Immune parameters and level of cortisol in patients with opiate addiction during withdrawal syndrome

Abstract

The purpose: investigate changes in immunity parameters and cortisol level in subjects with opiate addiction during the treatment of opiate withdrawal syndrome. Methods. The study enrolled 136 subjects with opiate addiction with physical dependence receiving injections of opium extract. Patients received conventional therapy with complete opiate withdrawal. The study was performed at the following stages: at admission to the hospital (acute withdrawal syndrome (AWS); on days 5-7 of therapy (transition into post-withdrawal state – PWS); on days 25-28 of therapy (formation of therapeutic remission –FTR). Laboratory methods included determination count of lymphocytes with receptors CD3⁺, CD4⁺, CD8⁺, СD16⁺, with receptors to dopamine (D-RFC); the serum levels of IgМ, IgG, IgА, cortisol, circulating immune complexes (CIC). Results. The principal immunoendocrine pattern for all stages of withdrawal syndrome therapy is characterized in comparison to the reference normal values quantitative deficit of CD3⁺, CD4⁺, СD8⁺ Т-lymphocyte subpopulations, increased count of lymphocytes with receptors to dopamine, activation of humoral immunity factors (IgM, IgG, CIC), high cortisol level. At AWS and PAS stages such changes are most pronounced; on days 25-28 of therapy positive changes in cytotoxic Т-lymphocytes (СD8⁺) and Т-lymphocytes СD3⁺ was revealed. CD4⁺ count remained steadily reduced, count of lymphocytes with receptors to dopamine and cortisol level were elevated. Clinical and immunological analysis demonstrated that consumption of high opiate doses, long-term narcotization are associated with higher intensity of disorders detected. Conclusion. Dysregulation of immunoendocrine parameters was revealed in subjects with opiate addiction at all stages of withdrawal syndrome therapy within the term observed evidencing instability of therapeutic remission achieved and necessity in further rehabilitation events.