Sandman C A
State Developmental Research Institute, Fairview, Costa Mesa, California 92626.
Synapse. 1988;2(3):193-9. doi: 10.1002/syn.890020304.
Peptides derived from pro-opiomelanocortin (POMC) influence neurodevelopmental processes. Earlier studies indicated that MSH/ACTH compounds improved behavioral efficiency in retarded individuals. Recent studies have shown that opiate blockers reduce treatment-resistant self-injurious behavior (SIB), an autistic-like, developmental disorder. Although the exact mechanisms are unknown, prenatal POMC disregulation, addiction to endogenous opiates and elevated pain threshold have been proposed to account for this behavior. In study one, four SIB patients were given 0, 25, 50 or 100 mg of naltrexone on separate weeks in a double blind, Latin square design. A specific dose dependent reduction in SIB was observed in three patients. In study two, plasma b-endorphin was measured in 40 patients with SIB, a related behavior, stereotypy (ST) or controls. SIB and ST patients had higher levels of endorphin than controls. These data added new support for the role of b-endorphin in a treatment-resistant patient group.
源自阿片促黑皮质素原（POMC）的肽会影响神经发育过程。早期研究表明，促黑素/促肾上腺皮质激素化合物可提高智力迟钝个体的行为效率。最近的研究表明，阿片类阻滞剂可减少难治性自伤行为（SIB），这是一种类似自闭症的发育障碍。尽管确切机制尚不清楚，但有人提出产前POMC失调、对内源性阿片类药物成瘾和痛阈升高是导致这种行为的原因。在研究一中，四名SIB患者在双盲拉丁方设计中，于不同周分别给予0、25、50或100毫克纳曲酮。三名患者出现了特定剂量依赖性的SIB减少。在研究二中，对40名患有SIB、相关行为刻板动作（ST）的患者或对照组进行了血浆β-内啡肽测量。SIB和ST患者的内啡肽水平高于对照组。这些数据为β-内啡肽在难治性患者群体中的作用提供了新的支持。
