Neuroimmunopharmacologic effects of drugs of abuse.

Direct studies linking drugs of abuse with changes in neurotransmitters and subsequent effects on the immune system are not abundant. One can, however, hypothesize that an indirect effect can occur since a variety of neurotransmitters known to be acted on by various drugs of abuse can, in turn, be correlated with changes in immunity. These changes most likely are mediated via alterations in the autonomic nervous system or the ratio of hormones regulated by the pituitary gland. In addition, there is sound evidence to suspect that the immune system might be capable of altering either the induction of tolerance or the severity of withdrawal symptoms. An increasing body of evidence indicates that IL-1, IFN-alpha, as well as C3a and C5a of the complement cascade, are capable of acting on central catecholamines within the brain. The possibility that immune system peptides are capable of regulating neurotransmitters is further suggested by the evidence of neuropsychiatric side effects during the course of clinical trials. Since a variety of drugs of abuse can directly alter immunocompetence as evidenced by the results of in vitro protocols described elsewhere in this volume, one could speculate that certain behavioral manifestations of drug addiction may be modulated, in part, by immunologic status.