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可卡因使用障碍患者血浆生长因子和趋化因子失调:探索性研究中双诊断精神分裂症和反社会人格障碍的意义。

Dysregulation of Plasma Growth Factors and Chemokines in Cocaine Use Disorder: Implications for Dual Diagnosis with Schizophrenia and Antisocial Personality Disorder in an Exploratory Study.

机构信息

Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Parque Tecnológico de Andalucía, Málaga, Spain.

Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Málaga, Spain.

出版信息

Neuropsychobiology. 2024;83(2):73-88. doi: 10.1159/000536265. Epub 2024 May 20.

Abstract

INTRODUCTION

Dual diagnosis in individuals with cocaine use disorders (CUDs) presents a mental health challenge marked by an increased susceptibility to disabling morbidities and premature mortality. Despite extensive research on depression and anxiety, other prevalent comorbidities, such as psychotic and personality disorders, have received less attention. This study explores inflammation-related mediators as potential biomarkers for CUD and dual diagnosis with schizophrenia (SCZ) or antisocial personality disorder (APD).

METHODS

This exploratory study included 95 participants, comprising 40 healthy subjects and 55 abstinent patients with CUD. Lifetime CUD was diagnosed either as single diagnosis (CUD group, N = 25) or as a dual diagnosis (DD group. N = 30) with SCZ (CUD+SCZ subgroup) or APD (CUD+APD subgroup). Participants were clinically assessed, and the plasma concentrations of growth factors (i.e., G-CSF, BDNF, and VEGF-A) and chemokines (i.e., CCL11/eotaxin-1, CCL2/MCP-1, and CXCL12/SDF-1) were determined and log(10)-transformed for analysis.

RESULTS

Growth factors and chemokines were dysregulated by CUD and psychiatric diagnoses. Specifically, patients in the CUD group exhibited significantly lower concentrations of G-CSF and CCL11/eotaxin-1 than the control group. In contrast, the DD group showed significantly higher concentrations of all analytes than both the CUD and control groups. Additionally, no differences in these analytes were observed between the CUD+SCZ and CUD+APD subgroups within the DD group. Regarding cocaine-related variables, significant associations were identified in the CUD group: an inverse correlation between the age at first cocaine use and the concentrations of BDNF and CCL2/MCP-1; and a positive correlation between the duration of the cocaine abstinence and the concentrations of BDNF and CCL11/eotaxin-1. Lastly, a logistic regression model incorporating all these analytes demonstrated high discriminatory power in distinguishing patients with CUD alone from those with dual diagnosis.

CONCLUSIONS

Individuals with dual diagnosis of CUD exhibit elevated concentrations of growth factors and chemokines, distinguishing them from those with CUD alone. It is unclear whether the differences in these inflammatory mediators are specific to the presence of SCZ and APD. The study highlights potential biomarkers and associations, providing valuable insights into the intricate interplay of CUD and psychiatric disorders to enhance clinical diagnosis and therapeutics.

摘要

简介

可卡因使用障碍(CUD)患者的双重诊断带来了心理健康挑战,其特征是更容易出现致残性疾病和过早死亡。尽管对抑郁和焦虑进行了广泛的研究,但其他常见的合并症,如精神病和人格障碍,受到的关注较少。本研究探讨了与炎症相关的介质是否可以作为 CUD 以及与精神分裂症(SCZ)或反社会人格障碍(APD)双重诊断的潜在生物标志物。

方法

这项探索性研究纳入了 95 名参与者,包括 40 名健康对照和 55 名戒断的 CUD 患者。终生 CUD 被诊断为单纯诊断(CUD 组,N=25)或双重诊断(DD 组,N=30),伴有 SCZ(CUD+SCZ 亚组)或 APD(CUD+APD 亚组)。对参与者进行临床评估,并测定和对数(10)转换血浆中生长因子(即 G-CSF、BDNF 和 VEGF-A)和趋化因子(即 CCL11/eotaxin-1、CCL2/MCP-1 和 CXCL12/SDF-1)的浓度。

结果

CUD 和精神疾病诊断会导致生长因子和趋化因子失调。具体来说,CUD 组患者的 G-CSF 和 CCL11/eotaxin-1 浓度明显低于对照组。相比之下,DD 组所有分析物的浓度明显高于 CUD 组和对照组。此外,在 DD 组中,CUD+SCZ 和 CUD+APD 亚组之间的这些分析物没有差异。关于可卡因相关变量,在 CUD 组中发现了显著相关性:首次使用可卡因年龄与 BDNF 和 CCL2/MCP-1 浓度呈负相关;可卡因戒断时间与 BDNF 和 CCL11/eotaxin-1 浓度呈正相关。最后,一个包含所有分析物的逻辑回归模型显示,区分单纯 CUD 患者和双重诊断患者具有较高的判别能力。

结论

CUD 双重诊断患者表现出生长因子和趋化因子浓度升高,这将他们与单纯 CUD 患者区分开来。这些炎症介质的差异是否特定于 SCZ 和 APD 的存在尚不清楚。该研究强调了潜在的生物标志物和关联,为深入了解 CUD 和精神疾病之间的复杂相互作用提供了有价值的见解,以增强临床诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c9b/11210571/0c54353c3804/nps-2024-0083-0002-536265_F01.jpg

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