Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
J Neuroimmune Pharmacol. 2012 Dec;7(4):1025-33. doi: 10.1007/s11481-012-9400-1. Epub 2012 Sep 19.
Recent studies show that proinflammatory cytokines might be related to the development of opioid dependence (physiological, psychological, or both). In a double-blind, randomly stratified clinical trial investigating whether add-on dextromethorphan (60-120 mg/day) attenuated inflammation and the combined use of opioids in heroin-dependent patients undergoing methadone maintenance treatment, we evaluated whether inflammation is related to the progression of opioid dependence. All participants (107 heroin-dependent patients and 84 nondependent healthy controls) were recruited from National Cheng Kung University Hospital. Their plasma cytokine levels were measured to evaluate the effect of add-on dextromethorphan. Plasma TNF-α and IL-8 levels were significantly higher in long-term heroin-dependent patients than in healthy controls (p < 0.001). Chronic heroin-use-induced TNF-α and IL-8 levels were significantly (p < 0.05) attenuated in patients treated for 12 weeks with add-on dextromethorphan. Moreover, both tolerance to methadone and the combined use of opioids were significantly (p < 0.05) attenuated in patients taking dextromethorphan. We conclude that dextromethorphan might be a feasible adjuvant therapeutic for attenuating inflammation and inhibiting methadone tolerance and combined opioid use in heroin-dependent patients.
最近的研究表明，促炎细胞因子可能与阿片类药物依赖（生理、心理或两者兼有）的发展有关。在一项双盲、随机分层临床试验中，我们研究了附加右美沙芬（60-120mg/天）是否能减轻炎症和合并使用阿片类药物对接受美沙酮维持治疗的海洛因依赖患者的影响，评估了炎症是否与阿片类药物依赖的进展有关。所有参与者（107 名海洛因依赖患者和 84 名非依赖健康对照者）均来自国立成功大学医院。测量了他们的血浆细胞因子水平，以评估附加右美沙芬的效果。长期海洛因依赖患者的血浆 TNF-α和 IL-8 水平明显高于健康对照组（p<0.001）。慢性海洛因使用诱导的 TNF-α和 IL-8 水平在接受附加右美沙芬治疗 12 周的患者中明显（p<0.05）降低。此外，服用右美沙芬的患者对美沙酮的耐受性和合并使用阿片类药物的情况也明显（p<0.05）减轻。我们得出结论，右美沙芬可能是一种可行的辅助治疗方法，可减轻炎症，抑制海洛因依赖患者对美沙酮的耐受性和合并使用阿片类药物。
