Department of Internal Medicine, Jagiellonian University Medical College, Skawińska 8, PL 31-066 Kraków, Poland.
Maj Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Smętna 12, PL 31-343 Kraków, Poland.
Curr Neuropharmacol. 2019;17(11):1039-1055. doi: 10.2174/1570159X17666190617101726.
Cocaine use disorder is manifested by repeated cycles of drug seeking and drug taking. Cocaine exposure causes synaptic transmission in the brain to exhibit persistent changes, which are poorly understood, while the pharmacotherapy of this disease has not been determined. Multiple potential mechanisms have been indicated to be involved in the etiology of cocaine use disorder. The glutamatergic system, especially N-methyl-D-aspartate (NMDA) receptors, may play a role in several physiological processes (synaptic plasticity, learning and memory) and in the pathogenesis of cocaine use disorder. The composition of the NMDA receptor subunits changes after contingent and noncontingent cocaine administration and after drug abstinence in a region-specific and timedependent manner, as well as depending on the different protocols used for cocaine administration. Changes in the expression of NMDA receptor subunits may underlie the transition from cocaine abuse to dependence, as well as the transition from cocaine dependence to cocaine withdrawal. In this paper, we summarize the current knowledge regarding neuroadaptations within NMDA receptor subunits and scaffolding proteins observed following voluntary and passive cocaine intake, as well as the effects of NMDA receptor antagonists on cocaine-induced behavioral changes during cocaine seeking and relapse.
可卡因使用障碍表现为反复的觅药和用药循环。可卡因暴露导致大脑中的突触传递表现出持久的变化,这些变化目前还不太清楚,而这种疾病的药物治疗尚未确定。有多个潜在的机制被指出与可卡因使用障碍的病因有关。谷氨酸能系统,特别是 N-甲基-D-天冬氨酸(NMDA)受体,可能在几种生理过程(突触可塑性、学习和记忆)和可卡因使用障碍的发病机制中发挥作用。NMDA 受体亚基的组成在条件和非条件可卡因给药后以及药物戒断后会发生变化,具有区域特异性和时间依赖性,并且还取决于用于可卡因给药的不同方案。NMDA 受体亚基表达的变化可能是从可卡因滥用到依赖的转变,以及从可卡因依赖到可卡因戒断的转变的基础。本文总结了目前关于 NMDA 受体亚基和支架蛋白在自愿和被动摄入可卡因后的神经适应性的知识,以及 NMDA 受体拮抗剂对可卡因寻求和复发期间可卡因引起的行为变化的影响。