Disruption of Th1/Th2 cytokine balance by cocaine is mediated by corticosterone.

Cocaine has been shown to affect immune function through the release of corticosterone. Acute administration of both cocaine and corticosterone produces an enhancement of the T-dependent antibody response to sheep erythrocytes. The T-independent antibody response to DNP-ficoll is not enhanced under identical conditions, suggesting that the T-cell is involved as a cellular target. We examined T-helper cell cytokine production following in vivo cocaine administration and found an increase in IL-4 and IL-10; while IL-2 and IFN-gamma were unaffected. The rise in Th2 cytokines is consistent with an enhanced T-dependent antibody response, a measure of humoral immunity. Because previous results showed that the enhancement by cocaine is mediated via corticosterone, the direct effects of corticosterone on Th1/Th2 in vitro cytokine production were investigated. Th1 cytokines, IL-2 and IFN-gamma, were dose-dependently suppressed by corticosterone at physiologic concentrations. In contrast Th2 cytokines, IL-4 and IL-10, exhibited a biphasic dose response curve, whereby an enhancement was observed at low doses, followed by suppression at higher doses. In order to determine the consequences of this apparent shift towards a Th2 response on a Th1 response, we looked at the delayed-type hypersensitivity response to sheep erythrocytes. This measure of cell-mediated immunity was not significantly affected by acute cocaine, however, corticosterone administration resulted in a significant suppression. These results indicate that corticosterone can produce a shift towards a Th2 predominate response, possibly at the expense of Th1-mediated responses.

Evaluation of sex- and strain-dependency of cocaine-induced immunosuppression in B6C3F1 and DBA/2 mice.

The objective of these studies was to determine if the immunotoxic effects of cocaine in mice are sex- and strain-dependent, a profile of activity previously described for cocaine-induced hepatotoxicity. The latter effect has been attributed to differences in the metabolism of cocaine by the cytochrome P-450 system. Subchronic, (14-day) in vivo administration of cocaine to female B6C3F1 mice showed a significant decrease (80%) in the T-dependent primary antibody response only at 80 mg/kg, although exposure to 60 mg/kg produced only a 20% decrease. In contrast, exposure to 60 mg/kg cocaine in female DBA/2 mice produced a significant decrease of 50%. An even greater effect was observed in male mice where exposure to 40 mg/kg cocaine produced > 50% decreases in both B6C3F1 and DBA/2 mice. Similar results were obtained when male mice were only exposed for 7 days. Confirmation that hepatotoxicity occurred with a similar profile of sex- and strain-dependency was obtained in parallel studies when serum chemistries were measured. The immunosuppressive activity of cocaine in female B6C3F1 mice was markedly increased when mice were pretreated with phenobarbital, a cytochrome P-450 inducer. These results extend our previous studies that indicated that cocaine-induced immunosuppression occurs under conditions that are consistent with a mechanism mediated through metabolism by the cytochrome P-450 pathway.

Role of metabolism by esterase and cytochrome P-450 in cocaine-induced suppression of the antibody response.

To investigate the role of metabolism in cocaine-induced immunosuppression, diazinon and beta-ionone were administered as an esterase inhibitor and a cytochrome P-450 (P-450) inducer, respectively, to B6C3F1 female mice. When 10 or 30 mg/kg of diazinon was administered 30 min before cocaine (30 mg/kg) was administered i.p. for 7 consecutive days, the suppression of the T-dependent antibody response to sheep red blood cells was potentiated greatly when compared to the suppression by cocaine alone. Spleen and thymus weights were decreased significantly and serum glutamate-pyruvate transaminase activities were elevated dramatically when cocaine and diazinon were administered together. beta-Ionone was administered s.c. for 7 consecutive days and the P-450 activities were determined 3 days after the last administration. beta-Ionone induced cocaine N-demethylation, which is the first step in the activation of cocaine to the metabolites capable of producing hepatotoxicity, as well as P-450IA1- and P-450IIB1-specific monooxygenases. The inductive effects of beta-ionone on P-450IA1/2 and P-450IIB1/2 proteins were confirmed by using Western immunoblotting with selective monoclonal antibodies. In addition, when beta-ionone (600 mg/kg) was administered with cocaine for 7 days, the suppression of the antibody response was potentiated greatly, thymus weight was decreased significantly and serum glutamate-pyruvate transaminase was elevated. Our present results suggest that inhibition of the esterase pathway of cocaine shunts the metabolism of cocaine into an immunotoxic pathway, and that the metabolism of cocaine by P-450 may be the critical pathway for the generation of the metabolites capable of suppressing the antibody response.

Immunosuppression induced by acute exposure to cocaine is dependent on metabolism by cytochrome P-450.

The primary objective of this paper was to characterize the role of metabolism in immunosuppression by acute exposure to cocaine. beta-Ionone has been used to study the role of metabolism in hepatotoxicity associated with acute exposure to cocaine, and was shown to produce a greater effect than other cytochrome P-450 (P-450) inducers. When beta-ionone (600 mg/kg s.c.) was pretreated 72 and 48 hr before the acute administration of cocaine (30 mg/kg i.p.) in B6C3F1 female mice, the antibody response to sheep red blood cells was significantly suppressed. Exposure to cocaine alone produced little or no suppression. The immunosuppression in cocaine + beta-ionone-treated mice was accompanied by a decrease in thymus weight and an increase in liver weight. Administration of metyrapone (40 mg/kg i.p.) 30 min before cocaine administration (40 mg/kg) blocked completely the suppression of the antibody response by cocaine in beta-ionone-pretreated mice. The reversal by metyrapone was additional evidence that a P-450 pathway was the critical metabolic pathway of cocaine to be immunosuppressive, and the inhibitory effect of metyrapone on cocaine N-demethylase was confirmed in liver microsomes. The inductive effects of beta-ionone were also characterized further. Cocaine N-demethylase activity was significantly induced by beta-ionone. The induction of P-450IIB1/2, the only isozyme shown previously to be associated with the hepatotoxicity by cocaine, was demonstrated by Western immunoblotting to be induced by beta-ionone at doses as low as 300 mg/kg; but was less than the induction associated with phenobarbital. Studies confirmed that acute exposure to cocaine also was immunosuppressive in phenobarbital-pretreated mice. Taken together, our present results suggest that the immunosuppression by acute exposure to cocaine is associated with the increased metabolism of cocaine to toxic metabolites by P-450, probably P-450IIB1/2, as demonstrated previously for its hepatotoxicity.

Role of corticosterone in the enhancement of the antibody response after acute cocaine administration.

A model has been developed in which acute cocaine administration results in an enhanced T-dependent antibody response to sheep erythrocytes. This enhancement occurs when cocaine (30 mg/kg, twice in 1 day) is administered 1 or 2 days before sensitization with antigen, in mice older than 16 wk. Acute cocaine has been shown to elicit a rise in serum corticosterone, and the administration of exogenous corticosterone, under similar conditions as cocaine, also results in a similar immunoenhancement. Further evidence in support of a role by corticosterone is the lack of an enhancement in adrenalectomized mice and the ability of alpha-helical corticotropin releasing factor to block the enhancement by cocaine. The role of concomitant epinephrine release from the adrenal was addressed by adrenal demedullation. Eliminating epinephrine, but not corticosterone release, had no effect on the cocaine-induced immunoenhancement. The evidence presented provides support for a major role by corticosterone in mediating cocaine's effects on at least one measure of immune function, the T-dependent antibody response.