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Low-dose naltrexone for treatment of duodenal Crohn's disease in a pediatric patient
Inflamm Bowel Dis
September 2010
https://academic.oup.com/ibdjournal/article/16/9/1457/4628412
Naltrexone is an opioid receptor antagonist used as an opiate antidote. It acts as a competitive antagonist at several opioid receptor sites, showing the highest affinity for mu receptors. Studies have shown that opioids have immunomodulatory activity, including modulation of the inflammatory response and healing and repair of tissues. Short-term blockade of opioid receptors has been shown to lead to increased endogenous levels of opioids, which is the basis for naltrexone use in Crohn's disease (CD). The presumption is that high levels of opioid receptor antagonism would lead to a complete block of the receptors and prohibit the effect of the endogenous opioids. Hence, low-dose naltrexone (LDN) therapy has been used in a study of adult patients with CD. This study demonstrated the effectiveness and safety of LDN therapy in subjects with moderate to severe CD. We describe the first case of treating CD with LDN in a pediatric patient.