Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-003, Brazil.
Child and Adolescent Psychiatry Service (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 4° andar, sala 400N, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil.
Psychopharmacology (Berl). 2018 Jan;235(1):215-222. doi: 10.1007/s00213-017-4759-6. Epub 2017 Oct 28.
Cocaine and amphetamine-regulated transcript (CART) is an endogenous antioxidant present since the embryonic period. CART is activated by high levels of dopamine and might be of interested in understanding the changes in the REDOX system associated with crack/cocaine intake. The goal of this study was to determine whether exposure to crack in utero is associated with increased CART levels.
In this cross-sectional study with consecutive sampling, we compared the umbilical cord blood (UCB) CART levels (μg/mL) of newborns exposed to crack/cocaine in utero (EN, n = 57) to levels in non-exposed newborns (NEN, n = 99). In addition, we compared serum CART levels between EN and NEN mothers, in the immediate postpartum period. Potential confounders, such as perinatal data (e.g., weight, Apgar, etc.), psychopathology (DSM-IV), and use of drugs other than crack (ASSIST) were assessed.
According to general linear model analysis, the adjusted mean CART was significantly higher in EN (0.180, 95% CI 0.088-0.272) than in NEN (0.048, 95% CI 0.020-0.076; p < 0.002; d = 0.68). The difference in CART levels between EN and NEN mothers was not significant (p ≥ 0.05).
The increase in CART levels in EN UBC suggests a response to crack/cocaine-induced oxidative stress during gestational period, as a potential attempt of neuroprotection. In adult women in puerperium, however, this endogenous antioxidant recruitment does not seem to operate.
可卡因和苯丙胺调节转录物（CART）是一种内源性抗氧化剂，存在于胚胎期。CART 被高水平的多巴胺激活，可能有助于理解与吸食 crack/cocaine 相关的氧化还原系统的变化。本研究的目的是确定宫内暴露于 crack 是否与 CART 水平升高有关。
本研究采用连续抽样的横断面研究，比较了宫内暴露于 crack/cocaine 的新生儿（EN，n=57）和未暴露于 crack 的新生儿（NEN，n=99）的脐血（UCB）CART 水平（μg/mL）。此外，我们比较了 EN 和 NEN 母亲产后即刻的血清 CART 水平。评估了潜在的混杂因素，如围产期数据（如体重、阿普加评分等）、精神病理学（DSM-IV）和除 crack 以外的其他药物使用情况（ASSIST）。
根据一般线性模型分析，EN 的调整后平均 CART 明显高于 NEN（0.180，95%CI 0.088-0.272）（0.048，95%CI 0.020-0.076；p<0.002；d=0.68）。EN 和 NEN 母亲之间的 CART 水平差异无统计学意义（p≥0.05）。
EN UBC 中 CART 水平的升高表明在妊娠期 crack/cocaine 诱导的氧化应激反应中，作为一种潜在的神经保护尝试。然而，在产后的成年女性中，这种内源性抗氧化剂的募集似乎并没有发生作用。
