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Vol 3, No 2 (2004): Polish Palliative Medicine
Artykuły poglądowe
Published online: 2004-04-09
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Opioids and the immune system: implications for clinical practice

Małgorzata Krajnik
Advances in Palliative Medicine 2004;3(2):139-164.

open access

Vol 3, No 2 (2004): Polish Palliative Medicine
Artykuły poglądowe
Published online: 2004-04-09

Abstract

The first observations of the adverse effects of opiods on the immune system were made more than a century ago. Since then there have been many reports that show that opioids have immunomodulating effects on different parts of the immune system such as macrophages, granulocytes, NK-cells, or different cytokines. However, most conclusions are based on observations from in vitro or animal studies. There are 3 proposed mechanisms of immunosuppression by opioids, including a direct impact on opioid receptors on immune cells and an indirect effect on the adrenergic system and opioid-induced steroid release. Nevertheless, it is unclear whether these findings have any clinical relevance. This article will present the controversies concerning the impact of opioid therapy on different clinical concerns such as infections, HIV-1 promotion and cancer. There is still an urgent need for studies in clinical settings with clinical parameters.

Abstract

The first observations of the adverse effects of opiods on the immune system were made more than a century ago. Since then there have been many reports that show that opioids have immunomodulating effects on different parts of the immune system such as macrophages, granulocytes, NK-cells, or different cytokines. However, most conclusions are based on observations from in vitro or animal studies. There are 3 proposed mechanisms of immunosuppression by opioids, including a direct impact on opioid receptors on immune cells and an indirect effect on the adrenergic system and opioid-induced steroid release. Nevertheless, it is unclear whether these findings have any clinical relevance. This article will present the controversies concerning the impact of opioid therapy on different clinical concerns such as infections, HIV-1 promotion and cancer. There is still an urgent need for studies in clinical settings with clinical parameters.
Get Citation

Keywords

opioids; immune system; cancer; HIV-1; infections

About this article
Title

Opioids and the immune system: implications for clinical practice

Journal

Advances in Palliative Medicine

Issue

Vol 3, No 2 (2004): Polish Palliative Medicine

Pages

139-164

Published online

2004-04-09

Bibliographic record

Advances in Palliative Medicine 2004;3(2):139-164.

Keywords

opioids
immune system
cancer
HIV-1
infections

Authors

Małgorzata Krajnik

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