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Does ecstasy attack the immune system?

There are numerous stories of people who use E regularly catching colds, suffering from cystitis and other problems. Does MDMA damage the immune system?

Has there been any research on whether MDMA effects the immune system?

Reply from Dr Cozzi

Searching back to 1981, this is all I could find. In a nutshell, MDMA enhances immune system function in vitro.

The abstract suggests that MDMA has differential effects on immune function. Specifically, at *very low* concentration, (0.1 nM), MDMA enhances interleukin-2 production, but has no effect on interleukin-4 production. IL-2 induces proliferation of T-cells and also stimulates B-cells (these cells produce antibodies), natural killer (NK) cells, and macrophages. IL-4 mainly stimulates B-cells, but also T-cells and macrophages. B-cells themselves were unaffected by MDMA at all concentrations tested. NK cells' killing ability was enhanced over a range of concentrations. Cytotoxic T lymphocytes were suppressed at 100 uM.

FYI, MDMA at effective doses probably *does not* reach 100 uM concentration in the human. A study by Errol B. De Souza, et al. showed that in the rat, at active doses, MDMA could reach 40 uM in the brain.

Unique Identifier 95167675 Authors House RV. Thomas PT. Bhargava HN. Institution Life Sciences Department, IIT Research Institute, Chicago, IL 60616. Title Selective modulation of immune function resulting from in vitro exposure to methylenedioxymethamphetamine (Ecstasy). Source Toxicology. 96(1):59-69, 1995 Jan 19. Abstract Abuse of illicit analogs of methamphetamine (i.e., 'designer drugs') represents a growing problem. One of the most popular methamphetamine analogs is (+/-)-3,4-methylenedioxymethamphetamine (MDMA), commonly known as Ecstasy. The authors demonstrated previously that in vitro exposure to methamphetamine results in modulation of immune functional parameters necessary for host defense. The current study was performed to assess the potential direct (in vitro) immunomodulatory effect of exposure to a modified methamphetamine. Splenocytes or peritoneal macrophages from B6C3F1 mice were cultured in vitro at MDMA concentrations of 0.0001-100 microM. T-cell regulatory function was assessed by anti-CD3-mediated production of IL-2 and IL-4, B-cell function was assessed by quantitating cellular proliferation, natural immunity was assessed by quantitating natural killer (NK) cell activity, T-cell effector function was evaluated as a function of cytotoxic T-lymphocyte (CTL) activity, and macrophage function was assessed by IL-6 tumor necrosis factor (TNF) production. In vitro exposure to MDMA had no effect on B-cell proliferation at any concentration tested. In comparison, in the absence of direct cellular toxicity, production of IL-2 was enhanced at concentrations as low as 0.0001 microM. IL-4 production was not affected by exposure to any concentration of MDMA examined, suggesting a differential alteration in T-helper cell function by this compound. Basal and augmented NK cell function were enhanced at MDMA concentrations between 0.0001 and 1.0 microM when examined at an effector:target ratio of 100:1. CTL induction was significantly suppressed at a concentration of 100 microM. Finally, macrophage production of TNF was slightly suppressed at 10 and 100 microM MDMA, although this inhibition was not statistically significant.
Nicholas V. Cozzi, Ph.D.
Department of Pharmacology
University of Wisconsin Medical School

Reply from Dr Nichols

Any ideas that MDMA either enhances or depresses the immune system are, to my knowledge, anecdotal personal accounts. I rather think it should not, at least from a very reductionistic perspective, else all those minions taking dexfenfluramine should either be suffering no allergies and colds at all, or they would all be in the hospital with a host of opportunistic infections!

On the other hand, if MDMA was used therapeutically, to rid someone of guilt or fear, leading to a greater state of emotional health, those who believe in the strength of the mind-body connection could probably argue persuasively that the immune system ought to be improved. This latter possibility cannot be excluded, but it would not represent a *direct* action of MDMA on the immune system but rather a sort of indirect effect, modulated by psychology, so to speak.

Dr Dave Nichols
Department of Pharmacology
Purdue University