Effect of Naltrexone on Interleukins 2 and 4 in a Sample of Egyptian Patients With Heroin Use Disorder: A Prospective Case-control Study

Objectives: Opiates, particularly heroin, have been used for centuries for their positive reinforcing properties that lead to addiction. Naltrexone (NTX), an opioid antagonist, is capable of reducing these positive reinforcing effects. Heroin affects the immune system through its action on the interleukins (ILs). This study aimed to determine changes in the level of IL-2 and IL-4 in patients with heroin use disorder compared with healthy controls. Materials and Methods: This was a prospective case-control study conducted on 25 patients with heroin use disorder and 20 cross-matched healthy controls. We compared the levels of IL-2 and IL-4 between patients and controls and determined the changes that occurred to IL-2 and IL-4 during 4 different stages (during active use, 1 mo after abstinence, 1 and 4 mo after NTX treatment). It also evaluated the effect of dose and duration of heroin use on the level of ILs before and after NTX treatment. Results: This study revealed that patients showed a significantly lower level of IL-2 and a higher level of IL-4 in the patients' group compared with the control group during active use and 1 month after discontinuation while these significant differences disappeared after NTX treatment. Serum IL-4 level was affected by both heroin dose and duration of use. Conclusion: Heroin use negatively affects immunity by changing the level of IL-2 and IL-4 while NTX reversed this effect, so the study approved the beneficial use of NTX treatment on the immunity system in patients with heroin use disorder.