Marchette Renata C N, Vendruscolo Leandro F, Koob George F
Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, BRC Room 08A505.19, 251 Bayview Blvd, Baltimore, MD 21224 USA.
Stress and Addiction Neuroscience Unit, Integrative Neuroscience Research Branch, Division of Intramural Clinical and Biological Research, National Institute on Drug Abuse, Intramural Research Program, and National Institute On Alcohol Abuse and Alcoholism, National Institutes of Health, Baltimore, MD 21224 USA.
Curr Addict Rep. 2025;12(1):11. doi: 10.1007/s40429-025-00618-x. Epub 2025 Feb 4.
Drug addiction is characterized by compulsive drug seeking and use, accompanied by negative emotional states (hyperkatifeia) and heightened pain sensitivity (hyperalgesia) during withdrawal. Both hyperalgesia and hyperkatifeia are integral components of substance use disorders, negatively impacting treatment and recovery. The underlying neurobiological mechanisms of hyperalgesia and hyperkatifeia involve alterations of brain reward and stress circuits, including the dynorphin/κ-opioid receptor (KOR) system. The dynorphin/KOR system modulates pain perception, negative affect, and addictive behaviors. Here, we review the preclinical evidence of dynorphin/KOR signaling in opioid withdrawal-induced hyperalgesia and hyperkatifeia.
In opioid dependence models, pharmacological and genetic interventions of the dynorphin/KOR system attenuate somatic and motivational signs of withdrawal and addictive-like behaviors, highlighting its therapeutic potential. Understanding the intricate interplay between dynorphin/KOR signaling, hyperalgesia, hyperkatifeia, and addiction offers novel insights into treatment strategies for opioid use disorder and other substance use disorders.
Further research is needed to elucidate precise mechanisms of the sexual dimorphism of dynorphin/KOR signaling and identify targeted interventions to mitigate hyperalgesia and hyperkatifeia and facilitate recovery from addiction.
药物成瘾的特征是强迫性觅药和用药,同时在戒断期间伴有负面情绪状态(快感缺失)和疼痛敏感性增强(痛觉过敏)。痛觉过敏和快感缺失都是物质使用障碍的组成部分,对治疗和康复产生负面影响。痛觉过敏和快感缺失的潜在神经生物学机制涉及大脑奖赏和应激回路的改变,包括强啡肽/κ-阿片受体(KOR)系统。强啡肽/KOR系统调节痛觉、负面影响和成瘾行为。在此,我们综述了强啡肽/KOR信号在阿片类药物戒断诱导的痛觉过敏和快感缺失中的临床前证据。
在阿片类药物依赖模型中,强啡肽/KOR系统的药理学和基因干预可减轻戒断的躯体和动机症状以及成瘾样行为,突出了其治疗潜力。了解强啡肽/KOR信号、痛觉过敏、快感缺失和成瘾之间复杂的相互作用,为阿片类药物使用障碍和其他物质使用障碍的治疗策略提供了新的见解。
需要进一步研究以阐明强啡肽/KOR信号性别差异的精确机制,并确定有针对性的干预措施,以减轻痛觉过敏和快感缺失,并促进成瘾康复。