a Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
Int Rev Psychiatry. 2018 Oct;30(5):107-116. doi: 10.1080/09540261.2018.1514295. Epub 2018 Dec 6.
There are several biological factors that might play a role in physiological response to opioids and/or the onset of problematic opioid use; however, sex-based differences in non-analgesic opioid-based effects are poorly understood. The goal of this review is to provide a current analysis of the pre-clinical literature on sex-based differences in response to endogenous and exogenous opioids, including the interplay between sex hormones and opioid receptor-mediated neuronal activity and associated behaviours. A systematic search was performed on the following terms within PubMed between March and April 2018: 'opioid oestrogen', 'opioid progesterone', 'opioid oestradiol', and 'opioid testosterone'. Pre-clinical research on the non-analgesic, sex-based effects of opioids is disparate, both in terms of methodology and outcomes, which prohibits a cohesive summary of the results. Themes from the pre-clinical literature suggest that opioid receptor binding, coupling, and density vary as a function of hormone exposure. Findings also suggest that interactions between endogenous opioid and stress systems may differ between males and females as a function of ovarian hormones. Given the current opioid-related public health crisis, there is a pressing need to increase systematic pre-clinical and clinical research on sex-based differences in opioid-effects and opioid use disorder.
有一些生物学因素可能在生理对阿片类药物的反应和/或出现问题性阿片类药物使用中起作用；然而，性别的差异在非镇痛阿片类药物作用方面的理解很差。本综述的目的是对目前关于内源性和外源性阿片类药物反应中基于性别的差异的临床前文献进行分析，包括性激素与阿片受体介导的神经元活动及其相关行为之间的相互作用。2018 年 3 月至 4 月期间，在 PubMed 中使用以下术语进行了系统搜索：“阿片类雌激素”、“阿片类孕激素”、“阿片类雌二醇”和“阿片类睾酮”。非镇痛、基于性别的阿片类药物的临床前研究在方法和结果上存在差异，这使得无法对结果进行有凝聚力的总结。临床前文献中的主题表明，阿片受体结合、偶联和密度随激素暴露而变化。研究结果还表明，内源性阿片和应激系统之间的相互作用可能因卵巢激素的不同而在男性和女性之间存在差异。鉴于当前与阿片类药物相关的公共卫生危机，迫切需要增加关于阿片类药物作用和阿片类药物使用障碍中基于性别的差异的系统临床前和临床研究。
