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Opioid Drug Abuse and Modulation of Immune Function: Consequences in the Susceptibility to Opportunistic Infections

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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.

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Acknowledgement

This work was supported by National Institutes of Health grants NIH RO1 DA12104, RO1 DA022935, KO2 DA015349, R01 DA031202 and P50 DA11806 (S.R.)

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  1. Department of Surgery, University of Minnesota, Minneapolis, MN, 55455, USA

    Sabita Roy, Jana Ninkovic, Santanu Banerjee, Subhas Das, Raini Dutta, Varvara A. Kirchner, Jing Ma & Roderick A. Barke

  2. Department of Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA

    Sabita Roy & Jingjing Meng

  3. Department of Surgery, Veterans Affairs Medical Center, Minneapolis, MN, 55417, USA

    Richard Gene Charboneau & Roderick A. Barke

  4. School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA

    Lisa Koodie

  5. Division of Infection, Inflammation and Vascular Biology, University of Minnesota, MMC 195, 420 Delaware Street SE, Minneapolis, MN, 55455, USA

    Sabita Roy

  6. Department of Surgery and Pharmacology, University of Minnesota, 11-204 Moos Tower, MMC 195, 420 Delaware Street SE, Minneapolis, MN, 55455, USA

    Sabita Roy

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  1. Sabita Roy
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Roy, S., Ninkovic, J., Banerjee, S. et al. Opioid Drug Abuse and Modulation of Immune Function: Consequences in the Susceptibility to Opportunistic Infections. J Neuroimmune Pharmacol 6, 442–465 (2011). https://doi.org/10.1007/s11481-011-9292-5

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