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[催产素在自闭症谱系障碍中的可能作用]

[The Possible Role of Oxytocin in Autism Spectrum Disorder].

作者信息

Munesue Toshio, Minabe Yoshio

出版信息

Seishin Shinkeigaku Zasshi. 2016;118(6):399-409.

PMID:30620499
Abstract

The core symptoms of autism spectrum disorder (ASD) comprise impairments of social communication and social interactions as well as restricted and repetitive patterns of interests and activities. No definitive treatments for these core symptoms currently exist. Oxytocin, a highly conserved peptide, has been suggested to moderate inter-individual relationships based on the results of many vertebrate studies. Recently, oxytocin has received a great deal of attention as a promising candidate for the treatment of ASD. Here, we review studies on the role of oxytocin in ASD. Numerous randomized controlled trials (RCTs) have shown single- dose oxytocin administration to have significantly favorable effects compared with placebo for both neuro-typical individuals and individuals with ASD. Furthermore, extended administra- tion of oxytocin was associated with effects that significantly exceeded those of a placebo in three of five published RCTs for ASD. Moreover, approximately 20 RCTs investigating whether oxytocin is favorable for ASD participants are in progress, according to clinical trial registries certified by the World Health Organization. The results of these RCTs may elucidate the issues regarding favorable and adverse effects, appropriate doses and treatment durations, participant selection, and specifically how to assess the changes in impairments of social com- munication and social interactions. In addition, it is necessary to consider which version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is used for the diagnosis of ASD in each RCT because the range of individuals diagnosed with ASD has become gradually nar- rower with each DSM revision, i. e., the Fourth Edition, the Fourth Edition Text Revision, and the Fifth Edition.

摘要

自闭症谱系障碍(ASD)的核心症状包括社交沟通和社交互动障碍,以及兴趣和活动的局限及重复模式。目前尚无针对这些核心症状的确切治疗方法。基于许多脊椎动物研究的结果,人们认为催产素这种高度保守的肽可调节个体间的关系。最近,催产素作为治疗ASD的一个有前景的候选药物受到了广泛关注。在此,我们综述了关于催产素在ASD中作用的研究。众多随机对照试验(RCT)表明,与安慰剂相比,单剂量给予催产素对神经典型个体和ASD个体均有显著的有利影响。此外,在已发表的五项针对ASD的RCT中,有三项显示催产素的长期给药效果显著超过安慰剂。而且,根据世界卫生组织认证的临床试验注册信息,约20项研究催产素对ASD参与者是否有益的RCT正在进行中。这些RCT的结果可能会阐明有关有利和不利影响、合适剂量和治疗持续时间、参与者选择等问题,特别是如何评估社交沟通和社交互动障碍的变化。此外,由于随着《精神疾病诊断与统计手册》(DSM)的每次修订,即第四版、第四版文本修订版和第五版,被诊断为ASD的个体范围逐渐变窄,因此有必要考虑每项RCT中使用的是哪个版本的DSM来诊断ASD。

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