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Gastrointestinal motility, dysbiosis and opioid-induced tolerance: is there a link?

Studies show that gut microbial dysbiosis induced by chronic opioid use is linked to central opioid tolerance. Here, we suggest that a persistent decrease in gastrointestinal motility by opioids is a primary cause of gut microbial dysbiosis and that improving gastrointestinal transit might be a strategy in preventing opioid analgesic tolerance.

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Fig. 1: Antinociceptive tolerance to opioids through changes in the gut microbiota.


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This work was supported by National Institutes of Health grant DA036975.

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Correspondence to Hamid I. Akbarali.

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The authors declare no competing interests.

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Akbarali, H.I., Dewey, W.L. Gastrointestinal motility, dysbiosis and opioid-induced tolerance: is there a link?. Nat Rev Gastroenterol Hepatol 16, 323–324 (2019).

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