Guzel Derya, Yazici Ahmet Bulent, Yazici Esra, Erol Atila
Department of Physiology, Faculty of Medicine, Sakarya University, 54100 Sakarya, Turkey.
Department of Psychiatry, Faculty of Medicine, Sakarya University, 54100 Sakarya, Turkey.
J Addict. 2018 Dec 9;2018:2036145. doi: 10.1155/2018/2036145. eCollection 2018.
The long-term use of opioids leads alternations in both innate-adaptive immune systems and other diagnostic hematologic cells. The purpose of this study is to evaluate the alterations of these parameters in patients with heroin/opioid addictions. Adults, meeting the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria of the American Psychiatric Association regarding opioid use disorder (Heroin Group or HG, n = 51) and healthy controls (Control Group or CG, n = 50), were included in the study. All hematological parameters, inflammation indexes (neutrophil-lymphocyte ratio and platelet-lymphocyte ratio), and iron panel were compared with the controls. Mean corpuscular volume, red blood cell distribution width, mean corpuscular hemoglobin content, unsaturated iron-binding capacity, and total iron-binding capacity were significantly higher in HG compared to CG, while red blood cell count, hemoglobin, hematocrit, and serum iron levels were significantly lower. Additionally, platelet and platelet distribution width were significantly high while mean platelet volume was low in HG. Regarding the parameters related to immunity, white blood cell, neutrophil count, and neutrophil percentage were significantly high while lymphocyte percentage and basophils count were significantly low. Besides, inflammatory indexes were significantly higher in HG compared to CG. Intravenous administration of heroin resulted in lower levels of hemoglobin, hematocrit, and mean corpuscular volume than inhalation and intranasal administration. Our data demonstrated that chronic use of opioids is related to all of the hematologic series. The chronic use of opioid alters the immunologic balance in favor of innate immunity cells and changes the hematometric/morphometric characteristics of erythrocytes. What is more, the route of heroin administration should be taken into consideration as well. This study may lead to a better understanding of the hematological effects of heroin/opioid use in patients with relevant addictions.
长期使用阿片类药物会导致先天性 - 适应性免疫系统以及其他诊断性血液学细胞发生改变。本研究的目的是评估海洛因/阿片类药物成瘾患者这些参数的变化。本研究纳入了符合美国精神病学协会《精神疾病诊断与统计手册》第五版（DSM - 5）关于阿片类药物使用障碍标准的成年人（海洛因组或HG，n = 51）以及健康对照组（对照组或CG，n = 50）。将所有血液学参数、炎症指标（中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值）以及铁代谢指标与对照组进行比较。与CG组相比，HG组的平均红细胞体积、红细胞分布宽度、平均红细胞血红蛋白含量、不饱和铁结合能力和总铁结合能力显著更高，而红细胞计数、血红蛋白、血细胞比容和血清铁水平显著更低。此外，HG组血小板和血小板分布宽度显著升高，而平均血小板体积降低。关于免疫相关参数，白细胞、中性粒细胞计数和中性粒细胞百分比显著升高，而淋巴细胞百分比和嗜碱性粒细胞计数显著降低。此外，与CG组相比，HG组炎症指标显著更高。静脉注射海洛因导致的血红蛋白、血细胞比容和平均红细胞体积水平低于吸入和鼻内给药。我们的数据表明，长期使用阿片类药物与所有血液学系列相关。长期使用阿片类药物会改变免疫平衡，有利于先天性免疫细胞，并改变红细胞的血液学/形态学特征。此外，海洛因给药途径也应予以考虑。本研究可能有助于更好地理解海洛因/阿片类药物使用对相关成瘾患者血液学方面的影响。
