|Exogenous and endogenous opioids as biological response modifiers.|| ||Carr DJJ, Serou M
| ||"Among the unwarranted side effects of respiratory depression, constipation, and physical dependence are the immunosuppressive qualities, particularly those which affect cell-mediated immunity. The immunosuppressive characteristics of opioid narcotics (e.g., morphine) have recently come into focus with the advent of acquired immune deficiency syndrome (AIDS) and the putative causative agent, human immunodeficiency virus type 1 (HIV-1). Moreover, experimental evidence would suggest narcotic opioids may increase viral load in infected individuals."|
| ||Immunopharmacology, 1995, 31(1): 59-71||1995|
|Severe systemic infections complicating mainline heroin addiction.|| ||Briggs, J. H., McKerron, C. G., Souhami, R. L., Taylor, D. J. E. and Andrews, H.
| ||No abstract / Pubmed|
| ||Lancet ii: 1227-1231, 1967||1967|
|Immunologic dysfunction in heroin addicts.|| ||Brown, S. M., Stimmel, B., Taub, R. N., Kochwa, S. and Rosenfield, R. E.
| ||No abstract / Pubmed|
| ||Arch. Intern. Med. 134: 1001-1006, 1974||1974|
|Predictors of mortality in the Amsterdam cohort of human immunodeficiency virus (HIV)-positive and HIV-negative drug users.|| ||Van Haastrecht HJ, van Ameijden EJ, van den Hoek JA, Mientjes GH, Bax JS, Coutinho RA.
| ||"The impact of human immunodeficiency virus (HIV) infection and other risk factors on mortality was studied in a cohort of Dutch injection drug users and drug users who did not inject. Participants were recruited between 1985 and 1992 and followed up through 1993. Vital status was ascertained through repeat visit information, supplemented by population register data. A total of 77 deaths were recorded among 632 drug users, for a mortality rate per 1,000 person-years of 7 for HIV-negative noninjection drug users, 18 for HIV-negative injection drug users, and 64 for HIV-positive injection drug users. In multivariate analyses, limited to injection drug users, a positive HIV serostatus, age above 40 years, and using benzodiazepines several times daily were significantly associated with an elevated risk of death, both for death from all causes and for death preceding acquired immunodeficiency syndrome (AIDS) diagnosis (pre-AIDS). For pre-AIDS death, the adjusted relative risk associated with HIV infection was 2.2 (95% confidence interval 1.3-3.7). Only 38% of HIV-infected injection drug users who died were diagnosed with AIDS. However, 76% of HIV-infected injection drug users who died without AIDS diagnosis had evidence of immunosuppression (CD4 count < 500/microliters). ... "|
| ||Am J Epidemiol 1996 Feb 15;143(4):380-91||1996|
|Harrison’s. Principles of Internal Medicine.|| ||Fauci A.S., Braunwald, E., Isslbacher, K.J., et al.
| ||“a markedly higher age-specific mortality rate among injection drug users in the general population was documented even before the epidemic of infection with HIV and AIDS. For example, in New York City between 1965 and 1972, the death rate among relatively young (20 to 54-year-olds) adult heroin addicts not involved in drug-treatment programs was estimated to be five time greater than that among age-matched non-heroin-addicted adults (28.2 per 1000 versus 5.6 per 1000). A substantial portion of this excess mortality was the result of infectious complications of injection drug use... At least 25 percent of such opiate abusers are likely to die within 10 to 20 years of active abuse”.|
| ||McGraw-Hill Companies, Inc. New York USA, ed. 14, 1998||1998|
|Suppression of human peripheral blood mononuclear cell function by methadone and morphine.|| ||Peterson PK, Gekker G, Brummitt C, Pentel P, Bullock M, Simpson M, Hitt J, Sharp B.
| ||"Recent studies have shown that in vitro exposure of peripheral blood mononuclear cells (PBMC) to morphine results in suppressed respiratory-burst activity of monocytes and impaired interferon-gamma (IFN-gamma) production by lymphocytes... Because reactive oxygen intermediates produced by PBMC may participate in host defense against opportunistic pathogens in AIDS, these results underscore the need for investigations of the biological consequences of opiate-mediated immunosuppression."|
| ||J Infect Dis 1989 Mar;159(3):480-7||1989|
|Action de la morphine sur les proprietes leucocytaires; leuco-diagnostic du morphinisme.|| ||Achard, C., Bernard, H. and Gagneux, C.
| ||No abstract|
| ||Bulletin et Memoires de la Societe Medicale des Hopitaux de Paris 28, 3rd Series: 958-966, 1909||1909|
|The Opium Problem|| ||Terry, C. E. and Pellens, M.
| ||No abstract|
| ||Bureau of Social Hygiene of New York, 1928||1928|
|Effect of morphine on resistance to infection.|| ||Tubaro, E., Borelli, G., Croce, C., Cavallo, G. and Santiangeli, C.
| ||Morphine was demonstrated to exacerbate infections. Experiments were performed to evaluate variations of phagocytic physiology during morphine treatment. In mice, morphine drastically reduced reticuloendothelial system activity, phagocyte count, phagocytic index, killing properties, and superoxide anion production in polymorphonuclear leukocytes and macrophages. Similar effects on alveolar macrophage count, phagocytosis, and killing were found in rabbits, a result which suggested a lack of species specificity. Additional experiments demonstrated that morphine (1) induces a reduction of lymphoid organ weight, (2) impairs the ability to eradicate infections and (3) is counteracted in its depressing activity on phagocytic physiology by small amounts of Corynebacterium parvum. The results suggest that there is a close relationship between the fact that morphine exacerbates infections and the fact that morphine depresses phagocytic functions; therefore, the negative effect of morphine on phagocytosis is at least one of the reasons for its negative effect on the development of infections.|
| ||J. Infect. Dis. 148: 656-666, 1983||1983|