Gold Mark S, Kobeissy Firas H, Wang Kevin K W, Merlo Lisa J, Bruijnzeel Adriaan W, Krasnova Irina N, Cadet Jean Lud
Center for Neuroproteomics and Biomarkers Research, McKnight Brain Institute of the University of Florida, Gainesville, Florida 32610, USA.
Biol Psychiatry. 2009 Jul 15;66(2):118-27. doi: 10.1016/j.biopsych.2009.02.021. Epub 2009 Apr 5.
The use of methamphetamine (METH) is a growing public health problem, because its abuse is associated with long-term biochemical and structural effects on the human brain. Neurodegeneration is often observed in humans, because of mechanical injuries (e.g., traumatic brain injury [TBI]) and ischemic damage (strokes). In this review, we discuss recent findings documenting the fact that the psychostimulant drug METH can cause neuronal damage in several brain regions. The accumulated evidence from our laboratories and those of other investigators indicates that acute administration of METH leads to activation of calpain and caspase proteolytic systems. These systems are also involved in causing neuronal damage secondary to traumatic and ischemic brain injuries. Protease activation is accompanied by proteolysis of endogenous neuronal structural proteins (alphaII-spectrin protein and microtubule-associated protein-tau), evidenced by the appearance of their breakdown products after these injuries. When taken together, these observations suggest that METH exposure, like TBI, can cause substantial damage to the brain by causing both apoptotic and necrotic cell death in the brains of METH addicts who use large doses of the drug during their lifetimes. Finally, because METH abuse is accompanied by functional and structural changes in the brain similar to those in TBI, METH addicts might experience greater benefit if their treatment involved greater emphasis on rehabilitation in conjunction with potential neuroprotective pharmacological agents such as calpain and caspase inhibitors similar to those used in TBI.
甲基苯丙胺(METH)的使用正成为一个日益严重的公共卫生问题,因为其滥用会对人类大脑产生长期的生化和结构影响。在人类中,由于机械性损伤(如创伤性脑损伤 [TBI])和缺血性损伤(中风),经常会观察到神经退行性变。在这篇综述中,我们讨论了最近的研究发现,这些发现证明精神兴奋药物METH可导致多个脑区的神经元损伤。来自我们实验室以及其他研究者的累积证据表明,急性给予METH会导致钙蛋白酶和半胱天冬酶蛋白水解系统的激活。这些系统也参与了创伤性和缺血性脑损伤继发的神经元损伤。蛋白酶激活伴随着内源性神经元结构蛋白(αII-血影蛋白和微管相关蛋白-τ)的蛋白水解,这可通过这些损伤后其降解产物的出现得到证明。综合来看,这些观察结果表明,METH暴露与TBI一样,可通过在一生中大量使用该药物的METH成瘾者大脑中引发凋亡和坏死性细胞死亡,从而对大脑造成实质性损害。最后,由于METH滥用会伴随着大脑中与TBI类似的功能和结构变化,如果对METH成瘾者的治疗更加强调康复,并结合潜在的神经保护药物(如与TBI中使用的类似的钙蛋白酶和半胱天冬酶抑制剂),他们可能会获得更大的益处。