Stress and the HPA axis: role of glucocorticoids in alcohol dependence.
Stress and the HPA axis: role of glucocorticoids in alcohol dependence.
复制标题
DOI：
--
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
M. Stephens;G. Wand
中科院分区：
文献类型：
--
作者：
M. Stephens;G. Wand
长期以来，压力一直被认为是不受控制的饮酒和复发的重要相关因素。下丘脑-垂体-肾上腺（HPA）轴可能参与了这一过程，特别是被称为糖皮质激素的应激激素，主要是皮质醇。这种激素系统的活动通常受到严格的调节，以确保身体能够迅速对压力事件做出反应，并迅速恢复正常状态。HPA轴活性的主要决定因素是遗传背景、早期生活环境和当前生活压力。HPA轴调节的改变与有问题的酒精使用和依赖有关;然而，这种调节障碍的性质似乎随酒精依赖的阶段而变化。大部分研究都特别关注皮质醇在慢性酒精使用的风险，发展和复发中的作用。这些研究发现，皮质醇可以与大脑的奖励系统相互作用，这可能有助于酒精的强化作用。皮质醇还可以影响一个人的认知过程，促进基于习惯的学习，这可能有助于习惯的形成和复发的风险。最后，戒酒期间的皮质醇水平可能是酒精依赖者复发脆弱性的有用临床指标。
Stress has long been suggested to be an important correlate of uncontrolled drinking and relapse. An important hormonal response system to stress-the hypothalamic-pituitary-adrenal (HPA) axis-may be involved in this process, particularly stress hormones known as glucocorticoids and primarily cortisol. The actions of this hormone system normally are tightly regulated to ensure that the body can respond quickly to stressful events and return to a normal state just as rapidly. The main determinants of HPA axis activity are genetic background, early-life environment, and current life stress. Alterations in HPA axis regulation are associated with problematic alcohol use and dependence; however, the nature of this dysregulation appears to vary with respect to stage of alcohol dependence. Much of this research has focused specifically on the role of cortisol in the risk for, development of, and relapse to chronic alcohol use. These studies found that cortisol can interact with the brain's reward system, which may contribute to alcohol's reinforcing effects. Cortisol also can influence a person's cognitive processes, promoting habit-based learning, which may contribute to habit formation and risk of relapse. Finally, cortisol levels during abstinence may be useful clinical indicators of relapse vulnerability in alcohol-dependent people.