Arezoomandan Mohammad, Zhiani Rahele, Mehrzad Jamshid, Motavalizadehkakhky Alireza, Eshrati Sahar, Arezoomandan Reza
Department of Biochemistry, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran.
Department of Chemistry, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran; New Materials Technology and Processing Research Center, Department of Chemistry, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran.
J Clin Neurosci. 2022 Jul;101:57-62. doi: 10.1016/j.jocn.2022.04.018. Epub 2022 May 6.
Methadone and buprenorphine which are widely used for opioid maintenance treatment can affect redox status and also brain functions. The present study aimed to compare inflammation, oxidative stress, and cognitive function in methadone maintenance patients (MMP), buprenorphine maintenance patients (BMP), and healthy participants.
Oxidative- antioxidant markers, inflammatory factors were investigated in MMP (n = 30), BMP (n = 30), and healthy participants (n = 30) by evaluating the ferritin, malondialdehyde (MDA), total antioxidant capacity (TAC), and also High-sensitivity C-reactive protein (hs-CRP). Also, executive function was evaluated using Wisconsin Card Sorting Test (WCST).
MMP and BMP showed impairment in executive function compared to the healthy participants. Both buprenorphine and methadone treatments induced oxidative stress. The ferritin level in BMP was significantly lower compared to MMP and healthy participants (P = 0.01). There was a significant difference between control and MMP and BMP (P > 0.0001) in terms of hs-CRP level. BMP had the highest and healthy participant's lowest MDA level (P < 0.001). The TAC levels in BMP were lower than in MMP (p = 0.002) and healthy participants (p = 0.001). Finally, executive function was significantly correlated with oxidative-antioxidant status.
Both methadone and buprenorphine induced severe oxidative activity (especially buprenorphine) and cognitive deficits compared to healthy participants. Stress oxidative can affect normal brain activity and consequently cognitive functions. It's suggested that concomitant antioxidant administration with buprenorphine or methadone can potentially enhance their beneficial action by regulating blood redox status.
广泛用于阿片类药物维持治疗的美沙酮和丁丙诺啡会影响氧化还原状态以及脑功能。本研究旨在比较美沙酮维持治疗患者（MMP）、丁丙诺啡维持治疗患者（BMP）和健康参与者的炎症、氧化应激及认知功能。
通过评估铁蛋白、丙二醛（MDA）、总抗氧化能力（TAC）以及高敏C反应蛋白（hs-CRP），对30名MMP患者、30名BMP患者和30名健康参与者的氧化-抗氧化标志物、炎症因子进行了研究。此外，使用威斯康星卡片分类测验（WCST）评估执行功能。
与健康参与者相比，MMP和BMP患者的执行功能受损。丁丙诺啡和美沙酮治疗均诱导了氧化应激。BMP患者的铁蛋白水平显著低于MMP患者和健康参与者（P = 0.01）。在hs-CRP水平方面，对照组与MMP组和BMP组之间存在显著差异（P > 0.0001）。BMP患者的MDA水平最高，健康参与者的MDA水平最低（P < 0.001）。BMP患者的TAC水平低于MMP患者（p = 0.002）和健康参与者（p = 0.001）。最后，执行功能与氧化-抗氧化状态显著相关。
与健康参与者相比，美沙酮和丁丙诺啡均诱导了严重的氧化活性（尤其是丁丙诺啡）和认知缺陷。氧化应激会影响正常的脑活动，进而影响认知功能。建议在使用丁丙诺啡或美沙酮的同时给予抗氧化剂，通过调节血液氧化还原状态可能会增强它们的有益作用。
