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Opioids and matrix metalloproteinases: the influence of morphine on MMP-9 production and cancer progression

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Abstract

Opioids are widely administered to alleviate pain, including chronic pain in advanced cancer patients. Among opioids, morphine is one of the most clinically effective drugs for the palliative management of severe pain. In the last few decades, there has been a debate around the possible influence of opioids such as morphine on tumour growth and metastasis. Whilst several in vitro and in vivo studies suggest the possible modulatory effects of morphine on tumour cells, little is known about the impact of this analgesic drug on other mediators such as matrix metalloproteinases (MMPs) that play a key role in the control of cancer cell invasion and metastasis. MMP-9 has been considered as one of the principal mediators in regulation of not only the initial steps of cancer but during the invasion and spreading of cancer cells to distant organs. Herein, current studies regarding the direct and indirect effects of morphine on regulation of MMP-9 production are discussed. In addition, drawing from previous in vivo and in vitro studies on morphine action in regulating MMP-9 production, the potential roles of several underlying factors are summarised, including nuclear factor kappa-B and intracellular molecules such as nitric oxide.

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Abbreviations

AC:

Adenylyl cyclase

AP-1:

Activator protein 1

BMM:

Bone marrow-derived macrophages

CREB:

cAMP responsive element binding

cAMP:

Cyclic adenosine monophosphate

cGMP:

Cyclic guanosine monophosphate

cNOS:

Constitutive nitric oxide synthase

DRG:

Dorsal root ganglia

eNOS:

Endothelial nitric oxide synthase

ECM:

Extracellular matrix

GPCR:

G protein-coupled receptor

Gβγ:

G beta-gamma

iNOS:

Inducible nitric oxide synthase

IL-1β:

Interleukin 1 beta

IL-4:

Interleukin 4

IL-6:

Interleukin 6

IκB:

Nuclear factor-κB inhibitor

LPS:

Lipopolysaccharide

MMPs:

Matrix metalloproteinases

MMP-9:

Matrix metalloproteinase 9

NF-κB:

Nuclear factor kappa B

NO:

Nitric oxide

NOS:

Nitric oxide synthase

nNOS:

Neuronal nitric oxide synthase

PKCδ:

Protein kinase C-delta

PKA:

Protein kinase A

PLC:

Phospholipase C

PKC:

Protein kinase C

PI3K:

Phosphoinositide 3-kinase

PKB:

Protein kinase B

PEA3:

Polyoma enhancer activator 3

Sp-1:

Stimulating protein-1

TNFR-6:

Tumour necrosis factor receptor-associated factor 6

TLR:

Toll-like receptor

TIMP-1:

Tissue inhibitor of metalloproteinase 1

TNF-α:

Tumour necrosis factor alpha

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Funding

Authors’ own work discussed was supported in part by National Health and Medical Research Council Australia (NHMRC) project grants and fellowships (numbers 0508046, 0508047 and 1042105).

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SK and MH designed and conducted the literature review and drafted the manuscript. AH, PY and YS conducted the literature review. CJX designed and conceptualised the manuscript.

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Correspondence to Cory J. Xian.

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Khabbazi, S., Hassanshahi, M., Hassanshahi, A. et al. Opioids and matrix metalloproteinases: the influence of morphine on MMP-9 production and cancer progression. Naunyn-Schmiedeberg's Arch Pharmacol 392, 123–133 (2019). https://doi.org/10.1007/s00210-019-01613-6

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