effects of opiate dependence and withdrawal on measures of immune function. Four pigtailed macaques drank a mixture of morphine (20 mg/kg/session) and orange-flavored drink every 6 h for several months. During stable morphine dependence, absolute numbers of neutrophils, monocytes and lymphocytes did not change relative to pre-morphine levels. However, there was a significant decrease in the absolute number and percentage of natural killer (NK) cells in morphine dependence. Either precipitated withdrawal or abstinence for 24 h resulted in behavioral withdrawal signs in all animals. Absolute lymphocyte counts decreased and absolute netrophil counts increased significantly in withdrawal, relative to levels during morphine dependence. Lymphocyte subset (CD4+, CD8+, CD20+) cells were also decreased in absolute numbers with little change in their percentage distributions. There was, however, a significant increase in the percentage of NK cells in withdrawal relative to levels during morphine dependence. This study demonstrates the usefulness of voluntary oral self-dosing procedures for maintaining morphine dependence in nonhuman primates and demonstrates that the morphine withdrawal syndrome includes large alterations in blood parameters of immune system function, including nearly 50% reduction in numbers of CD4+, CD8+ and CD20+ cells.

Morphine withdrawal contributes to Th cell differentiation by biasing cells toward the Th2 lineage

The consequences that drug withdrawal has on immune functioning has only recently been appreciated; however, given the wide variety of use and abuse of opiate analgesics, understanding the decrements to immune function that withdrawal from these drugs causes is of crucial importance. In previous work, we have demonstrated that morphine treatment contributes to immunosuppression by polarizing Th cells toward the Th2 lineage. In the current study, it was hypothesized that morphine withdrawal would result in Th2 differentiation and subsequent immune dysfunction. To address this hypothesis, mice were chronically treated with morphine for 72 h followed by a 24-h withdrawal period. It was determined that 24-h morphine withdrawal resulted in a decrease in IFN-gamma, the Th1 signature cytokine, whereas the Th2 cytokine, IL-4, was increased. In addition, Western blot and EMSA experiments revealed that morphine withdrawal-induced Th2 differentiation was mediated through the classical Th2 transcription factors Stat-6 and GATA-3. In addition, the consequence of morphine withdrawal in the presence of an immune stimulation was also examined by treating mice in vivo with LPS before morphine withdrawal. Following withdrawal, it was found that the Th1-polarizing cytokine IL-12 was significantly decreased, providing further support for the observation that withdrawal results in Th2 differentiation by possibly impacting the generation of an appropriate innate immune response which directs subsequent adaptive Th1/Th2 responses.

Splenic macrophages and B cells mediate immunosuppression following abrupt withdrawal from morphine

We have previously shown that abrupt withdrawal (AW) from morphine induces greater than 80% immunosuppression in murine spleen cells, as assessed by the capacity to mount an in vitro plaque-forming cell response to sheep red blood cells. Present studies about the mechanisms of immunosuppression following AW showed that addition of highly enriched (CD11b+) splenic macrophages (obtained by cell sorting or magnetic separation) from AW mice to cultures of normal, unfractionated spleen cells suppressed immune responses. Further, addition of highly enriched (CD19+) B cells (but not T cells) from AW mice to normal cells was also immunosuppressive. B cells from AW mice were also able to inhibit the proliferative response of normal spleen cells to concanavalin A but not to lipopolysaccharide. Overall, the data suggest that immunosuppression by AW spleen cells is a result of active suppression by macrophages and B cells.

Novel assay format permitting the prolonged use of regeneration-based sensor chip technology

A polyclonal antibody raised against morphine-3-glucuronide (M3G, the main metabolite of heroin and morphine) was used in the development of a novel assay format using a surface plasmon resonance (SPR)-based biosensor. Previously developed assays have generated calibration curves based on differences in the quantity of response units binding to the surface of a chip coated with the analyte. The novel assay described here was based on the development of a standard curve using the slope of a series of consecutive binding interactions. Using this format, regeneration between each assay cycle was no longer required. This increased the useable life span of the chip surface and, as a result, decreased the cost associated with the assay. Thus, at least 15 binding interactions could be carried out before the saturation of antibody on the surface of the chip caused the response to deviate significantly from linearity. After 15 nonregenerated binding interactions, the slope still remained within 1.5% of the slope after a single binding event. Analysis time, and the sample volumes required were also markedly decreased while sensitivity was enhanced. The inhibition assay developed had a detection range of 270 to 17,500 pg ml(-1).

Abrupt or precipitated withdrawal from morphine induces immunosuppression

The present studies tested the effect of withdrawal from morphine by two different paradigms, abrupt withdrawal (AW) or precipitated withdrawal (PW), on the capacity of murine spleen cells to mount an in vitro antibody response. Mice were made dependent by chronic treatment using s.c. implanted morphine slow-release pellets. Splenocytes were harvested at various time points after withdrawal and the number of antibody-forming cells determined using a plaque-forming cell (PFC) assay. The results indicate that induction of abstinence from morphine in dependent mice by either paradigm caused marked immunosuppression between 24 and 48 h post-withdrawal. However, the kinetics of onset and recovery from immunosuppression were different in AW and PW.

Effects of morphine on T-cell recirculation in rhesus monkeys

A 2-yr study on effects of morphine on lymphocyte circulation in rhesus monkeys (Macaca mulatta) showed that, over time, a well-maintained morphine-dependency caused biphasic depressive effects on circulating lymphocyte levels. Depression of T cell circulation by opiates actually was a relative effect. Morphine exposure basically stabilized T cell circulation in the context of concurrent increases in controls. Biphasic effects of morphine were attributable to distinctions in circulation kinetics of CD4+/CD62L (+ & -) T cells. That is, levels of CD4+/CD62L+ T cells were selectively depressed by opiates through the first 32wk after initiation of drug, and levels of CD4+/CD62L- T cells were selectively depressed thereafter. Regression analyses also showed that morphine stabilized lymphocyte recirculation. Circulating levels of resting and activated-memory types of T cells were positively correlated in opiate-exposed monkeys during the first 32wk after opiate exposure--an effect not seen with control monkeys. Considerations of changes in the types of experimental stressors extant during the study suggested that temporally differential effects of opiates on T cell recirculation were connected with changes in the stress environment and the ability of morphine to modulate these changes. Thus, morphine, and by inference the endogenous opioid system, are involved in homeostasis of lymphocyte recirculation, probably through effects on central mediation of the stress axis.

[The effect of melatonin on enhancing immune function and inhibiting the ability of NO over-release in morphine dependent mice]

AIM

To observe the effects and mechanism of melatonin (MT) on the immune function of morphine dependent mice.

METHODS

A physical dependent mice model was established by repeated subcutaneous injection of morphine. The intensity of morphine withdrawal syndrome was evaluated according to the weight of immune organs, the proliferation reaction of stimulated splenic lymphocytes by Con A, the phagoindex of blood primed macrophages and the content of NO induced in the peritoneal macrophage (pM phi).

RESULTS

MT reversed the inhibitory effect of morphine on the proliferation ability of splenic lymphocytes and enhanced the phagocytosis of macrophages of morphine dependent mice obviously and prevented the over-release of NO from pM phi. The enhancing effects of MT on the phagocytosis can be prevented by naloxon.

CONCLUSION

MT can significantly enhance the immune function of morphine dependent mice and inhibit NO excessive release from pM phi.

Differential tolerance to morphine's immunomodulatory effects following continuous administration

Rats were continuously infused with either morphine or saline via an osmotic minipump for 20 consecutive days. Effects on immune status were assessed on the twentieth day of the chronic administration period following a bolus injection of morphine administered 1 h prior to sacrifice. The morphine injection suppressed measures of splenic natural killer (NK) cell activity, mitogen-stimulated T-cell proliferation, and gamma-interferon (IFN) production in rats that received saline via the minipump. In rats that received chronic morphine via the minipump, the morphine injection also suppressed mitogen-stimulated splenocyte proliferation and gamma-IFN production but did not suppress NK cell activity. These data indicate that chronic morphine administration via osmotic minipumps leads to differential tolerance to the immunomodulatory effects of morphine. These findings support previous results indicating differential tolerance development within the immune system following chronic morphine administration via the drinking water.

Tolerance development to morphine-induced alterations of immune status

A variety of in vitro immune measures were examined in groups of Lewis rats that chronically consumed either tap water or a 0.2, 0.4, or 0.6 mg/ml morphine drinking solution. Rats received a subcutaneous injection of either saline or 15 mg/kg morphine sulfate 1 h before sacrifice. In the drinking groups, the acute morphine injection significantly suppressed splenic natural killer (NK) cell activity, mitogen-stimulated splenic T- and B-cell proliferation and gamma-interferon (gamma-IFN) production. A single, acute injection of morphine did not suppress NK cell activity in rats that drank the two highest concentrations of morphine, whereas it did suppress the mitogen-stimulated splenic T- and B-cell proliferation and gamma-IFN production. These results suggest that rats that drank morphine for 20 days developed tolerance to morphine's suppressive effect on NK cell activity but not to other measures of immune status. Morphine drinking rats also developed tolerance to morphine's antinociceptive effects and revealed signs of physical dependence when the morphine solution was withdrawn or when naltrexone was administered.

Suppression of immune parameters in animal models of morphine dependence

Implantation of pellets containing 75 mg of morphine induced short term (4 day) morphine dependence and markedly reduced total number of spleen cells of BALB/c mice, without affecting total body or liver weight. Polyclonal responses induced by anti-CD3 antibodies, Concanavalin A or Escherichia coli lipopolysaccharide in the remaining spleen cells of morphine-treated mice were also inhibited. Cytofluorimetric analysis indicated that the proportion of major functional lymphocyte populations (Ig+, CD3+, CD4+ and CD8+ lymphocytes) were not significantly changed in the spleen from morphine-dependent mice. Furthermore, expression levels of surface Ig, CD3, CD4, and CD8, were similar in spleen cells from control or morphine-treated mice. So, morphine dependence in BALB/c mice under these controlled conditions results in a specific defect in lymphoid cell number and function, with no incidence on body weight or particular lymphocyte subsets.

[Psychoneuroimmunological effects of morphine and the immunoprotection of Ganoderma polysaccharides peptide in morphine-dependent mice]

Different kinds of single, multiple, acute or chronic administrations of morphinized animal models were established, with which a series of experiments in both in vivo and in vitro systems as well as molecular levels were pharmacologically designed to investigate the psychoneuroimmunological effects of morphine (Mor) and the immunoprotection of Ganoderma polysaccharides peptide (GPP) in Mor-dependent mice. It was first discovered that both c-myb and c-myc mRNA expression in splenocytes of repetitive Mor-treated mice were detected to be significantly decreased, and that GPP could induce restoration of several immunologic parameters depressed by Mor treatment to or even beyond normal levels. This provides the experimental animal evidence that immune response modifiers such as GPP could be of potential application in controlling abuse of opiates-induced immunodeficiency.

Effects of morphine tolerance and abstinence on cellular immune function

Female B6C3F1 mice were rendered tolerant-dependent on morphine by a combination of injections and pellet implantation. Mice were injected with morphine sulfate (20 mg/kg, s.c.) twice a day on day 1. On day 2, they were implanted s.c. with a 75 mg morphine pellet for 3 days. On day 5, the pellets were either left intact (tolerant) or removed 8 h prior (abstinent) to carrying out the immune function tests. A high degree of tolerance to the analgesic and hypothermic effect of morphine developed as a result of this procedure. Similarly, physical dependence also developed as evidenced by the signs of the abrupt and naltrexone-precipitated abstinence syndrome. Implantation with morphine pellets resulted in a profound, statistically significant reduction in spleen and thymus weight and cellularities, with the greatest degree of reduction noted in abstinent animals. Morphine tolerance was associated with suppressed B-cell proliferation following in vitro stimulation, as well as interleukin-2 (IL-2) and interleukin-4 production by T-cells. NK cell activity was significantly reduced in morphine-tolerant, but not in morphine-abstinent, mice following a 24 h incubation in the presence or absence of IL-2. In comparison, the in vitro induction of cytotoxic T-cells was significantly depressed in morphine-abstinent, but not morphine-tolerant, animals. Exposure to morphine apparently had limited effect on macrophage function as assessed by production of tumor necrosis factor. These studies demonstrate a differential effect on immune effector and regulatory mechanisms in morphine tolerance and abstinence processes.

[The effect of catecholamine and serotonin antibodies on pain sensitivity and the development of morphine tolerance in experimental drug addiction]

The effect of antibodies to catecholamine and serotonin on the thermal pain sensitivity and tolerance to morphine was studied in rats immunized by protein-conjugated neurotransmitters before chronic drug intoxication. The antibodies to catecholamine have been found to affect bifunctionally on the nociception bifunctionally: either accelerating or delaying the pain reaction to thermal irritation. The antibodies to serotonin were ineffective as modulators both of the pain sensitivity and tolerance to morphine development. In contrast, the antibodies to catecholamine suppressed the expression of tolerance to chronic morphine. Serotonin antibodies virtually produced no effects on pain sensitivity and the development of morphine tolerance.

[Induction of autoantibodies to serotonin and catecholamines in chronically morphine addicted rats with manifestations of abstinence syndrome]

The possibility of formation of autoantibodies to neurotransmitters has been studied in experimental model of opiate addiction. Chronic treatment of rats with morphine that leads to formation of dependence, causes induction of antibodies to norepinephrine, dopamine and serotonin. The latter could be considered as indicators of impaired neurotransmitter metabolism. Induction of autoantibodies to neurotransmitters could be a sort of defence mechanism in opiate addiction.

Opioid dependency and T-helper cell functions in rhesus monkey

Administration of morphine sulfate to rhesus monkeys may activate the quiescent lymphocyte for proliferation, induce a transient increase in the T cell proliferative response to mitogens, and cause an enhanced interleukin-2 release from the mitogen-stimulated lymphocytes. However, longitudinal studies of the animals dependent upon morphine or L-a-acetyl-methadol, a long-acting opioid, revealed an overall immunosuppression of T helper functions. In vitro studies using morphine and its antagonist naloxone suggested that the immunosuppression was not a result of a direct interaction between the opioids and conventional opiate receptors which might have been present on the lymphocytes. The studies also showed the importance of measuring [3H]thymidine incorporation rather than its uptake into cells to assess T cell activation.

Induction of antibodies to morphine during chronic morphine treatment in rodents and opiate addicts

The phenomenon of induction of antibodies to morphine in morphine-treated animals and opiate addicts was shown by means of ELISA. The reaction of the immune system to injections of a morphine solution had the characteristics of a primary immune response. Opiate addicts differed from normal controls in the level of antibodies to morphine of IgM class. Elevated levels of such antibodies could be detected in about 70-80% of addicts with regular longterm opiate use when the time since the last drug intake did not exceed 60 days. Antibodies to morphine could serve as indicators of chronic opiate use especially in periods long after the last drug intake.

[Antibody formation to morphine and neuromediators in morphinized rats]

The paper demonstrates induction of antibodies to morphine and neurotransmitters (dopamine, norepinephrine, serotonin) in rats treated with intraperitoneal injections of morphine hydrochloride during 2 and 4 weeks in increasing doses. A contribution of such antibodies to the mechanisms of morphine tolerance and formation of physical dependence is considered.

[Analytical exploration of drug addiction]

The natural and synthetic substances most frequently leading to drug addiction are described. They include cannabis, opium and cocaine with their respective derivatives. The authors insist on the problems encountered by analytical chemists when they examine urine samples containing these substances, owing to their metabolic degradation and to interferences between lawful and unlawful drugs. The limitations imposed by these problems to an unambiguous interpretation of the results obtained are defined, but they do not throw any doubt on the value of these investigations.

[The course of early syphilis in morphine base-dependent rabbits]

Eleven rabbits made dependent on morphine base were observed which were infected with syphilis studying the clinical and serological course of the infection. The control group comprised five non-dependent rabbits infected with syphilis. After 30 days from the infection all animals were given procaine penicillin in daily doses of 75,000 mu/kg. The treatment was carried on for 20 days. In all animals the following serological tests: VDRL, IgG, FTA, TPHA, and TPI were done before the treatment and 1, 3, 6, and 12 months after it. Ulcerations at the site of injection of Nichols strain of spirochetae in all morphinedependent rabbits developed earlier (5-6 days after infection) than in controls (9-10 days), were much larger and persisted longer, while the antibody titres were lower, as a rule, in the morphine-dependent animals. The results presented justify the conclusion that the clinical and serological course of the early stages of syphilis is different in the morphine-dependent animals when compared with controls.

The immune system and opiate withdrawal

Whole body exposure to 500 rad ionizing irradiation suppresses the immune system in rats. Moreover, when administered prior to chronic morphine treatment, irradiation exposure also dramatically reduces the severity of naloxone-precipitated withdrawal in morphine dependent animals. The reinstillment of 2-6 x 10(8) normal lymphoid immunocompetent cells to irradiated rats by adoptive transfer prior to chronic morphine treatment restores all withdrawal signs precipitated by naloxone injection. The data suggest that specific cellular activities or factors derived from lymphoid cells are required for the expression of opiate withdrawal, indicating that the immune system participates in the manifestation of opiate dependence.

Participation of lymphoid cells in the withdrawal syndrome of opiate dependent rats

Treatment of rats with 500 Rads whole-body ionizing irradiation prior to chronic administration of morphine reduced the severity of the naloxone induced withdrawal signs. In contrast, adoptive transfer of 2-6 X 10(8) lymphoid cells to irradiated rats prior to chronic morphine treatment completely restored the ability to manifest the withdrawal signs precipitated by naloxone. These observations offer the possibility that the immune system participates in opiate addiction.

Single injection of three different preparations of alpha-interferon modifies morphine abstinence signs for a prolonged period

Opiates exert numerous effects on all levels of the central nervous system, with tolerance and physical dependence (addiction) being characteristics of this drug class. The capacity of the immune system to participate in processes primarily considered to be central nervous system phenomena has been suggested recently by several studies demonstrating the ability of various immune-modifiers to attenuate opiate withdrawal severity. Therefore, the immunomodulator agent, interferon was investigated to determine the effect upon the opiate withdrawal signs in an animal model. The degree of morphine dependence is measured by quantifying the various behavioral signs associated with naloxone-induced withdrawal. Three different preparations of human alpha interferon (alpha-IFN) were investigated to determine the duration of their attenuating effect upon the naloxone-induced abstinence syndrome in morphine-addicted rats. All three preparations of alpha-IFN reduced the severity of the opiate withdrawal (i.e., addiction) signs for several weeks. There were differences in the potency and the duration of the effects among the three different preparations of alpha-IFN.

Evidence of neuro-immunologic interactions: cyclosporine modifies opiate withdrawal by effects on the brain and immune components

The capacity of the immune system to participate in processes primarily considered to be central nervous system (CNS) phenomena has been suggested recently by several studies demonstrating the ability of various immune modifiers to attenuate opiate withdrawal severity. The present study demonstrates that within 2 h after injection, the immune modifier cyclosporine A (CsA) has the ability to attenuate the opiate withdrawal syndrome precipitated by naloxone in morphine-dependent animals. Furthermore, it is demonstrated that this effect of CsA can be adoptively transferred by splenic mononuclear cells from immune-modulated (CsA-treated) donors into morphine-dependent recipients. However, unlike direct injections of CsA, CsA-treated immune components require at least 24 h to achieve their full attenuating effect upon withdrawal severity. Since opiate withdrawal behavior is predominantly a CNS-mediated phenomenon, these observations suggest both direct effects of CsA on the brain as well as the participation of immune components in the opiate withdrawal syndrome. This finding lends further support to the hypothesis that immune components have the ability to modulate central nervous system activities in a neuro-immunologic axis of communication.

Evidence that opiate addiction is in part an immune response. Destruction of the immune system by irradiation-altered opiate withdrawal

Experiments were performed to determine whether physical dependence on opiates (CNS phenomena) can be altered by destruction of the immune system. Irradiation, prior to or after chronic treatment with morphine significantly reduced the opiate-withdrawal syndrome as assessed by naloxone-induced abstinence. This study supports the proposition that addiction to opiates is related, at least in part, to interaction between the central nervous system (CNS) and the immune system.

Cyclosporine alters opiate withdrawal in rodents

Opiates exert numerous effects on all levels of the central nervous system with tolerance, physical dependence and withdrawal being characteristics of this drug class. The degree of dependence is directly correlated to the intensity of withdrawal. Therefore, success in modifying the withdrawal syndrome may shed light on the dynamics of opiate addiction. The present study demonstrates that cyclosporine, a widely used immunosuppressive drug, considerably modified the behavioral signs of a naloxone-induced abstinence syndrome in morphine-addicted rats. In previous experiments, alpha-interferon has shown similar results. The similarity in actions of these two immunomodulator drugs is discussed and we suggest that opiate addiction may involve the immune system.

Morphine and methadone impact on human phagocytic physiology

Human subjects submitted to treatment with morphine show a severe depression of phagocytosis, killing properties and superoxide production both of their polymorphonuclear leukocytes and monocytes. Polymorphonuclear leukocyte adherence, chemotaxis, random migration, myeloperoxidase content, lysozyme content and lymphocyte Rosette E formation were poorly influenced. Methadone-treated subjects show a similar effect at phagocytic level but far less evident. These results confirm those previously found in animals and reinforce the evidence of a depressive role of morphine on phagocytic physiology.

Influence of immune stimulation and suppression on morphine physical dependence and tolerance

The role of the immune system in the development of physical dependence and tolerance to morphine was studied in mice in which the immune response was either stimulated or suppressed. Immunization of mice against morphine increased the blood and brain levels of morphine as compared to controls. However, the development of physical dependence and tolerance was decreased. The chronic responses to morphine were also decreased by nonspecific immunosuppression (vincristine-cyclophosphamide treatment and gamma-irradiation exposure) and specific immunosuppression (antithymocyte and antilymphocyte sera treatment). Immunosuppressive treatments did not alter the rate of morphine absorption from the subcutaneous depot used to induce chronic exposure to the drug. However, the blood and brain levels of morphine were higher than control after 72 hours of morphine pellet implantation. It is apparent that manipulation of the immune system can alter the physical dependence and tolerance development to morphine.

Naturally occurring human antiglobulins with specificity for E

Human sera have been examined for antibodies with specific reactivity for gammaE using the tanned cell hemagglutination test. Cells tanned with three different gammaE myeloma proteins provided a reproducible test system. Inhibition of agglutination reactions by gammaE proteins, but not by gammaG, gammaA, gammaM, or gammaD confirmed the specificity of these reactions. 8.5% of 304 serial serum samples obtained from miscellaneous hospitalized patients showed clear-cut anti-gamma-globulins with specificity for gammaE. In most of these instances no definite clinical history of concomitant allergic disorders could be obtained. 53% of 73 patients with well-established allergic disorders (hay fever, extrinsic asthma) showed serum anti-gamma-globulins with reactivity for gammaE. Some patients studied before and after desensitization to Bermuda grass allergen showed an increase in titer or a conversion from negative to positive reactions for anti-gammaE antibodies following several month courses of progressive desensitization. Gradient and gel filtration studies indicated that anti-gammaE globulins were 19S gammaM in all instances. No clear correlation was noted between quantitative serum gammaE levels and titer of anti-gammaE antibodies.19S serum fractions with anti-gammaE antibody activity did not release histamine from normal human peripheral blood leukocytes, whereas specific rabbit anti-gammaE antisera consistently induced leukocytic histamine release. Moreover, macroglobulin fractions with anti-gammaE activity did not block allergen-specific leukocyte histamine release induced by in vitro leukocyte challenge with allergens such as Bermuda grass and leukocytes from allergic donors. In some instances 19S human serum fractions with anti-gammaE activity appeared to potentiate histamine release when incubated concomitantly with specific allergen and leukocytes from allergic individuals.