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Specifically, peptides and proteins that have been denatured or degraded can lead to adverse patient reactions such as undesired immune responses 34,35,36

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doi: 10.1186/s13045-019-0720-y 12 MaLChenCZhaoCLiTMaLJiangJet al

A need for antibiotic therapy may be indicated

Considering the recent surveys that document much improved safety of kratom compared to the prescription or illicit opioids 83,93,94 , a further decrease of MORs G protein signaling efficacy of the key mediator of kratoms opioid-like effects, 7OH 17 , may lead to even safer compounds, and illustrates the potential importance of the present work