Publicado

2009-07-01

Fundamentos bioquímicos de la inmunotoxicología de los opiáceos

Fundamentals of opioids biochemical immunotoxicology

Palabras clave:

morfina, opiáceos, toxicología, sistema inmune, droga de abuso. (es)
morphine, opioid peptides, toxicology, immune system, street drugs. (en)

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Autores/as

  • Guillermo Orlando Narváez Quintero Centro de Estudios para el Acondicionamiento Bioquímico y Metabólico. Bogotá, Colombia.
  • Carlos Arturo Guerrero Fonseca Profesor Asociado, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá.
Se ha descubierto que la morfina, anteriormente conocida como una sustancia de origen vegetal extraída de la amapola, es sintetizada también por el cuerpo humano y hace parte del sistema opioide endógeno. La morfina endógena está involucrada en la regulación negativa del sistema inmune, regresándolo a sus condiciones basales luego de haber sido activado. Las investigaciones experimentales preclínicas y clínicas han mostrado que la administración de morfina conduce a efectos inmunosupresores, inhibiendo la actividad de las células asesinas naturales, la proliferación linfocitaria y la capacidad fagocítica de los polimorfonucleares y monocitos. Adicionalmente esta sustancia altera el patrón de síntesis, secreción y actividad paracrina de citocinas, favoreciendo así la respuesta inmune mediada por anticuerpos (Th2-dependiente) e inhibiendo la respuesta inmune mediada por células (Th1- dependiente). Estos efectos son suprimidos por la naloxona, un antagonista de los receptores μ. Al parecer la morfina actúa a través de una nueva variante del receptor μ de péptidos opioides denominado μ3, presente en la superficie de las células inmunocíticas. Llama la atención la similitud entre los efectos inmunotóxicos generados en adictos al opio, VIH negativos, con aquellos observados en pacientes no drogadictos VIH positivos que progresan hacia sida.
Morphine, previously known as a substance of plant origin extracted from poppy flowers, is also produced by the human body as a part of the endogenous opioid system. Endogenous morphine is involved in the regulation of the immune system, helping it return to its baseline state after it has been activated. Clinical and pre-clinical investigations have shown that the administration of morphine leads to immunosuppressive effects, inhibiting the actions of natural killer cells, lymphocyte proliferation and the phagocytic activity of polymorphonuclear cells and monocytes. Additionally, this substance alters the pattern of synthesis and secretion and the paracrine activity of cytokines, favoring the antibody-mediated immune response (Th2- dependent) and inhibiting cell-mediated immune responses (Th1-dependent). These effects are suppressed by naloxone, an antagonist of the miu opioid receptors. Apparently naloxone acts through an isoform called miu- 3, present at the surface of diverse immune cells. Remarkably, the immunotoxic effects observed in HIV negative opium addicts are very similar to those observed in non-addict HIV positive patients who progress to AIDS.

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Narváez Quintero, G. O., & Guerrero Fonseca, C. A. (2009). Fundamentos bioquímicos de la inmunotoxicología de los opiáceos. Revista De La Facultad De Medicina, 57(3), 258-273. https://revistas.unal.edu.co/index.php/revfacmed/article/view/14384

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