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Evidence for morphine downregulating immunocytes during cardiopulmonary bypass in a porcine model
T V Bilfinger1, V Kushnerik, S Bundz
1Department of Surgery, State University of New York at Stony Brook, USA.
Abstract:
Cardiopulmonary bypass is associated with both cellular immunosuppression and an inflammatory response. Previous studies have demonstrated that morphine, a naturally occurring substance, can downregulate granulocyte, monocyte and endothelial activity. It can even prevent the activation caused by exposing these cells to plasma obtained from patients undergoing cardiopulmonary bypass. The present study demonstrates that preadministering a high dose of morphine (3.3 mg/kg) to pigs prior to cardiopulmonary bypass also diminishes the activation levels of these cells. In animals not given morphine, monocyte activation levels were 45% compared to 14% exposed to the opiate. Granulocytes also exhibited the same statistically significant (P < 0.05) drop in cellular activation. Activation is determined by computer-assisted microscopic image analysis whereby cellular shape is indicative of the cells activity. Additionally, in animals pretreated with morphine, a twofold increase in the number of cells was obtained, indicating that the endothelium also was downregulated.
Insights
Morphine administration before cardiopulmonary bypass significantly reduces immune cell activation. This study shows morphine's potential to mitigate inflammatory responses during cardiac surgery.
Area of Science:
- Immunology
- Pharmacology
- Cardiovascular Surgery
Background:
- Cardiopulmonary bypass (CPB) triggers both immunosuppression and inflammation.
- Morphine, a natural opioid, has demonstrated potential in downregulating immune cell activity.
- Previous research indicates morphine can prevent CPB-induced activation of granulocytes, monocytes, and endothelial cells.
Purpose of the Study:
- To investigate the effect of pre-administering a high dose of morphine on cellular activation during CPB.
- To assess morphine's impact on monocyte, granulocyte, and endothelial cell activation in a porcine model.
Main Methods:
- A porcine model was used to study the effects of CPB.
- Animals were pretreated with a high dose of morphine (3.3 mg/kg) or received no pretreatment.
- Cellular activation was quantified using computer-assisted microscopic image analysis, assessing cell shape as an indicator of activity.
Main Results:
- Preadministration of morphine significantly diminished monocyte activation levels (14% in morphine group vs. 45% in control).
- A statistically significant decrease (P < 0.05) in granulocyte activation was observed in the morphine-treated group.
- Morphine pretreatment resulted in a twofold increase in cell numbers, indicating endothelial downregulation.
Conclusions:
- High-dose morphine pretreatment effectively reduces immune cell activation during cardiopulmonary bypass.
- Morphine demonstrates a protective effect against CPB-induced inflammatory responses.
- These findings suggest a potential therapeutic role for morphine in managing CPB-associated complications.