The Journal of Infectious Diseases · 1997 · 155 citations · 43 references
MedicinePharmacologyPerioperative PharmacologyPharmacodynamicsSepsisOpioid AnalgesicsOpioid PharmacologyOpioid TherapyPostoperative SepsisSepsis PathophysiologySeptic ShockEndogenous Opioid SignalingEndogenous OpioidsEndotoxin TranslocationEnteric InflammationNaltrexone TreatmentOpioid Antagonist Therapy
Gram-negative sepsis and subsequent endotoxic shock remain major health problems in the United States. The present study examined the role of morphine in inducing sepsis. Mice administered morphine by the subcutaneous implantation of a slow-release pellet developed colonization of the liver, spleen, and peritoneal cavity with gram-negative and other enteric bacteria. In addition, the mice became hypersusceptible to sublethal endotoxin challenge. The effects were blocked by the simultaneous implantation of a pellet containing the opioid antagonist naltrexone. These findings show that morphine pellet implantation in mice results in the escape of gram-negative organisms from the gastrointestinal tract, leading to the hypothesis that morphine used postoperatively or chronically for analgesia may serve as a cofactor in the precipitation of sepsis and shock. In addition, morphine-induced sepsis may provide a physiologically relevant model of gram-negative sepsis and endotoxic shock.
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Shock and Tissue Injury Induced by Recombinant Human Cachectin
Kevin J. Tracey, Bruce Beutler, Stephen F. Lowry et al. · Science · 1986 · 2.6K citations
Seijiro Okusawa, Jeffrey A. Gelfand, Takashi Ikejima et al. · Journal of Clinical Investigation · 1988 · 988 citations · Full text
Medicine, Immunology, Pharmacology +17
J. A. Nelder, Chester I. Bliss · Journal of the Royal Statistical Society Series A (General) · 1971 · 764 citations