Abstract

Recent studies examining the neurobiology of substance abuse have revealed a significant role of neuroimmune signaling as a mechanism through which drugs of abuse induce aberrant changes in synaptic plasticity and contribute to substance abuse-related behaviors. Immune signaling within the brain and the periphery critically regulates homeostasis of the nervous system. Perturbations in immune signaling can induce neuroinflammation or immunosuppression, which dysregulate nervous system function including neural processes associated with substance use disorders (SUDs). In this review, we discuss the literature that demonstrates a role of neuroimmune signaling in regulating learning, memory, and synaptic plasticity, emphasizing specific cytokine signaling within the central nervous system. We then highlight recent preclinical studies, within the last 5 years when possible, that have identified immune mechanisms within the brain and the periphery associated with addiction-related behaviors. Findings thus far underscore the need for future investigations into the clinical potential of immunopharmacology as a novel approach toward treating SUDs. Considering the high prevalence rate of comorbidities among those with SUDs, we also discuss neuroimmune mechanisms of common comorbidities associated with SUDs and highlight potentially novel treatment targets for these comorbid conditions. We argue that immunopharmacology represents a novel frontier in the development of new pharmacotherapies that promote long-term abstinence from drug use and minimize the detrimental impact of SUD comorbidities on patient health and treatment outcomes.

Highlights

  • Substance Use Disorders (SUDs) are a significant public health concern and remain a leading cause of preventable death in the United States (US) and worldwide

  • Memory, and synaptic plasticity is not a new concept per se, recent research has greatly expounded the role of immune signaling in neuropsychiatric disorders and diseases, providing a firm foundation for future investigations into novel treatment targets

  • The clinical and preclinical findings discussed here underscore the need for future investigations into the efficacy of adjunctive immunomodulatory medications that may be therapeutically efficacious in the treatment of substance use disorders (SUDs) and associated comorbidities such as major depressive disorder (MDD), posttraumatic stress disorder (PTSD), chronic pain, and human immunodeficiency virus (HIV)

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Summary

Introduction

Substance Use Disorders (SUDs) are a significant public health concern and remain a leading cause of preventable death in the United States (US) and worldwide. These studies provide clear evidence that immunomodulatory signals such as TNFα crucially regulate synaptic plasticity in a brain region-specific manner, which may have important implications for understanding the pathophysiology of SUDs. Like TNFα, microglia and astrocytes release interleukin6 (IL-6) within the CNS, a cytokine involved in modulating learning and memory (Ye and Johnson, 1999; Dong and Benveniste, 2001; Choi et al, 2014).

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