Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia)

Isaza, Carlos Alberto; Arias, Juan Carlos Sepúlveda; Vélez, Juan Pablo; Valencia, Sandra Yolanda; Restrepo, Juan Camilo

doi:10.33132/01248146.72

Titulo:

Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia)
.

Sumario:

Introducción: el tratamiento con metadona constituye el estándar de manejo de adictos a heroína. Durante la rehabilitación los pacientes mejoran su estado de salud y parecen volverse inmunocompetentes; hecho atribuido al abandono de prácticas de riesgo, mejor nutrición y suspensión de la heroína, cuyo efecto inmunodepresor es conocido. Pero como la metadona es también antagonista del glutamato, podría tener actividad inmunoestimulante adicional.Objetivo: comparar niveles séricos de las citoquinas FNT-a, IFN-y e IL-10, entre adictos a heroína en consumo activo (CA=32), adictos tratados con metadona (Met=20) y controles sanos sin historia de adicción (Cont=20).Materiales y métodos: participaron 72 individuos de ambos sexos, mayores de edad, c... Ver más

Guardado en:

Revista:

Revista Investigaciones Andina

ISSN:

0124-8146

EISSN:

2538-9580

Autores:

Isaza, Carlos Alberto

Arias, Juan Carlos Sepúlveda

Vélez, Juan Pablo

Valencia, Sandra Yolanda

Restrepo, Juan Camilo

Editor:

FUNDACIÓN UNIVERSITARIA DEL AREA ANDINA

DOI:

10.33132/01248146.72

Volumen:

Año de publicación:

2015-06-17

Pagina inicial:

922

Pagina final:

931

Pais:

Colombia

Licencia:

INVESTIGACIONES ANDINA - 2015

info:eu-repo/semantics/openAccess

http://purl.org/coar/access_right/c_abf2

id	metarevistapublica_areaandina_revistainvestigacionesandina_21_article_72
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spelling	Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia) Cytokine levels in serum of heroin addicts under active consumption or methadone maintenance therapy and healthy control in Pereira (Colombia) Introducción: el tratamiento con metadona constituye el estándar de manejo de adictos a heroína. Durante la rehabilitación los pacientes mejoran su estado de salud y parecen volverse inmunocompetentes; hecho atribuido al abandono de prácticas de riesgo, mejor nutrición y suspensión de la heroína, cuyo efecto inmunodepresor es conocido. Pero como la metadona es también antagonista del glutamato, podría tener actividad inmunoestimulante adicional.Objetivo: comparar niveles séricos de las citoquinas FNT-a, IFN-y e IL-10, entre adictos a heroína en consumo activo (CA=32), adictos tratados con metadona (Met=20) y controles sanos sin historia de adicción (Cont=20).Materiales y métodos: participaron 72 individuos de ambos sexos, mayores de edad, con pruebas serológicas para VIH/SIDA, hepatitis B y C negativas, que no utilizaran fármacos con efectos sobre el sistema inmune.Resultados: no hubo diferencias entre los grupos respecto a género (91,7% hombres), edad (25,2 ± 8 años) y tiempo de abuso de heroína (5,3 ± 2,9 años). Todos los adictos reportaron consumo de otras drogas ilícitas: 96% marihuana, 79% cocaína/basuco y 52% otros psicoactivos. Ningún individuo del grupo Met seguía consumiendo cocaína/basuco, pero la mayoría continuaba el consumo de marihuana. Se encontraron diferencias significativas en los niveles de FNT-a (p=0,0004), IFN-y (p=0,014) e IL-10 (p=0,0001) entre los tres grupos estudiados; esta diferencia se conserva para las tres citoquinas cuando se comparan adictos con no adictos.Conclusión: se encontró un patrón de producción de citoquinas séricas diferencial entre adictos y no adictos, pero no fue posible determinar un patrón de respuesta inmune inducido por metadona. Introduction: methadone constitutes the standard therapy for the management of heroin addiction. During the rehabilitation, patients improve their health status and seem to become immunocompetent, a fact attributed to the decrease in risk practices, better nutrition and the cessation of heroin consumption, whose immunosuppressive effects are known. However, since methadone is also a glutamate antagonist, it might have an additional immunostimulant activity.Aim: to compare serum levels of the cytokines TNF-a, IFN-y and IL-10 between heroin addicts under active consumption (CA=32), addicts under methadone maintenance therapy (Met=20) and healthy controls without history of addiction (Cont=20).Materials and methods: seventy two individuals from both sexes, under 18 years-old, without any recent infection or a positive HIV, hepatitis B or hepatitis C test, were included in the study. None of the subjects were taking drugs with effects on the immune system.Results: there were no differences between the groups in terms of gender (91,7 % men), age (25,2 ± 8 years) and time of heroin abuse (5,3 ± 2,9 years). All the addicts reported the use of other illicit drugs such as marijuana (96%), cocaine/ bazuco (79%) and other psychoactive drugs (52%). In the Met group, none of the individuals reported the use of cocaine/bazuco but most of them kept on consuming marijuana. Significant differences in the TNF-a (p=0.0004), IFN-y (p=0.014) and IL-10 (p=0.0001) levels between the studied groups were found; these differences persist when we compared addicts and control individuals.Conclusion: a differential pattern of cytokine production in the sera of addicts and healthy individuals was found, however, a clear pattern of immune response induced by the methadone treatment could not be determined. Isaza, Carlos Alberto Arias, Juan Carlos Sepúlveda Vélez, Juan Pablo Valencia, Sandra Yolanda Restrepo, Juan Camilo 16 28 Artículo de revista Journal article 2015-06-17T00:00:00Z 2015-06-17T00:00:00Z 2015-06-17 application/pdf Fundación Universitaria Área Andina Revista Investigaciones Andina 0124-8146 2538-9580 https://revia.areandina.edu.co/index.php/IA/article/view/72 10.33132/01248146.72 https://doi.org/10.33132/01248146.72 spa https://creativecommons.org/licenses/by-nc-sa/4.0/ INVESTIGACIONES ANDINA - 2015 922 931 Khokhar JY, Ferguson CS, Zhu AZ, Tyndale RF. Pharmacogenetics of drug dependence: role of gene variations in susceptibility and treatment. Annu Rev Pharmacol Toxicol. 2010; 50:39-61. Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007; 11:1-17. Bosshart H. Morphine-mediated suppression of phagocytosis. Int Immunopharmacol. 2010; 10:264-5. Börner C, Warnick B, Smida M, Hartig R, Lindquist JA, Schraven B, et al. Mechanisms of opioid-mediated inhibition of human T cell receptor signaling. J Immunol. 2009; 183:882-9. Toskulkao T, Pornchai R, Akkarapatumwong V, Vatanatunyakum S, Govitrapong P. Alteration of lymphocyte opioid receptors in methadone maintenance subjects. Neurochem Int. 2010; 56:285-90. Kraus J, Lehmann L, Börner C, Höllt V. Epigenetic mechanisms involved in the induction of the mu opioid receptor gene in Jurkat T cells in response to interleukin-4. Mol Immunol. 2010; 48:257-63. Wang J, Ma J, Charboneau R, Barke R, Roy S. Morphine inhibits murine dendritic cell IL-23 production by modulating Toll-like receptor 2 and Nod2 signaling. J Biol Chem. 2011;286:10225-32. Hutchinson MR, Shavit Y, Grace PM, Rice KC, Maier SF, Watkins LR. Exploring the neuroimmunopharmacology of opioids: an integrative review of mechanisms of central immune signaling and their implications for opioid analgesia. Pharmacol Rev. 2011; 63:772- 810. Nugent AL, Houghtling RA, Bayer BM. Morphine suppresses MHC-II expression on circulating B lymphocytes via activation of the HPA. J Neuroimmune Pharmacol. 2011; 6:130- 41. Al-Hashimi M, Scott SW, Thompson JP, Lambert DG. Opioids and immune modulation: more questions than answers. Br J Anaesth. 2013; 111:80-8. Eisenstein TK. Opioids and the immune system: what is their mechanism of action? Br J Pharmacol. 2011; 164:1826-8. Wang X, Ye L, Zhou Y, Liu MQ, Zhou DJ, Ho WZ. Inhibition of anti-HIV microRNA expression: a mechanism for opioid- mediated enhancement of HIV infection of monocytes. Am J Pathol. 2011; 178:41-7. Sauriyal DS, Jaggi AS, Singh N. Extending pharmacological spectrum of opioids beyond analgesia: multifunctional aspects in different pathophysiological states. Neuropeptides. 2011; 45:175-88. Sacerdote P. Opioid-induced immunosuppression. Curr Opin Support Palliat Care. 2008; 2:14-8. Shirzad H, Shahrani M, Rafieian-Kopaei M. Comparison of morphine and tramadol effects on phagocytic activity of mice peritoneal phagocytes in vivo. Int Immunopharmacol. 2009; 9:968-70. Kvaratskhelia E, Maisuradze E, Dabrundashvili NG, Natsvlishvili N, Zhuravliova E, Mikeladze DG. N-methyl-D- aspartate and sigma-ligands change the production of interleukins 8 and 10 in lymphocytes through modulation of the NMDA glutamate receptor. Neuroimmunomodulation. 2009; 16:201-7. Mashkina AP, Cizkova D, Vanicky I, Boldyrev AA. NMDA receptors are expressed in lymphocytes activated both in vitro and in vivo. Cell Mol Neurobiol. 2010; 30:901-7. Capuron L, Miller AH. Immune system to brain signaling: neuropsychopharmacological implications. Pharmacol Ther. 2011; 130:226-38. Boldyrev AA, Bryushkova EA, Vladychenskaya EA. NMDA Receptors in Immune Competent Cells. Biochemistry. 2012; 77:128-34. Bart G. Maintenance medication for opiate addiction: the foundation of recovery. J Addict Dis. 2012; 31:207-25. Soyka M, Kranzler HR, van den Brink W, Krystal J, Möller HJ, Kasper S; WFSBP Task Force on Treatment, Guidelines for Substance Use Disorders. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of substance use and related disorders. Part 2: Opioid dependence. World J Biol Psychiatry. 2011; 12:160-87. Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev. 2009, (3).CD002209. http://dx.doi. org/10.1002/14651858. Newman RG. Opiate agonist treatment for addiction. Lancet. 2008; 372:1951-2. D’Egidio PF, Bignamini E, De Vivo E, Leonardi C, Pieri MC, González-Saiz F, et al. METODO, A Prospective Observational Study to Assess the Efficacy and Tolerability of Methadone in Heroin-Addicted Patients Undergoing a Methadone Maintenance Treatment: Preliminary Results at Baseline Evaluation. Subst Use Misuse. 2013; 1-11. http://dx.doi.or g/10.3109/10826084.2013.800886. Skeie I, Brekke M, Lindbaek M, Waal H. Somatic health among heroin addicts before and during opioid maintenance treatment: a retrospective cohort study. BMC Public Health. 8:43. DeBeck K, Kerr T, Li K, Milloy MJ, Montaner J, Wood E. Incarceration and drug use patterns among a cohort of injection drug users. Addiction. 2009; 104:69-76. Barta WD, Kurth ME, Stein MD, Tennen H, Kiene SM. Craving and self-efficacy in the first five weeks of methadone maintenance therapy: a daily process study. J Stud Alcohol Drugs. 2009; 70:735-40. Sacerdote P, Franchi S, Gerra G, Leccese V, Panerai AE, Somaini L. Buprenorphine and methadone maintenance treatment of heroin addicts preserves immune function. Brain Behav Immun. 2008; 22:606-13. Hutchinson MR, Somogyi AA. (S)-(+)- methadone is more immunosuppressive than the potent analgesic (R)-(--)-methadone. Int Immunopharmacol. 2004; 4:1525-30. Sacerdote P, Franchi S, Panerai AE. Nonanalgesic effects of opioids: mechanisms and potential clinical relevance of opioid-induced immunodepression. Curr Pharm Des. 2012; 18:6034-42. Carrigan KA, Saurer, TB, Ijames SG, Lysle DT. Buprenorphine produces naltrexone reversible alterations of immune status. Int. Immunopharmacol. 2004; 4:419-28. Azarang A, Mahmoodi M, Rajabalian S, Shekari MA, Nosratabadi J, Rezaei N. T helper 1 and 2 serum cytokine assay in chronic opioid addicts. Eur Cytokine Netw. 2007; 18:210-14. Riss GL, Chang DI, Wevers C, Westendorf AM, Buer J, Scherbaum N, et al. Opioid maintenance therapy restores CD4+ T cell function by normalizing CD4+CD25(high) regulatory T cell frequencies in heroin user. Brain Behav Immun. 2012; 26:972-78. https://revia.areandina.edu.co/index.php/IA/article/download/72/572 info:eu-repo/semantics/article http://purl.org/coar/resource_type/c_6501 http://purl.org/coar/resource_type/c_2df8fbb1 http://purl.org/redcol/resource_type/ART info:eu-repo/semantics/publishedVersion http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 Text Publication
institution	FUNDACIÓN UNIVERSITARIA DEL AREA ANDINA
thumbnail	https://nuevo.metarevistas.org/FUNDACIONUNIVERSITARIADELAREAANDINA/logo.png
country_str	Colombia
collection	Revista Investigaciones Andina
title	Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia)
spellingShingle	Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia) Isaza, Carlos Alberto Arias, Juan Carlos Sepúlveda Vélez, Juan Pablo Valencia, Sandra Yolanda Restrepo, Juan Camilo
title_short	Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia)
title_full	Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia)
title_fullStr	Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia)
title_full_unstemmed	Niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en Pereira (Colombia)
title_sort	niveles de citoquinas en suero de adictos a heroína bajo consumo activo o en terapia de mantenimiento con metadona y controles sanos en pereira (colombia)
title_eng	Cytokine levels in serum of heroin addicts under active consumption or methadone maintenance therapy and healthy control in Pereira (Colombia)
description	Introducción: el tratamiento con metadona constituye el estándar de manejo de adictos a heroína. Durante la rehabilitación los pacientes mejoran su estado de salud y parecen volverse inmunocompetentes; hecho atribuido al abandono de prácticas de riesgo, mejor nutrición y suspensión de la heroína, cuyo efecto inmunodepresor es conocido. Pero como la metadona es también antagonista del glutamato, podría tener actividad inmunoestimulante adicional.Objetivo: comparar niveles séricos de las citoquinas FNT-a, IFN-y e IL-10, entre adictos a heroína en consumo activo (CA=32), adictos tratados con metadona (Met=20) y controles sanos sin historia de adicción (Cont=20).Materiales y métodos: participaron 72 individuos de ambos sexos, mayores de edad, con pruebas serológicas para VIH/SIDA, hepatitis B y C negativas, que no utilizaran fármacos con efectos sobre el sistema inmune.Resultados: no hubo diferencias entre los grupos respecto a género (91,7% hombres), edad (25,2 ± 8 años) y tiempo de abuso de heroína (5,3 ± 2,9 años). Todos los adictos reportaron consumo de otras drogas ilícitas: 96% marihuana, 79% cocaína/basuco y 52% otros psicoactivos. Ningún individuo del grupo Met seguía consumiendo cocaína/basuco, pero la mayoría continuaba el consumo de marihuana. Se encontraron diferencias significativas en los niveles de FNT-a (p=0,0004), IFN-y (p=0,014) e IL-10 (p=0,0001) entre los tres grupos estudiados; esta diferencia se conserva para las tres citoquinas cuando se comparan adictos con no adictos.Conclusión: se encontró un patrón de producción de citoquinas séricas diferencial entre adictos y no adictos, pero no fue posible determinar un patrón de respuesta inmune inducido por metadona.
description_eng	Introduction: methadone constitutes the standard therapy for the management of heroin addiction. During the rehabilitation, patients improve their health status and seem to become immunocompetent, a fact attributed to the decrease in risk practices, better nutrition and the cessation of heroin consumption, whose immunosuppressive effects are known. However, since methadone is also a glutamate antagonist, it might have an additional immunostimulant activity.Aim: to compare serum levels of the cytokines TNF-a, IFN-y and IL-10 between heroin addicts under active consumption (CA=32), addicts under methadone maintenance therapy (Met=20) and healthy controls without history of addiction (Cont=20).Materials and methods: seventy two individuals from both sexes, under 18 years-old, without any recent infection or a positive HIV, hepatitis B or hepatitis C test, were included in the study. None of the subjects were taking drugs with effects on the immune system.Results: there were no differences between the groups in terms of gender (91,7 % men), age (25,2 ± 8 years) and time of heroin abuse (5,3 ± 2,9 years). All the addicts reported the use of other illicit drugs such as marijuana (96%), cocaine/ bazuco (79%) and other psychoactive drugs (52%). In the Met group, none of the individuals reported the use of cocaine/bazuco but most of them kept on consuming marijuana. Significant differences in the TNF-a (p=0.0004), IFN-y (p=0.014) and IL-10 (p=0.0001) levels between the studied groups were found; these differences persist when we compared addicts and control individuals.Conclusion: a differential pattern of cytokine production in the sera of addicts and healthy individuals was found, however, a clear pattern of immune response induced by the methadone treatment could not be determined.
author	Isaza, Carlos Alberto Arias, Juan Carlos Sepúlveda Vélez, Juan Pablo Valencia, Sandra Yolanda Restrepo, Juan Camilo
author_facet	Isaza, Carlos Alberto Arias, Juan Carlos Sepúlveda Vélez, Juan Pablo Valencia, Sandra Yolanda Restrepo, Juan Camilo
citationvolume	16
citationissue	28
publisher	Fundación Universitaria Área Andina
ispartofjournal	Revista Investigaciones Andina
source	https://revia.areandina.edu.co/index.php/IA/article/view/72
language	spa
format	Article
rights	https://creativecommons.org/licenses/by-nc-sa/4.0/ INVESTIGACIONES ANDINA - 2015 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2
references	Khokhar JY, Ferguson CS, Zhu AZ, Tyndale RF. Pharmacogenetics of drug dependence: role of gene variations in susceptibility and treatment. Annu Rev Pharmacol Toxicol. 2010; 50:39-61. Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007; 11:1-17. Bosshart H. Morphine-mediated suppression of phagocytosis. Int Immunopharmacol. 2010; 10:264-5. Börner C, Warnick B, Smida M, Hartig R, Lindquist JA, Schraven B, et al. Mechanisms of opioid-mediated inhibition of human T cell receptor signaling. J Immunol. 2009; 183:882-9. Toskulkao T, Pornchai R, Akkarapatumwong V, Vatanatunyakum S, Govitrapong P. Alteration of lymphocyte opioid receptors in methadone maintenance subjects. Neurochem Int. 2010; 56:285-90. Kraus J, Lehmann L, Börner C, Höllt V. Epigenetic mechanisms involved in the induction of the mu opioid receptor gene in Jurkat T cells in response to interleukin-4. Mol Immunol. 2010; 48:257-63. Wang J, Ma J, Charboneau R, Barke R, Roy S. Morphine inhibits murine dendritic cell IL-23 production by modulating Toll-like receptor 2 and Nod2 signaling. J Biol Chem. 2011;286:10225-32. Hutchinson MR, Shavit Y, Grace PM, Rice KC, Maier SF, Watkins LR. Exploring the neuroimmunopharmacology of opioids: an integrative review of mechanisms of central immune signaling and their implications for opioid analgesia. Pharmacol Rev. 2011; 63:772- 810. Nugent AL, Houghtling RA, Bayer BM. Morphine suppresses MHC-II expression on circulating B lymphocytes via activation of the HPA. J Neuroimmune Pharmacol. 2011; 6:130- 41. Al-Hashimi M, Scott SW, Thompson JP, Lambert DG. Opioids and immune modulation: more questions than answers. Br J Anaesth. 2013; 111:80-8. Eisenstein TK. Opioids and the immune system: what is their mechanism of action? Br J Pharmacol. 2011; 164:1826-8. Wang X, Ye L, Zhou Y, Liu MQ, Zhou DJ, Ho WZ. Inhibition of anti-HIV microRNA expression: a mechanism for opioid- mediated enhancement of HIV infection of monocytes. Am J Pathol. 2011; 178:41-7. Sauriyal DS, Jaggi AS, Singh N. Extending pharmacological spectrum of opioids beyond analgesia: multifunctional aspects in different pathophysiological states. Neuropeptides. 2011; 45:175-88. Sacerdote P. Opioid-induced immunosuppression. Curr Opin Support Palliat Care. 2008; 2:14-8. Shirzad H, Shahrani M, Rafieian-Kopaei M. Comparison of morphine and tramadol effects on phagocytic activity of mice peritoneal phagocytes in vivo. Int Immunopharmacol. 2009; 9:968-70. Kvaratskhelia E, Maisuradze E, Dabrundashvili NG, Natsvlishvili N, Zhuravliova E, Mikeladze DG. N-methyl-D- aspartate and sigma-ligands change the production of interleukins 8 and 10 in lymphocytes through modulation of the NMDA glutamate receptor. Neuroimmunomodulation. 2009; 16:201-7. Mashkina AP, Cizkova D, Vanicky I, Boldyrev AA. NMDA receptors are expressed in lymphocytes activated both in vitro and in vivo. Cell Mol Neurobiol. 2010; 30:901-7. Capuron L, Miller AH. Immune system to brain signaling: neuropsychopharmacological implications. Pharmacol Ther. 2011; 130:226-38. Boldyrev AA, Bryushkova EA, Vladychenskaya EA. NMDA Receptors in Immune Competent Cells. Biochemistry. 2012; 77:128-34. Bart G. Maintenance medication for opiate addiction: the foundation of recovery. J Addict Dis. 2012; 31:207-25. Soyka M, Kranzler HR, van den Brink W, Krystal J, Möller HJ, Kasper S; WFSBP Task Force on Treatment, Guidelines for Substance Use Disorders. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of substance use and related disorders. Part 2: Opioid dependence. World J Biol Psychiatry. 2011; 12:160-87. Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev. 2009, (3).CD002209. http://dx.doi. org/10.1002/14651858. Newman RG. Opiate agonist treatment for addiction. Lancet. 2008; 372:1951-2. D’Egidio PF, Bignamini E, De Vivo E, Leonardi C, Pieri MC, González-Saiz F, et al. METODO, A Prospective Observational Study to Assess the Efficacy and Tolerability of Methadone in Heroin-Addicted Patients Undergoing a Methadone Maintenance Treatment: Preliminary Results at Baseline Evaluation. Subst Use Misuse. 2013; 1-11. http://dx.doi.or g/10.3109/10826084.2013.800886. Skeie I, Brekke M, Lindbaek M, Waal H. Somatic health among heroin addicts before and during opioid maintenance treatment: a retrospective cohort study. BMC Public Health. 8:43. DeBeck K, Kerr T, Li K, Milloy MJ, Montaner J, Wood E. Incarceration and drug use patterns among a cohort of injection drug users. Addiction. 2009; 104:69-76. Barta WD, Kurth ME, Stein MD, Tennen H, Kiene SM. Craving and self-efficacy in the first five weeks of methadone maintenance therapy: a daily process study. J Stud Alcohol Drugs. 2009; 70:735-40. Sacerdote P, Franchi S, Gerra G, Leccese V, Panerai AE, Somaini L. Buprenorphine and methadone maintenance treatment of heroin addicts preserves immune function. Brain Behav Immun. 2008; 22:606-13. Hutchinson MR, Somogyi AA. (S)-(+)- methadone is more immunosuppressive than the potent analgesic (R)-(--)-methadone. Int Immunopharmacol. 2004; 4:1525-30. Sacerdote P, Franchi S, Panerai AE. Nonanalgesic effects of opioids: mechanisms and potential clinical relevance of opioid-induced immunodepression. Curr Pharm Des. 2012; 18:6034-42. Carrigan KA, Saurer, TB, Ijames SG, Lysle DT. Buprenorphine produces naltrexone reversible alterations of immune status. Int. Immunopharmacol. 2004; 4:419-28. Azarang A, Mahmoodi M, Rajabalian S, Shekari MA, Nosratabadi J, Rezaei N. T helper 1 and 2 serum cytokine assay in chronic opioid addicts. Eur Cytokine Netw. 2007; 18:210-14. Riss GL, Chang DI, Wevers C, Westendorf AM, Buer J, Scherbaum N, et al. Opioid maintenance therapy restores CD4+ T cell function by normalizing CD4+CD25(high) regulatory T cell frequencies in heroin user. Brain Behav Immun. 2012; 26:972-78.
type_driver	info:eu-repo/semantics/article
type_coar	http://purl.org/coar/resource_type/c_6501
type_version	info:eu-repo/semantics/publishedVersion
type_coarversion	http://purl.org/coar/version/c_970fb48d4fbd8a85
type_content	Text
publishDate	2015-06-17
date_accessioned	2015-06-17T00:00:00Z
date_available	2015-06-17T00:00:00Z
url	https://revia.areandina.edu.co/index.php/IA/article/view/72
url_doi	https://doi.org/10.33132/01248146.72
issn	0124-8146
eissn	2538-9580
doi	10.33132/01248146.72
citationstartpage	922
citationendpage	931
url2_str_mv	https://revia.areandina.edu.co/index.php/IA/article/download/72/572
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