RESUMEN
Heroin addiction and withdrawal influence multiple physiological functions, including immune responses, but the mechanism remains largely elusive. The objective of this study was to investigate the molecular inflammatory interactome, particularly the cytokines and transcriptome regulatory network in heroin addicts undergoing withdrawal, compared to healthy controls (HCs). Twenty-seven cytokines were simultaneously assessed in 41 heroin addicts, including 20 at the acute withdrawal (AW) stage and 21 at the protracted withdrawal (PW) stage, and 38 age- and gender-matched HCs. Disturbed T-helper(Th)1/Th2, Th1/Th17, and Th2/Th17 balances, characterized by reduced interleukin (IL)-2, elevated IL-4, IL-10, and IL-17A, but normal TNF-α, were present in the AW subjects. These imbalances were mostly restored to the baseline at the PW stage. However, the cytokines TNF-α, IL-2, IL-7, IL-10, and IL-17A remained dysregulated. This study also profiled exosomal long non-coding RNA (lncRNA) and mRNA in the plasma of heroin addicts, constructed co-expression gene regulation networks, and identified lncRNA-mRNA-pathway pairs specifically associated with alterations in cytokine profiles and Th1/Th2/Th17 imbalances. Altogether, a large amount of cytokine and exosomal lncRNA/mRNA expression profiling data relating to heroin withdrawal was obtained, providing a useful experimental and theoretical basis for further understanding of the pathogenic mechanisms of withdrawal symptoms in heroin addicts.
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Ácidos Nucleicos Libres de Células/sangre , Citocinas/sangre , Consumidores de Drogas , Vesículas Extracelulares/metabolismo , Dependencia de Heroína/sangre , ARN Largo no Codificante/sangre , ARN Mensajero/sangre , Síndrome de Abstinencia a Sustancias/sangre , Subgrupos de Linfocitos T/metabolismo , Adulto , Biomarcadores/sangre , Estudios de Casos y Controles , Ácidos Nucleicos Libres de Células/genética , Vesículas Extracelulares/genética , Perfilación de la Expresión Génica , Redes Reguladoras de Genes , Dependencia de Heroína/genética , Dependencia de Heroína/inmunología , Humanos , Masculino , Persona de Mediana Edad , Fenotipo , ARN Largo no Codificante/genética , ARN Mensajero/genética , Síndrome de Abstinencia a Sustancias/genética , Síndrome de Abstinencia a Sustancias/inmunología , Subgrupos de Linfocitos T/inmunología , Factores de Tiempo , Transcriptoma , Adulto JovenRESUMEN
BACKGROUND: Heroin addiction and withdrawal have been associated with an increased risk for infectious diseases and psychological complications. However, the changes of metabolites in heroin addicts during withdrawal remain largely unknown. METHODS: A total of 50 participants including 20 heroin addicts with acute abstinence stage, 15 with protracted abstinence stage and 15 healthy controls, were recruited. We performed metabolic profiling of plasma samples based on ultraperformance liquid chromatography coupled to tandem mass spectrometry to explore the potential biomarkers and mechanisms of heroin withdrawal. RESULTS: Among the metabolites analyzed, omega-6 polyunsaturated fatty acids (linoleic acid, dihomo-gamma-linolenic acid, arachidonic acid, n-6 docosapentaenoic acid), omega-3 polyunsaturated fatty acids (docosahexaenoic acid, docosapentaenoic acid), aromatic amino acids (phenylalanine, tyrosine, tryptophan), and intermediates of the tricarboxylic acid cycle (oxoglutaric acid, isocitric acid) were significantly reduced during acute heroin withdrawal. Although majority of the metabolite changes could recover after months of withdrawal, the levels of alpha-aminobutyric acid, alloisoleucine, ketoleucine, and oxalic acid do not recover. CONCLUSIONS: In conclusion, the plasma metabolites undergo tremendous changes during heroin withdrawal. Through metabolomic analysis, we have identified links between a framework of metabolic perturbations and withdrawal stages in heroin addicts.
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Dependencia de Heroína/sangre , Heroína/toxicidad , Metabolómica , Síndrome de Abstinencia a Sustancias/sangre , Adulto , Aminoácidos Aromáticos/sangre , Biomarcadores/sangre , Estudios de Casos y Controles , Ácidos Grasos Omega-3/sangre , Ácidos Grasos Omega-6/sangre , Humanos , Masculino , Ácidos Tricarboxílicos/sangreRESUMEN
Cannabis is the most frequently used federally illicit substance in the United States. However, there are currently no FDA-approved pharmacotherapies to mitigate the withdrawal symptoms associated with cessation in heavy users. A promising, readily available, non-cannabinoid therapy are the gabapentinoids. Although currently approved for epilepsy and neuropathic pain, gabapentinoids are increasingly used for their "off-label" efficacy in treating various psychiatric conditions and substance abuse. Gabapentin (GBP) synergizes with cannabinoid agonism in neuropathic pain models, substitutes for Δ9-tetrahydrocannabinol (THC) in drug discrimination procedures, and reduced withdrawal symptoms in an outpatient clinical trial. However, there are limited data on the biological plausibility of the therapeutic action of gabapentinoids in cannabinoid withdrawal in preclinical models. The purpose of the current study was to determine the efficacy of GBP on attenuating THC withdrawal in mice, using an array of tests targeting withdrawal-induced and withdrawal-suppressed behaviors. Separate cohorts of male and female mice were administered THC (10 mg/kg, s.c.) or vehicle for 5.5 days, and withdrawal was precipitated by the CB1 antagonist rimonabant (2 or 3 mg/kg, i.p.) on the sixth day. GBP (≥10 mg/kg) reduced somatic signs of withdrawal (i.e., paw tremors and head twitches), but had no effect in locomotor activity or conditioned place preference. GBP (50 mg/kg) also restored withdrawal-suppressed responding on a progressive ratio reinforcement schedule. However, GBP (50 mg/kg) had no effect in withdrawal-suppressed marble burying or tail suspension struggling and did not normalize the stress response induced by THC withdrawal, as indicated by plasma corticosterone. These data suggest gabapentin may be effective at treating cannabinoid withdrawal symptoms including somatic and affective symptoms but may act independently of endocrine stress activation.
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Conducta Animal/efectos de los fármacos , Agonistas de Receptores de Cannabinoides/efectos adversos , Dronabinol/efectos adversos , Gabapentina/farmacología , Locomoción/efectos de los fármacos , Síndrome de Abstinencia a Sustancias/fisiopatología , Animales , Antagonistas de Receptores de Cannabinoides/farmacología , Corticosterona/sangre , Abuso de Marihuana , Ratones , Rimonabant/farmacología , Síndrome de Abstinencia a Sustancias/sangre , Síndrome de Abstinencia a Sustancias/etiología , Temblor/inducido químicamente , Temblor/fisiopatologíaRESUMEN
Background: The pathogenesis of methamphetamine usedisorders (MUDs) remains largely unknown; however, bile acids may play arole as potential mediators of liver injury and psychiatric comorbidities.The aim of this study was to characterize bile acid (BA) profiles in plasmaof patients with MUDs undergoing withdrawal. Methods: Liver functions and psychiatric symptoms wereevaluated in a retrospective cohort (30 MUDs versus 30 control subjects) andan exploratory cohort (30 MUDs including 10 subjects each at the 7-day,3-month, and 12-month withdrawal stages versus 10 control subjects). BAcompositions in plasma samples from MUD patients in the exploratory cohortwere determined by gas-liquid chromatography. Results: Both psychiatric comorbidities andmethamphetamine-induced liver injury were observed in patients in both MUDcohorts. The plasma concentrations of the total BA, cholic acid (CA), andchenodeoxycholic acid (CDCA) were lower in MUD patients relative tocontrols. The maximum decline was observed at the 3-month stage, withgradual recovery at the 12-month stage. Notably, the ratios of deoxycholicacid (DCA)/CA and lithocholic acid (LCA)/CDCA were statistically significantat the 3-month stage comparing with controls. Significant correlations werefound between the LCA/CDCA and taurolithocholic acid (TLCA)/CDCA ratios andthe levels of alanine transaminase and aspartate aminotransferase, andbetween the LCA/CDCA ratio and the HAM-A score. Conclusion: BA profile during METH withdrawal weremarkedly altered, with these unbalanced BAs being associated with liverinjury. The associations between BA profiles and psychiatric symptomssuggest an association between specific BAs and disease progression,possibly through the liver-brain axis.
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Ácidos y Sales Biliares/sangre , Hígado/lesiones , Trastornos Mentales/sangre , Metanfetamina/efectos adversos , Síndrome de Abstinencia a Sustancias/sangre , Adulto , Humanos , Masculino , Trastornos Mentales/complicaciones , Persona de Mediana Edad , Estudios Retrospectivos , Síndrome de Abstinencia a Sustancias/complicacionesRESUMEN
Orexin has been suggested to play a role in regulating the reward circuits and enhancing drug-seeking behaviors; however, its role in methamphetamine (METH) addiction remains unclear. We previously found that blood orexin-A levels are upregulated in individuals with recent METH exposure. Whether the levels would be altered following withdrawal is unknown. In this study, we compared the levels of serum orexin-A in individuals who use METH between the acute withdrawal (AW) phase and the subacute withdrawal (SAW) phase at baseline (T1) and examined the alterations in these levels after 2 weeks of abstinence (T2). In total, 60 participants (51 men and 9 women) were enrolled in the study; 20 participants with METH-positive urine test results were included in the AW group, and 40 participants with METH-negative urine test results who had self-reportedly last taken METH within the preceding 1-2 months were included in the SAW group. Serum orexin-A levels were measured using enzyme-linked immunosorbent assay. No significant differences in orexin-A levels were observed between the AW and SAW groups at baseline (p = .06). After 2 additional weeks of abstinence, the levels decreased significantly in the SAW group (0.58 ± 0.13 ng/mL) but not in the AW group (0.50 ± 0.14 ng/mL, p = .004). Our results demonstrated that orexin-A levels might decrease after a longer period of METH withdrawal, indicating that the orexin system is dysregulated in the addictive process of METH. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Trastornos Relacionados con Anfetaminas , Estimulantes del Sistema Nervioso Central , Metanfetamina , Síndrome de Abstinencia a Sustancias , Comportamiento de Búsqueda de Drogas , Femenino , Humanos , Masculino , Orexinas/sangre , Síndrome de Abstinencia a Sustancias/sangreRESUMEN
OBJECTIVE: It is unclear if stopping treatment with dabigatran, a new oral anticoagulant (NOAC), induces a paradoxical rebound prothrombotic state. We investigated if short-term (1-3 days) dabigatran cessation is associated with a higher thrombus volume than expected from a simple reversal of the anticoagulant effect. METHODS: Ten-week-old C57Bl/6 mice (n = 338) received one of the following oral treatments: phosphate-buffered saline (PBS), dabigatran for 7 days with or without 1 to 4 day cessation, and aspirin in either a single dose or daily for 7 days. Some of the animals that ceased dabigatran for 1 to 3 days received single-dose aspirin. Thereafter, we induced FeCl3 -mediated carotid thrombosis in 130 mice, after which we performed micro computed tomography thrombus imaging. The other 208 mice underwent coagulation assays or platelet function tests. As an explorative pilot study, we reviewed the medical records of 18 consecutive patients with NOAC cessation-related cerebral infarction in a large acute stroke cohort. RESULTS: We observed a ~ 40% higher volume of carotid thrombus after dabigatran cessation at 1 to 3 days than after vehicle treatment and showed that this effect could be prevented by single-dose aspirin pretreatment. Dabigatran cessation unduly increased platelet aggregability for 2 days after drug cessation, an effect mediated through thrombin or arachidonic acid, which effect was significantly attenuated by single-dose aspirin pretreatment. In patients, short-term (≤ 3 days) cessation of NOAC therapy, compared with longer-term (≥ 5 days) cessation, tended to be associated with relatively high stroke severity. INTERPRETATION: We provide the first preclinical evidence that a rebound prothrombotic state follows short-term cessation of dabigatran therapy. ANN NEUROL 2021;89:444-458.
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Antitrombinas/efectos adversos , Trombosis de las Arterias Carótidas/diagnóstico por imagen , Dabigatrán/efectos adversos , Deprescripciones , Agregación Plaquetaria/efectos de los fármacos , Síndrome de Abstinencia a Sustancias/sangre , Trombofilia/sangre , Anciano , Anciano de 80 o más Años , Animales , Antitrombinas/farmacología , Ácido Araquidónico/sangre , Aspirina/farmacología , Trombosis de las Arterias Carótidas/inducido químicamente , Trombosis de las Arterias Carótidas/prevención & control , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/etiología , Infarto Cerebral/fisiopatología , Infarto Cerebral/prevención & control , Cloruros/toxicidad , Angiografía por Tomografía Computarizada , Dabigatrán/farmacología , Inhibidores del Factor Xa/efectos adversos , Femenino , Compuestos Férricos/toxicidad , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/etiología , Accidente Cerebrovascular Isquémico/fisiopatología , Accidente Cerebrovascular Isquémico/prevención & control , Angiografía por Resonancia Magnética , Masculino , Volúmen Plaquetario Medio , Ratones , Noxas/toxicidad , Proyectos Piloto , Inhibidores de Agregación Plaquetaria/farmacología , Recuento de Plaquetas , Pirazoles/efectos adversos , Piridonas/efectos adversos , Rivaroxabán/efectos adversos , Índice de Severidad de la Enfermedad , Síndrome de Abstinencia a Sustancias/etiología , Síndrome de Abstinencia a Sustancias/prevención & control , Trombina/metabolismo , Trombofilia/etiología , Trombofilia/prevención & control , Microtomografía por Rayos XRESUMEN
Misuse of prescription medications has risen to popularity. Reasons for this practice include the self-medication of sleep and psychiatric disorders and attempts to counteract the dysphoric side effects of stimulant drugs. Clonazepam, a commonly prescribed benzodiazepine, has been increasingly used as a countermeasure to cocaine side-effects, including sleep reduction and anxiety. As both substances may impair sleep and aggravate psychiatric conditions, this study aimed to evaluate the long-term effects of the interaction of clonazepam and cocaine on anxiety-like behavior, and the short-term effects of this drug combination on sleep using male Wistar rats. Animals received saline, cocaine (15 mg/kg), clonazepam (1.25 mg/kg) or both drugs for 16 days. Sleep recording was performed on the first day of treatment to evaluate acute treatment effects. One day after the end of the treatment period, the open field and elevated plus-maze tests were used to assess anxiety-like behavior. Blood samples were collected for analysis of corticosterone levels. Rats receiving both drugs presented an increase in impulsivity when moving between arms in the elevated plus-maze and a reduction in exploratory behavior in the open field test. These findings suggest the presence of a withdrawal behavioral syndrome, which can manifest as a paradoxical increase in exploratory activity after a period without receiving the drug and may indicate the development of dependence. Combined treatment reduced paradoxical sleep time and increased its onset latency. There was no significant difference regarding corticosterone levels across any group. Our results contribute to the understanding of the risks of combining cocaine and clonazepam. Association of these drugs may impair sleep architecture and aggravate the dependence symptoms already seen when these substances are used separately. These findings may be useful in helping to counteract the impairments resulting from the combined use of these 2 substances and to raise awareness of these associated risks.
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Ansiedad/inducido químicamente , Conducta Animal/efectos de los fármacos , Clonazepam/efectos adversos , Clonazepam/farmacología , Cocaína/efectos adversos , Cocaína/farmacología , Sueño REM/efectos de los fármacos , Síndrome de Abstinencia a Sustancias/etiología , Animales , Ansiedad/sangre , Clonazepam/administración & dosificación , Cocaína/administración & dosificación , Corticosterona/sangre , Conducta Exploratoria/efectos de los fármacos , Masculino , Prueba de Campo Abierto/efectos de los fármacos , Ratas , Ratas Wistar , Síndrome de Abstinencia a Sustancias/sangreRESUMEN
Brain-Derived Neurotrophic Factor (BDNF) is a neuropeptide that plays an important role in Central Nervous System development, plasticity, learning, and memory. Its role has been explored in alcohol-dependent patients, though the results have been inconclusive. Thus, we aimed to compare serum BDNF levels in alcohol-dependent patients during withdrawal with age and gender matched controls, and assess changes in BDNF levels in the initial abstinence period. BDNF levels of alcohol-dependent patients (n = 25) were compared with controls (n = 25) at baseline. Additionally, BDNF levels were measured in cases on days 5 and 10 of inpatient detoxification. BDNF levels of controls did not differ with cases on day 1, 5, or 10. But BDNF levels increased significantly during alcohol abstinence from baseline to day 10 (Pillai's Trace F = 3.753, p = .039, partial η2 = 0.246), which may suggest its protective role. Thus, serum BDNF values may be potentially used as a biomarker to assess the abstinence state. However, longitudinal studies in different body samples is essential to better understand the role of BDNF in alcohol dependence.
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Alcoholismo/sangre , Factor Neurotrófico Derivado del Encéfalo/sangre , Síndrome de Abstinencia a Sustancias/sangre , Adolescente , Adulto , Anciano , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Introduction The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has a key role in drug addiction susceptibility. In addition to the well-known relationship between cortisol and the HPA axis, other molecules are involved with stress response and could modify the HPA activation, such as the neuropeptide Y (NPY), which has anxiolytic proprieties. There are few studies evaluating the effect of NPY levels on addiction, especially in crack cocaine dependence. Objective To evaluate NPY in crack users during early withdrawal to determine its relationship with drug use and cortisol levels. Methods We analyzed 25 male inpatient crack users. Serum NPY levels were measured at admission and discharge (mean of 24 days). Morning salivary cortisol was measured at admission. Results Serum NPY levels at admission and discharge were very similar. Lower NPY levels at discharge were associated with higher lifetime crack use. Also, a negative correlation was found between morning cortisol and delta NPY (NPY discharge - NPY admission). Conclusion These preliminary findings indicate that crack use influences the modulation of NPY levels and modifies stress response. The NPY pathway may play an important role in the pathophysiology of crack addiction, and the anxiolytic effect of NPY may be impaired in crack users. Future studies should consider NPY as a measurable indicator of the biological state in addiction.
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Trastornos Relacionados con Cocaína/sangre , Cocaína Crack , Hidrocortisona/sangre , Neuropéptido Y/sangre , Estrés Psicológico/sangre , Síndrome de Abstinencia a Sustancias/sangre , Adulto , Humanos , Pacientes Internos , Masculino , Persona de Mediana EdadRESUMEN
AIMS: Rodent studies propose potential mechanisms linking excessive drinking and pain hypersensitivity (hyperalgesia), such that stress hormones (i.e. epinephrine and cortisol) mediate induction and maintenance of alcohol withdrawal-induced hyperalgesia. The first aim of this study was to examine whether hyperalgesia would occur within 48 h after a drinking episode in healthy young adult binge drinkers. The second was to examine whether stress hormones and negative effect would be associated with binge drinking or alcohol withdrawal-associated hyperalgesia. METHODS: A cross-sectional experiment was conducted in five groups with naturally occurring drinking (mean age = 19.6, range 18-29 years): abstainers (n = 43, 54% female), moderate drinkers with (n = 50, 50% female) or without recent drinking (i.e. within 48 h, n = 23, 26% female) and binge drinkers with (n = 36, 58% female) or without recent drinking (n = 25, 44% female). All types of drinkers endorsed drinking about 2-3 times a month and 2-3 years of drinking history. RESULTS: Muscle pressure pain thresholds were significantly lower in the binge group with recent drinking compared to other groups, but cutaneous mechanical and heat pain thresholds were not significantly different across the five groups. Basal epinephrine levels were significantly higher in binge groups regardless of recent drinking, but cortisol and negative effect were not significantly different across the five groups. CONCLUSIONS: This is the first study to show that alcohol withdrawal-associated muscle hyperalgesia may occur in healthy episodic binge drinkers with only 2-3 years of drinking history, and epinephrine may play a role in binge drinking-associated hyperalgesia.
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Consumo Excesivo de Bebidas Alcohólicas/complicaciones , Consumo Excesivo de Bebidas Alcohólicas/diagnóstico , Hiperalgesia/diagnóstico , Hiperalgesia/etiología , Síndrome de Abstinencia a Sustancias/diagnóstico , Síndrome de Abstinencia a Sustancias/etiología , Adolescente , Adulto , Consumo Excesivo de Bebidas Alcohólicas/sangre , Estudios Transversales , Epinefrina/sangre , Femenino , Estudios de Seguimiento , Humanos , Hidrocortisona/sangre , Hiperalgesia/sangre , Masculino , Síndrome de Abstinencia a Sustancias/sangre , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Abstract Introduction The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has a key role in drug addiction susceptibility. In addition to the well-known relationship between cortisol and the HPA axis, other molecules are involved with stress response and could modify the HPA activation, such as the neuropeptide Y (NPY), which has anxiolytic proprieties. There are few studies evaluating the effect of NPY levels on addiction, especially in crack cocaine dependence. Objective To evaluate NPY in crack users during early withdrawal to determine its relationship with drug use and cortisol levels. Methods We analyzed 25 male inpatient crack users. Serum NPY levels were measured at admission and discharge (mean of 24 days). Morning salivary cortisol was measured at admission. Results Serum NPY levels at admission and discharge were very similar. Lower NPY levels at discharge were associated with higher lifetime crack use. Also, a negative correlation was found between morning cortisol and delta NPY (NPY discharge - NPY admission). Conclusion These preliminary findings indicate that crack use influences the modulation of NPY levels and modifies stress response. The NPY pathway may play an important role in the pathophysiology of crack addiction, and the anxiolytic effect of NPY may be impaired in crack users. Future studies should consider NPY as a measurable indicator of the biological state in addiction.
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Adulto , Humanos , Masculino , Persona de Mediana Edad , Estrés Psicológico/sangre , Síndrome de Abstinencia a Sustancias/sangre , Neuropéptido Y/sangre , Hidrocortisona/sangre , Cocaína Crack , Trastornos Relacionados con Cocaína/sangre , Pacientes InternosAsunto(s)
Desamino Arginina Vasopresina/efectos adversos , Hipernatremia/inducido químicamente , Hipopituitarismo/tratamiento farmacológico , Síndrome de Abstinencia a Sustancias/diagnóstico , Adulto , Craneofaringioma/cirugía , Desamino Arginina Vasopresina/administración & dosificación , Esquema de Medicación , Femenino , Humanos , Hipernatremia/sangre , Hipernatremia/diagnóstico , Hipopituitarismo/sangre , Hipopituitarismo/diagnóstico , Examen Neurológico/efectos de los fármacos , Neoplasias Hipofisarias/cirugía , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/diagnóstico , Sodio/sangre , Síndrome de Abstinencia a Sustancias/sangreRESUMEN
OBJECTIVE: Withdrawal symptoms are common during methamphetamine (METH) abstinence. This study aimed to explore the association between serum interleukins and withdrawal symptoms during METH abstinence. METHODS: This study recruited 120 METH users, and 94 of them completed the 2-week follow-up. Serum interleukin-1ß, 6,8,10 were tested at admission. Withdrawal symptoms were assessed by the Methamphetamine Withdrawal Questionnaire (MAWQ). RESULTS: Serum IL-8 levels were positively correlated with MAWQ scores at the 2-week endpoint (r = .257, p = .013). The variation of the MAWQ scores during the 2-week follow-up was negatively correlated with serum IL-8 levels at admission (r = -.249, p = .026). Serum IL-8 levels remained associated with the severity of METH withdrawal symptoms (ß = .363, p = .023), after adjusting for potential confounders. LIMITATIONS: This study did not include normal controls. Most patients were male and cigarette smokers. Patients were only followed up for 2 weeks, and their toxicology data were not collected. Interleukins were only measured at admission, and were tested in serum, not in the cerebrospinal fluid. CONCLUSIONS: Our study demonstrated that higher serum IL-8 levels may predict more severe withdrawal symptoms at 2 weeks after METH abstinence.
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Trastornos Relacionados con Anfetaminas/rehabilitación , Interleucina-8/sangre , Metanfetamina/efectos adversos , Síndrome de Abstinencia a Sustancias/fisiopatología , Adulto , Trastornos Relacionados con Anfetaminas/sangre , Femenino , Estudios de Seguimiento , Humanos , Masculino , Metanfetamina/administración & dosificación , Estudios Prospectivos , Síndrome de Abstinencia a Sustancias/sangre , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Alcohol withdrawal syndrome (AWS) is a serious medical condition of high variability in alcohol use disorder (AUD) after drinking cessation. Identification of clinical biomarkers capable of detecting severe AWS is needed. While alcohol consumption and withdrawal are linked with lipid profile dysregulation, the relationship between lipid levels (high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides) and AWS is unknown. Therefore, this study investigated whether HDL-C, LDL-C, and triglycerides conferred risk for moderate-to-severe AWS symptoms in treatment-seeking individuals (n = 732) admitted to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) alcohol treatment program. Lipid levels were measured upon admission, and the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) assessed AWS severity for generating a three-level AWS typology (none-to-mild, moderate, and severe). Multivariable multinomial logistic regression examined whether lipid levels were associated with risk for moderate-to-severe AWS. We found significant predictive relationships between AWS and HDL-C, LDL-C, and triglycerides. While extremely high HDL-C (≥100 mg/dL) conferred the highest odds for moderate (4.405, 95% CI, 2.572-7.546, p < 0.001) and severe AWS (5.494, 95% CI, 3.541-8.523, p < 0.001), the lowest odds ratios for moderate AWS (0.493, 95% CI, 0.248-0.981, p = 0.044) and severe AWS (0.303, 95% CI, 0.223-0.411, p < 0.001) were associated with high LDL-C (≥160 mg/dL). The present study demonstrates that altered lipid levels, measured upon admission for inpatient AUD treatment, may help to predict which individuals are at risk for medically relevant moderate-to-severe AWS. This suggests that further research into the role of lipid biomarkers in AWS may be beneficial for identifying biologically determined risk profiles in AUD.
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Alcoholismo/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Síndrome de Abstinencia a Sustancias/sangre , Triglicéridos/sangre , Adulto , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Síndrome de Abstinencia a Sustancias/diagnósticoRESUMEN
Objective: To evaluate the association between childhood trauma (CT) and serum levels of brain-derived neurotrophic factor (BDNF) and thiobarbituric acid-reactive substances (TBARS) during crack-cocaine withdrawal. Method: Thirty-three male crack-cocaine users were recruited at admission to a public addiction treatment unit. Serum BDNF and TBARS levels were evaluated at intake and discharge. Information about drug use was assessed by the Addiction Severity Index-6th Version (ASI-6); CT was reported throughout the Childhood Trauma Questionnaire (CTQ). CTQ scores were calculated based on a latent analysis model that divided the sample into low-, medium-, and high-level trauma groups. Results: There was a significant increase in BDNF levels from admission to discharge, which did not differ across CT subgroups. For TBARS levels, we found a significant time vs. trauma interaction (F2,28 = 6.357, p = 0.005,ηp 2 = 0.312). In participants with low trauma level, TBARS decreased, while in those with a high trauma level, TBARS increased during early withdrawal. Conclusion: TBARS levels showed opposite patterns of change in crack-cocaine withdrawal according to baseline CT. These results suggest that CT could be associated with more severe neurological impairment during withdrawal.
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Humanos , Masculino , Femenino , Adulto , Adulto Joven , Síndrome de Abstinencia a Sustancias/psicología , Síndrome de Abstinencia a Sustancias/sangre , Sustancias Reactivas al Ácido Tiobarbitúrico/análisis , Factor Neurotrófico Derivado del Encéfalo/sangre , Trastornos Relacionados con Cocaína/psicología , Trastornos Relacionados con Cocaína/terapia , Adultos Sobrevivientes de Eventos Adversos Infantiles/psicología , Cocaína Crack , Trastornos Relacionados con Cocaína/sangreRESUMEN
The increasing abuse of opioids - such as oxycodone - poses major challenges for health and socioeconomic systems. Human prescription opioid abuse is marked by chronic, voluntary, oral intake and sex differences. To develop interventions, the field would benefit from a preclinical paradigm that similarly provides rodents with chronic, continuous, oral, voluntary and free-choice access to oxycodone. Here we show female and male rats voluntarily ingest and choose oxycodone over water and show both dependence and motivation to take oxycodone during a chronic oral voluntary, two-bottle choice, continuous access paradigm. Adult female and male Long-Evans rats were given unlimited, continuous homecage access to two bottles containing water (Control) or one bottle of water and one bottle of oxycodone dissolved in water (Experimental). Virtually all experimental rats voluntarily drank oxycodone (~10 mg/kg/day) and escalated their intake over 22 weeks. Females self-administered twice as much oxycodone by body weight (leading to higher blood levels of oxycodone) and engaged in more gnawing behavior of wooden blocks relative to males. Precipitated withdrawal revealed high levels of dependence in both sexes. Reflecting motivation to drink oxycodone, ascending concentrations of citric acid suppressed the intake of oxycodone (Experimental) and the intake of water (Control); however, Experimental rats returned to pre-citric acid preference levels whereas Controls rats did not. Pre-screening behaviors of rats on open field exploration predicted oxycodone intake. Thus, rats consumed and preferred oxycodone over time in this chronic two-bottle oral choice paradigm and both sexes displayed many features of human oxycodone abuse.
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Analgésicos Opioides/administración & dosificación , Conducta de Elección/efectos de los fármacos , Trastornos Relacionados con Opioides/psicología , Oxicodona/administración & dosificación , Caracteres Sexuales , Agua/administración & dosificación , Administración Oral , Analgésicos Opioides/sangre , Animales , Conducta de Elección/fisiología , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Masculino , Trastornos Relacionados con Opioides/sangre , Oxicodona/sangre , Ratas , Ratas Long-Evans , Autoadministración , Síndrome de Abstinencia a Sustancias/sangre , Síndrome de Abstinencia a Sustancias/psicologíaRESUMEN
Alcohol use disorder is one of the most disabling diseases worldwide. Glial-cell derived neurotrophic factor (Gdnf) shows promising results concerning the inhibition of alcohol consumption in rodent models. We investigated the epigenetic regulation of Gdnf following ethanol consumption and withdrawal in a rat model. 32 Wistar rats underwent 7 weeks of intermittent access to alcohol in a 2-bottle choice (IA2BC). Whole blood, Nucleus Accumbens (NAc) and Ventral Tegmental Area (VTA) were collected immediately after the last 24â¯h of an alcohol-drinking session (alcohol group, AG) or 24â¯h after withdrawal (withdrawal group, WG). MRNA levels were measured using real-time quantitative PCR. Bisulfite-conversion of DNA and capillary sequencing was used to determine methylation levels of the core promoter (CP) and the negative regulatory element (NRE). The CP of the AG in the NAc was significantly less methylated compared to controls (pâ¯<â¯0.05). In the NAc, mRNA expression was significantly higher in the WG (pâ¯<â¯0.05). In the WG, mRNA expression levels in the VTA were significantly lower (pâ¯<â¯0.05) and showed significantly less methylation in the NRE in the VTA (pâ¯<â¯0.001) and the NAc (pâ¯<â¯0.01) compared to controls. Changes in the cerebral mRNA expression correspond to alterations in DNA methylation of the Gdnf promoter in a rodent model. Our results hold clinical relevance since differences in Gdnf mRNA expression and DNA methylation could be a target for pharmacological interventions.
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Consumo de Bebidas Alcohólicas/metabolismo , Alcoholismo/metabolismo , Metilación de ADN , Epigénesis Genética , Factor Neurotrófico Derivado de la Línea Celular Glial/metabolismo , Núcleo Accumbens/metabolismo , Síndrome de Abstinencia a Sustancias/metabolismo , Área Tegmental Ventral/metabolismo , Consumo de Bebidas Alcohólicas/sangre , Alcoholismo/sangre , Animales , Modelos Animales de Enfermedad , Femenino , Masculino , ARN Mensajero/metabolismo , Ratas , Ratas Wistar , Síndrome de Abstinencia a Sustancias/sangreRESUMEN
AIMS: We investigated the cardiac effects of ethanol withdrawal and the possible role of AT1 receptors in such response. METHODS: Male Wistar rats were treated with increasing doses of ethanol (3 to 9%, vol./vol.) for 21 days. The cardiac effects of ethanol withdrawal were investigated 48 h after abrupt discontinuation of ethanol. Some animals were orally treated with losartan (10 mg/kg/day), a selective AT1 receptor antagonist. RESULTS: Ethanol withdrawal did not affect serum levels of creatine kinase (CK)-MB. Losartan prevented ethanol withdrawal-induced increase in superoxide anion (O2â¢-) production in the left ventricle (LV). However, ethanol withdrawal did no alter the levels of thiobarbituric acid reactive substances (TBARS) or the expression of Nox1, Nox2 or Nox4 were found in the LV. Ethanol withdrawal reduced the concentration of hydrogen peroxide (H2O2) in the LV and this response was prevented by losartan. Ethanol withdrawal increased catalase activity in the LV and losartan attenuated this response. No changes on superoxide dismutase (SOD) activity or expression were detected in the LV during ethanol withdrawal. The expression of AT1, AT2 or angiotensin converting enzyme (ACE) was not affected by ethanol withdrawal. Similarly, no changes on the expression of ERK1/2, SAPK/JNK, COX-1 or COX-2 were found in the LV during ethanol withdrawal. CONCLUSIONS: Ethanol withdrawal altered the cardiac oxidative state through AT1-dependent mechanisms. Our findings showed a role for angiotensin II/AT1 receptors in the initial steps of the cardiac effects induced by ethanol withdrawal.
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Etanol/efectos adversos , Ventrículos Cardíacos/metabolismo , Receptor de Angiotensina Tipo 1/biosíntesis , Síndrome de Abstinencia a Sustancias/metabolismo , Superóxidos/metabolismo , Animales , Catalasa/metabolismo , Forma MB de la Creatina-Quinasa/sangre , Ciclooxigenasa 1/biosíntesis , Ciclooxigenasa 2/biosíntesis , Peróxido de Hidrógeno/metabolismo , Losartán/farmacología , Masculino , Proteínas de la Membrana/biosíntesis , Proteína Quinasa 1 Activada por Mitógenos/biosíntesis , Proteína Quinasa 3 Activada por Mitógenos/biosíntesis , Proteína Quinasa 8 Activada por Mitógenos/biosíntesis , NADPH Oxidasas/biosíntesis , Peptidil-Dipeptidasa A/biosíntesis , Ratas , Receptor de Angiotensina Tipo 2/biosíntesis , Síndrome de Abstinencia a Sustancias/sangre , Síndrome de Abstinencia a Sustancias/prevención & control , Superóxido Dismutasa/metabolismo , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismoRESUMEN
RATIONALE: Non-contingent chronic nicotine exposure procedures have evolved rapidly in recent years, culminating in electronic nicotine delivery systems (ENDS or e-cigarettes) to deliver vaporized drugs to rodents in standard housing chambers. OBJECTIVES: The aim of the current work was to use ENDS to test concentration-dependent effects of nicotine e-cigarette vapor inhalation on blood-nicotine concentrations, blood-cotinine concentrations, and somatic withdrawal signs over time in rats. METHODS: Male Wistar rats were exposed to vapor containing various concentrations of nicotine (20, 40, 80 mg/mL) for 11 days through ENDS, and blood concentrations of nicotine and cotinine, the major proximate metabolite of nicotine, as well as spontaneous and precipitated somatic withdrawal signs, were measured over time (across days of exposure and over hours after termination of vapor exposure). RESULTS: Exposing male Wistar rats to non-contingent nicotine vapor inhalation through ENDS produces somatic withdrawal symptoms and measurable blood-nicotine and blood-cotinine levels that change according to (1) concentration of nicotine in vape solution, (2) number of days of nicotine vapor exposure, (3) time since termination of nicotine vapor exposure, and (4) relative to the withdrawal signs, whether withdrawal was spontaneous or precipitated (by mecamylamine). CONCLUSIONS: The data presented here provide parameters that can be used as a reasonable starting point for future work that employs ENDS to deliver non-contingent nicotine vapor in rats, although many parameters can and should be altered to match the specific goals of future work.
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Cotinina/sangre , Sistemas Electrónicos de Liberación de Nicotina , Nicotina/administración & dosificación , Nicotina/sangre , Síndrome de Abstinencia a Sustancias/sangre , Vapeo/sangre , Administración por Inhalación , Factores de Edad , Animales , Cámaras de Exposición Atmosférica/efectos adversos , Relación Dosis-Respuesta a Droga , Masculino , Síntomas sin Explicación Médica , Distribución Aleatoria , Ratas , Ratas Wistar , Síndrome de Abstinencia a Sustancias/psicología , Vapeo/efectos adversos , Vapeo/psicologíaRESUMEN
OBJECTIVE: To evaluate the association between childhood trauma (CT) and serum levels of brain-derived neurotrophic factor (BDNF) and thiobarbituric acid-reactive substances (TBARS) during crack-cocaine withdrawal. METHOD: Thirty-three male crack-cocaine users were recruited at admission to a public addiction treatment unit. Serum BDNF and TBARS levels were evaluated at intake and discharge. Information about drug use was assessed by the Addiction Severity Index-6th Version (ASI-6); CT was reported throughout the Childhood Trauma Questionnaire (CTQ). CTQ scores were calculated based on a latent analysis model that divided the sample into low-, medium-, and high-level trauma groups. RESULTS: There was a significant increase in BDNF levels from admission to discharge, which did not differ across CT subgroups. For TBARS levels, we found a significant time vs. trauma interaction (F2,28 = 6.357, p = 0.005,ηp 2 = 0.312). In participants with low trauma level, TBARS decreased, while in those with a high trauma level, TBARS increased during early withdrawal. CONCLUSION: TBARS levels showed opposite patterns of change in crack-cocaine withdrawal according to baseline CT. These results suggest that CT could be associated with more severe neurological impairment during withdrawal.