γ-氨基丁酸A型(GABA(A))受体在酒精中毒发展过程中的作用。

The role of GABA(A) receptors in the development of alcoholism.

作者信息

Enoch Mary-Anne

机构信息

Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD, USA.

出版信息

Pharmacol Biochem Behav. 2008 Jul;90(1):95-104. doi: 10.1016/j.pbb.2008.03.007. Epub 2008 Mar 15.

Abstract

Alcoholism is a common, heritable, chronic relapsing disorder. GABA(A) receptors undergo allosteric modulation by ethanol, anesthetics, benzodiazepines and neurosteroids and have been implicated in the acute as well as the chronic effects of ethanol including tolerance, dependence and withdrawal. Medications targeting GABA(A) receptors ameliorate the symptoms of acute withdrawal. Ethanol induces plasticity in GABA(A) receptors: tolerance is associated with generally decreased GABA(A) receptor activation and differentially altered subunit expression. The dopamine (DA) mesolimbic reward pathway originating in the ventral tegmental area (VTA), and interacting stress circuitry play an important role in the development of addiction. VTA GABAergic interneurons are the primary inhibitory regulators of DA neurons and a subset of VTA GABA(A) receptors may be implicated in the switch from heavy drinking to dependence. GABA(A) receptors modulate anxiety and response to stress; important elements of sustained drinking and relapse. The GABA(A) receptor subunit genes clustered on chromosome 4 are highly expressed in the reward pathway. Several recent studies have provided strong evidence that one of these genes, GABRA2, is implicated in alcoholism in humans. The influence of the interaction between ethanol and GABA(A) receptors in the reward pathway on the development of alcoholism together with genetic and epigenetic vulnerabilities will be explored in this review.

摘要

酒精成瘾是一种常见的、遗传性的慢性复发性疾病。GABA(A)受体可通过乙醇、麻醉剂、苯二氮䓬类药物和神经甾体进行变构调节,并且与乙醇的急性和慢性效应有关,包括耐受性、依赖性和戒断反应。针对GABA(A)受体的药物可改善急性戒断症状。乙醇可诱导GABA(A)受体发生可塑性变化:耐受性通常与GABA(A)受体激活的普遍降低以及亚基表达的差异改变有关。起源于腹侧被盖区(VTA)的多巴胺(DA)中脑边缘奖赏通路以及相互作用的应激回路在成瘾的发展中起重要作用。VTA的GABA能中间神经元是DA神经元的主要抑制性调节因子,VTA的一部分GABA(A)受体可能与从大量饮酒到依赖的转变有关。GABA(A)受体调节焦虑和对应激的反应;这些是持续饮酒和复发的重要因素。位于4号染色体上的GABA(A)受体亚基基因在奖赏通路中高度表达。最近的几项研究提供了强有力的证据,表明这些基因之一GABRA2与人类酒精成瘾有关。本综述将探讨奖赏通路中乙醇与GABA(A)受体之间的相互作用对酒精成瘾发展的影响,以及遗传和表观遗传易感性。

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