The opioid system in depression.
The opioid system in depression.
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抑郁症中的阿片系统
DOI：
10.1016/j.neubiorev.2022.104800
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发表时间：
2022-09
影响因子：
8.2
通讯作者：
Mehta, Mitul A.
中科院分区：
文献类型：
--
作者：
Jelen, Luke A.;Stone, James M.;Young, Allan H.;Mehta, Mitul A.
关键词：
阿片受体广泛分布在整个大脑中，在调节人类情绪、奖励和幸福感方面发挥着重要作用。越来越多的证据表明内源性阿片系统在抑郁症中失调，μ、δ 和 kappa 阿片受体的药理调节剂具有治疗抑郁症的潜力。在这里，我们回顾了动物和临床数据，重点支持以下证据：抑郁症中阿片类药物系统的失调，阿片类药物调节行为过程和与抑郁症相关的大脑区域的证据，以及抗抑郁反应中阿片类药物调节的证据。我们评估了检查阿片类药物治疗抑郁症的安全性和有效性的临床试验，并考虑阿片类药物系统如何参与其他治疗的效果，包括氯胺酮，目前已知氯胺酮通过非阿片类药物作用发挥抗抑郁作用。最后，我们探讨了阿片类药物系统参与潜在治疗效果背后的关键神经化学和分子机制，这为进一步研究抑郁症治疗中的相关靶点提供了理论基础。阿片受体亚型调节情绪相关过程，包括奖励、动机和社会行为。阿片类药物系统与情绪处理有关，并且该系统在抑郁症中失调。 MOR/KOR 激动剂-拮抗剂组合显示出抗抑郁功效的早期迹象，同时最大限度地降低了滥用风险。 DOR 选择性激动剂和 KOR 选择性拮抗剂可能是 MDD 的可行治疗选择，且没有成瘾风险。需要进一步的工作来了解阿片类药物系统在调节现有抗抑郁药（如氯胺酮）的作用中的作用。
Opioid receptors are widely distributed throughout the brain and play an essential role in modulating aspects of human mood, reward, and well-being. Accumulating evidence indicates the endogenous opioid system is dysregulated in depression and that pharmacological modulators of mu, delta, and kappa opioid receptors hold potential for the treatment of depression. Here we review animal and clinical data, highlighting evidence to support: dysregulation of the opioid system in depression, evidence for opioidergic modulation of behavioural processes and brain regions associated with depression, and evidence for opioidergic modulation in antidepressant responses. We evaluate clinical trials that have examined the safety and efficacy of opioidergic agents in depression and consider how the opioid system may be involved in the effects of other treatments, including ketamine, that are currently understood to exert antidepressant effects through non-opioidergic actions. Finally, we explore key neurochemical and molecular mechanisms underlying the potential therapeutic effects of opioid system engagement, that together provides a rationale for further investigation into this relevant target in the treatment of depression. Opioid receptor subtypes, regulate mood-related processes including reward, motivation, and social behaviours. The opioid system is implicated in emotional processing and this system is dysregulated in depression. MOR/KOR agonist-antagonist combinations show early indication of antidepressant efficacy, while minimising the risk of abuse liability. DOR selective agonists and KOR selective antagonists, may be viable treatment options for MDD, without the risk of addiction. Further work is needed to understand the role of the opioid system in modulating the effects of existing antidepressants, such as ketamine.
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影响因子：
3.3
作者：
Chen, W.;McRoberts, J. A.;Marvizon, J. C. G.
通讯作者：
Marvizon, J. C. G.
影响因子：
4.7
作者：
Bertoletti, Eleonora;Zanoni, Annalisa;Battaglia, Marco
通讯作者：
Battaglia, Marco
影响因子：
5
作者：
BAAMONDE, A;DAUGE, V;ROQUES, BP
通讯作者：
ROQUES, BP
DOI：
10.1530/acta.0.1140509
发表时间：
1987-04-01
期刊：
ACTA ENDOCRINOLOGICA
影响因子：
--
作者：
ALLOLIO, B;SCHULTE, HM;WINKELMANN, W
通讯作者：
WINKELMANN, W
影响因子：
4.7
作者：
Bilecki, W;Wawrzczak-Bargiela, A;Przewlocki, R
通讯作者：
Przewlocki, R