Yamada Kiyofumi
Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan.
Biol Pharm Bull. 2008 Sep;31(9):1635-8. doi: 10.1248/bpb.31.1635.
Drug addiction/dependence is defined as a chronically relapsing disorder that is characterized by compulsive drug taking, inability to limit intake, and intense drug cravings. The positive reinforcing/rewarding effects of drugs primarily depend on the mesocorticolimbic dopamine system innervating the nucleus accumbens while the craving for drugs is associated with activation of the prefrontal cortex. The chronic intake of drugs causes homeostatic molecular and functional changes in synapses, which may be critically associated with the development of drug dependence. Recent studies have demonstrated that various cytokines and proteinases are produced in the brain on treatment with drugs of abuse, and play a role in drug dependence. These endogenous modulators of drug dependence are classified into two groups, pro-addictive and anti-addictive factors. The former including basic fibroblast growth factor, brain-derived neurotrophic factor, tissue plasminogen activator, matrix metalloproteinase (MMP)-2 and MMP-9 act to potentiate the rewarding effects of drugs, while the latter such as tumor necrosis factor-alpha and glial cell line-derived neurotrophic factor reduce the reward. These findings suggest that an imbalance between pro-addictive and anti-addictive factors contributes to the development and relapse of drug dependence. Furthermore, targeting these endogenous modulators would provide new therapeutic approaches to the treatment of drug dependence.
药物成瘾/依赖被定义为一种慢性复发性疾病,其特征为强迫性用药、无法控制用药量以及强烈的药物渴求。药物的正性强化/奖赏效应主要依赖于支配伏隔核的中脑皮质边缘多巴胺系统,而对药物的渴求则与前额叶皮质的激活有关。长期用药会导致突触发生稳态分子和功能变化,这可能与药物依赖的发展密切相关。最近的研究表明,滥用药物治疗后大脑中会产生各种细胞因子和蛋白酶,并在药物依赖中发挥作用。这些药物依赖的内源性调节因子分为两类,即促成瘾因子和抗成瘾因子。前者包括碱性成纤维细胞生长因子、脑源性神经营养因子、组织纤溶酶原激活物、基质金属蛋白酶(MMP)-2和MMP-9,它们会增强药物的奖赏效应,而后者如肿瘤坏死因子-α和胶质细胞系源性神经营养因子则会降低奖赏。这些发现表明,促成瘾因子和抗成瘾因子之间的失衡导致了药物依赖的发展和复发。此外,针对这些内源性调节因子将为药物依赖的治疗提供新的治疗方法。