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首页> 外文期刊>Current opinion in anaesthesiology >Is immunomodulation by opioid drugs of clinical relevance?
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Is immunomodulation by opioid drugs of clinical relevance?

机译：阿片类药物的免疫调节是否具有临床意义？

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There has been a growing interest in elucidating the immune consequences of opioid administration for the management of pain. Several studies in vitro and in vivo have demonstrated an immunomodulating effect of opioids. The neuro-endocrine interactions observed after opioid application contribute to this effect as well as direct alterations of immune effector cells. Opioid-induced immunomodulation is mediated by opioid receptors found on immunocytes and in the central nervous system. This review will elucidate the molecular mechanisms of central and peripheral immunomodulation by opioids with special emphasis on the clinical significance of these findings.Recent research has focused on the cellular signaling cascades associated with opioid receptor activation. The crosstalk between chemokine and opioid receptors on leukocytes has opened new insights into the molecular mechanisms involved in opioid-induced immunomodulation. Heterologous desensitization and phosphorylation of chemokine receptors by opioids may not only mediate the immunosuppressive effects of opioids but may also modulate the perception of pain.Although immunomodulating effects of opioids are well established, a final statement regarding the clinical relevance cannot be made, since the existing clinical and experimental data are preliminary and inconclusive. Therefore, further clinical studies are mandatory to elucidate the influence of opioid treatment on immune regulation in different clinical settings. Further investigations may help to provide sufficient analgesia by application of opioids, as well as assessing the advantages and disadvantages on immune function.
机译：阐明阿片类药物治疗疼痛的免疫结果引起了越来越多的兴趣。体外和体内的一些研究证明了阿片样物质的免疫调节作用。阿片类药物应用后观察到的神经内分泌相互作用促进了这种作用以及免疫效应细胞的直接改变。阿片样物质诱导的免疫调节是由免疫细胞和中枢神经系统中发现的阿片样物质受体介导的。这篇综述将阐明阿片类药物对中枢和外周免疫调节的分子机制，并特别着重于这些发现的临床意义。最近的研究集中在与阿片样物质受体激活相关的细胞信号级联反应上。白细胞上趋化因子与阿片样物质受体之间的串扰为阿片样物质诱导的免疫调节涉及的分子机制打开了新的见解。阿片类药物对趋化因子受体的异源脱敏和磷酸化不仅可能介导阿片类药物的免疫抑制作用，而且还可以调节疼痛的感觉。尽管阿片类药物的免疫调节作用已被很好地确定，但由于存在现有的临床相关性，所以尚无定论临床和实验数据尚无定论。因此，必须进行进一步的临床研究以阐明阿片类药物治疗对不同临床环境中免疫调节的影响。进一步的研究可能有助于通过使用阿片类药物来提供足够的镇痛作用，以及评估免疫功能的优缺点。

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