School of Psychology, University of Sussex, Falmer, Brighton, UK.
Br J Pharmacol. 2011 Oct;164(4):1335-56. doi: 10.1111/j.1476-5381.2011.01406.x.
Despite years of neurobiological research that have helped to identify potential therapeutic targets, we do not have a reliable pharmacological treatment for alcoholism. There are a range of possible explanations for this failure, including arguments that alcoholism is a spectrum disorder and that different population subtypes may respond to different treatments. This view is supported by categorisations such as early- and late-onset alcoholism, whilst multifactorial genetic factors may also alter responsivity to pharmacological agents. Furthermore, experience of alcohol withdrawal may play a role in future drinking in a way that may distinguish alcoholism from other forms of addiction. Additionally, our neurobiological models, based largely upon results from rodent studies, may not mimic specific aspects of the human condition and may reflect different underlying phenomena and biological processes from the clinical pattern. As a result, potential treatments may be targeting inappropriate aspects of alcohol-related behaviours. Instead, we suggest a more profitable approach is (a) to identify well-defined intermediate behavioural phenotypes in human experimental models that reflect defined aspects of the human clinical disorder and (b) to develop animal models that are homologous with those phenotypes in terms of psychological processes and underlying neurobiological mechanisms. This review describes an array of animal models currently used in the addiction field and what they tell us about alcoholism. We will then examine how established pharmacological agents have been developed using only a limited number of these models, before describing some alternative novel approaches to achieving homology between animal and human experimental measures.
尽管多年的神经生物学研究有助于确定潜在的治疗靶点,但我们并没有可靠的药物治疗酒精中毒。这种失败有多种可能的解释,包括认为酒精中毒是一种谱系障碍,不同的人群亚型可能对不同的治疗方法有反应。这种观点得到了诸如早发性和晚发性酒精中毒等分类的支持,而多因素遗传因素也可能改变对药物治疗的反应性。此外,酒精戒断的经历可能在未来的饮酒中发挥作用,这可能使酒精中毒与其他形式的成瘾区分开来。此外,我们的神经生物学模型主要基于啮齿动物研究的结果,可能无法模拟人类状况的特定方面,并且可能反映出与临床模式不同的潜在现象和生物学过程。因此,潜在的治疗方法可能针对的是与酒精相关行为的不适当方面。相反,我们建议采用一种更有利的方法:(a) 在人类实验模型中确定明确界定的中间行为表型,这些表型反映了人类临床疾病的特定方面;(b) 开发在心理过程和潜在神经生物学机制方面与这些表型同源的动物模型。本综述描述了目前在成瘾领域使用的一系列动物模型,以及它们告诉我们关于酒精中毒的信息。然后,我们将检查仅使用这些模型中的有限数量,如何开发已确立的药物治疗,然后描述在动物和人类实验测量之间实现同源性的一些替代新方法。