Possible mechanism for improving the endogenous immune system through the blockade of peripheral μ-opioid receptors by treatment with naldemedine

Br J Cancer. 2022 Nov;127(8):1565-1574. doi: 10.1038/s41416-022-01928-x. Epub 2022 Aug 9.

Abstract

Background: It has been considered that activation of peripheral μ-opioid receptors (MORs) induces side effects of opioids. In this study, we investigated the possible improvement of the immune system in tumour-bearing mice by systemic administration of the peripheral MOR antagonist naldemedine.

Methods: The inhibitory effect of naldemedine on MOR-mediated signalling was tested by cAMP inhibition and β-arrestin recruitment assays using cultured cells. We assessed possible changes in tumour progression and the number of splenic lymphocytes in tumour-bearing mice under the repeated oral administration of naldemedine.

Results: Treatment with naldemedine produced a dose-dependent inhibition of both the decrease in the cAMP level and the increase in β-arrestin recruitment induced by the MOR agonists. Repeated treatment with naldemedine at a dose that reversed the morphine-induced inhibition of gastrointestinal transport, but not antinociception, significantly decreased tumour volume and prolonged survival in tumour-transplanted mice. Naldemedine administration significantly decreased the increased expression of immune checkpoint-related genes and recovered the decreased level of toll-like receptor 4 in splenic lymphocytes in tumour-bearing mice.

Conclusions: The blockade of peripheral MOR may induce an anti-tumour effect through the recovery of T-cell exhaustion and promotion of the tumour-killing system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Animals
  • Immune System / metabolism
  • Mice
  • Morphine Derivatives
  • Naltrexone / analogs & derivatives
  • Neoplasms* / chemically induced
  • Receptors, Opioid, mu* / genetics
  • Receptors, Opioid, mu* / metabolism
  • Toll-Like Receptor 4 / metabolism
  • beta-Arrestins / metabolism

Substances

  • Analgesics, Opioid
  • Morphine Derivatives
  • Receptors, Opioid, mu
  • Toll-Like Receptor 4
  • beta-Arrestins
  • naldemedine
  • Naltrexone