Sun Zhongjie, Zhang Zhonge, Wang Xiuqing, Cade Robert, Elmir Zaher, Fregly Melvin
Department of Medicine, College of Medicine, University of Florida, Box 100274, 1600 SW Archer Road, Gainesville, FL 32610, USA.
Peptides. 2003 Jun;24(6):937-43. doi: 10.1016/s0196-9781(03)00156-6.
Sudden infant death syndrome (SIDS) is the most common cause of death in infants and its pathogenesis is complex and multifactorial. The aim of this review is to summarize recent novel findings regarding the possible association of beta-casomorphin (beta-CM) to apnea in SIDS, which has not been widely appreciated by pediatricians and scientists. beta-CM is an exogenous bioactive peptide derived from casein, a major protein in milk and milk products, which has opioid activity. Mechanistically, circulation of this peptide into the infant's immature central nervous system might inhibit the respiratory center in the brainstem leading to apnea and death. This paper will review the possible relationship between beta-CM and SIDS in the context of passage of beta-CM through the gastrointestinal tract and the blood-brain barrier (BBB), permeability of the BBB to peptides in infants, and characterization of the casomorphin system in the brain.
婴儿猝死综合征（SIDS）是婴儿死亡的最常见原因，其发病机制复杂且具有多因素性。本综述的目的是总结近期关于β-酪蛋白吗啡（β-CM）与SIDS中呼吸暂停可能关联的新发现，而这一点尚未得到儿科医生和科学家的广泛重视。β-CM是一种源自酪蛋白的外源性生物活性肽，酪蛋白是牛奶和奶制品中的主要蛋白质，具有阿片样活性。从机制上讲，这种肽进入婴儿未成熟的中枢神经系统可能会抑制脑干中的呼吸中枢，导致呼吸暂停和死亡。本文将在β-CM通过胃肠道和血脑屏障（BBB）的过程、婴儿血脑屏障对肽的通透性以及脑中酪蛋白吗啡系统的特征等背景下，综述β-CM与SIDS之间的可能关系。
