ReviewBritish journal of pharmacology2018
Opioids and the immune system - friend or foe.
Review in British journal of pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05172739 (Effect of a Perioperative Opioid Free Anaesthesia-Analgesia), which is not on this map. Cited by 272 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of a Perioperative Opioid Free Anaesthesia-Analgesia (OFA-A) Strategy on Surgical Stress Response and Immunomodulation in Elective VATS Lobectomy for NSCLC Lung Cancer: A Prospective Randomized Study
Who cites it
272 citing papers in PubMed, 3 syntheses or guidelines pooled it, 464 citations in OpenAlex.
- European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations.United European gastroenterology journal · 2026Guideline
- Risk of COVID-19 infection and the associated hospitalization, ICU admission and mortality in opioid use disorder: a systematic review and meta-analysis.Addiction science & clinical practice · 2022Pooled it
- Meta-analysis of retrospective studies suggests that the pre-operative opioid use is associated with an increased risk of adverse outcomes in total hip and or knee arthroplasty.International orthopaedics · 2021Pooled it
- Impact of opioid-free general anesthesia with locoregional blocks during breast cancer surgery on systemic inflammatory response: results from a randomized controlled trial.Regional anesthesia and pain medicine · 2026Trial
- Desflurane versus sevoflurane and postoperative inflammatory biomarkers in older adults undergoing minor- to moderate-risk noncardiac surgery.Scientific reports · 2026Trial
- Circadian rhythmicity and biopsychosocial characteristics influence opioid use in chronic low back pain.The Journal of clinical investigation · 2025Trial
- Efficacy of quadratus lumborum block type 3 on postoperative cell-mediated immunity and analgesia for laparoscopic radical gastrectomy: a prospective randomized controlled trial.Surgical endoscopy · 2025Trial
- Effectiveness of perioperative low-dose esketamine infusion for postoperative pain management in pediatric urological surgery: a prospective clinical trial.BMC anesthesiology · 2024Trial
- Effects of General Anesthesia on Changes of Serum Hepatitis B Virus-DNA Levels in Infected Patients Underwent Non-Hepatobiliary Minimally Invasive Surgery: A Pilot Observational Study.Infection and drug resistance · 2022Trial
- Progress in pain mechanisms and management.Signal transduction and targeted therapy · 2026Review
- Preliminary evidence of neuroimmune system disruption in opioid use disorder: Findings from a pilot PET TSPO imaging study.Brain, behavior, & immunity - health · 2026Article
- Mapping opioid exposure through prescription data and postmortem analysis of opioid drugs in multiple tissues.British journal of clinical pharmacology · 2026Article
- Efficacy of Acupuncture Combined With Pharmacotherapy for Depression: A Randomized Controlled Clinical Trial.Alpha psychiatry · 2026Article
- Dual CCR2/CCR5 Antagonism with Cenicriviroc Alleviates Nerve Injury-Induced Hypersensitivity and Prevents Morphine Tolerancevia Modulation of Neuroimmune Signaling.Cellular and molecular neurobiology · 2026Article
- Morphine disrupts antigen-presenting cell function through TLR-4 and autophagy pathways.Molecular biology reports · 2026Article
- The actions of morphine on microglia and the underlying effects on associated adverse effects.Psychopharmacology · 2026Review
- Effect of cannabidiol, cannabinol and tetrahydrocannabivarin in managing inflammatory pain.Scientific reports · 2026Article
- Morphine potentiates HIV infection and receptor expression in 3d brain organoids.Journal of neurovirology · 2026Article
- Opioid Signaling in Multiple Sclerosis: Emerging Targets for Repair.International journal of molecular sciences · 2026Review
- Crosstalk of peripheral cytokine-white matter alteration-insomnia during methadone maintenance treatment.Psychological medicine · 2026Article
212 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Systemically administered opioids are among the most powerful analgesics for treating severe pain. Several negative side effects (respiratory depression, addiction, nausea and confusion) and the risk of opioid-induced hyperalgesia accompany opioid administration. One other side effect is the potential of opioids to suppress the immune response and thereby to increase the vulnerability to infections. The link between opioids and immunosuppression has been investigated both in vitro and in vivo as well as in patients. However, the results are inconsistent: Exogenous opioids such as morphine and fentanyl have been found to impair the function of macrophages, natural killer cells and T-cells and to weaken the gut barrier in vitro and in animal studies. In epidemiological studies, high doses and the initiation of opioid therapy for non-malignant pain have been correlated with a higher risk of infectious diseases such as pneumonia. However clear randomized controlled studies are missing. Furthermore, immune cells including neutrophils, macrophages and T-cells have been shown to secrete endogenous opioid peptides, which then bind to peripheral opioid receptors to relieve inflammatory and neuropathic pain. In addition to cytokines, hormones and bacterial products, the release of opioid peptides is stimulated by the application of exogenous opioids. In summary, there is a reciprocal interaction between the immune system and endogenous as well as exogenous opioids. Further to the existing epidemiological studies, controlled clinical studies are needed in the future to elucidate the role of the opioid-immune system interaction in patients and to determine its clinical relevance. LINKED ARTICLES: This article is part of a themed section on Emerging Areas of Opioid Pharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.14/issuetoc.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.