Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Tongzipo Road 138#, Changsha 410013, Hunan, China.
Med Hypotheses. 2013 Mar;80(3):308-10. doi: 10.1016/j.mehy.2012.12.013. Epub 2013 Jan 11.
Cancer recurrence is one of the most important causes of cancer-related deaths. In present, it has been revealed that there exist some factors especially opioids being able to affect the recovery of cancer patients in a long period. As the most commonly used potent analgesics in practice, morphine appears to be of crucial importance in the regulation of neoplastic tissues by modulating immune responses and promoting angiogenesis. Indeed, regulatory T cells have been shown to inhibit the response of the immune system to tumor and thereby to worsen prognoses. Some reliable evidences indicate that morphine acts directly on regulatory T cells through VEGFR 2 and opioid receptors present in, both of which play a vital role in the cancer recurrence. In addition, morphine might have a noticeable effect on regulatory T cells by regulating the function of some other immune cells or cytokines, TGF-β and IL-2 for instance. Thus, this paper speculates that morphine could induce cancer recurrence by disturbing the behavior of the regulatory T cells and provides a logical reasoning.
癌症复发是癌症相关死亡的最重要原因之一。目前已经发现,一些因素,特别是阿片类药物,会在很长一段时间内影响癌症患者的康复。作为临床上最常用的强效镇痛药,吗啡通过调节免疫反应和促进血管生成,似乎对肿瘤组织的调节起着至关重要的作用。事实上,调节性 T 细胞已被证明可以抑制免疫系统对肿瘤的反应,从而使预后恶化。一些可靠的证据表明,吗啡通过存在于调节性 T 细胞中的 VEGFR2 和阿片受体直接作用于调节性 T 细胞,这两者在癌症复发中起着至关重要的作用。此外,吗啡可能通过调节其他一些免疫细胞或细胞因子(如 TGF-β 和 IL-2)的功能对调节性 T 细胞产生显著影响。因此,本文推测吗啡可能通过干扰调节性 T 细胞的行为导致癌症复发,并提供了合理的推理。