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脑源性神经营养因子在物质使用障碍中的作用:系统评价和荟萃分析。

Brain-derived neurotrophic factor in substance use disorders: A systematic review and meta-analysis.

机构信息

Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil; Postgraduate Program in Psychiatry and Behavioral Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil; Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, SC, Brazil.

出版信息

Drug Alcohol Depend. 2018 Dec 1;193:91-103. doi: 10.1016/j.drugalcdep.2018.08.036. Epub 2018 Oct 12.

Abstract

BACKGROUND

Brain-derived neurotrophic factor (BDNF) is associated with several neurodegenerative and psychiatric disorders. It is not clear, however, whether BDNF levels are modified in substance use disorders (SUDs).

METHODS

We conducted a systematic search of electronic databases to identify studies comparing peripheral plasma or serum BDNF levels in adults with SUDs vs. non-user controls. Forty studies were included in the meta-analysis involving a total of 2238 participants with SUDs and 2574 controls.

RESULTS

After trim and fill adjustment, current drug users presented lower serum BDNF levels (SMD = -0.99, 95%CI -1.40 to -0.58, I = 95.9) than non-user controls. However, this difference disappears during withdrawal. Studies using serum or plasma BDNF samples have shown different results. Subgroup analysis revealed lower levels of serum BDNF in alcohol users (SMD = -0.70, 95%CI -1.15 to -0.25, I = 89.81) and crack/cocaine users (SMD = -1.78, 95%CI -2.92 to -0.65, I = 97.59) than controls. Meta-regression analysis revealed that gender, age, and age of first use moderate the effects of drug use in peripheral BDNF levels.

CONCLUSIONS

Peripheral BDNF levels are decreased in the serum, but not the plasma, of active drug users. Altogether, these findings suggest that BDNF levels may be related to acute use and addiction severity and also point to BDNF's potential utility as a biomarker in this population.

摘要

背景

脑源性神经营养因子(BDNF)与多种神经退行性和精神疾病有关。然而,BDNF 水平是否在物质使用障碍(SUD)中发生改变尚不清楚。

方法

我们进行了系统的电子数据库检索,以确定比较 SUD 成年患者与非使用者对照的外周血浆或血清 BDNF 水平的研究。共有 40 项研究纳入荟萃分析,涉及 2238 名 SUD 患者和 2574 名对照者。

结果

经修剪和填充调整后,当前药物使用者的血清 BDNF 水平较低(SMD=-0.99,95%CI-1.40 至-0.58,I=95.9),而非使用者对照者。然而,这种差异在戒断期间消失。使用血清或血浆 BDNF 样本的研究显示出不同的结果。亚组分析显示,酒精使用者(SMD=-0.70,95%CI-1.15 至-0.25,I=89.81)和可卡因使用者(SMD=-1.78,95%CI-2.92 至-0.65,I=97.59)的血清 BDNF 水平低于对照组。元回归分析显示,性别、年龄和首次使用年龄调节了药物使用对周围 BDNF 水平的影响。

结论

活跃药物使用者的血清而非血浆 BDNF 水平降低。总之,这些发现表明 BDNF 水平可能与急性使用和成瘾严重程度有关,并表明 BDNF 作为该人群的生物标志物具有潜在的效用。

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