Opioid Mechanisms and the Treatment of Depression.
Opioid Mechanisms and the Treatment of Depression.
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阿片类药物机制和抑郁症的治疗。
DOI：
10.1007/7854_2023_448
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发表时间：
2023
影响因子：
--
通讯作者：
Jelen LA
中科院分区：
文献类型：
--
作者：
Jelen LA
阿片受体在大脑中广泛表达，阿片系统在调节情绪、奖励处理和压力反应方面发挥着关键作用。越来越多的证据表明，内源性阿片系统可能在抑郁症中失调，而针对 mu、delta 和 kappa 阿片受体的药物治疗可能显示出抗抑郁潜力。阿片类药物系统参与治疗作用的机制很复杂，而且可能是多因素的。本章探讨了阿片类药物系统的调节可能影响抑郁症的各种途径。这些包括对单胺能系统的影响、压力调节和下丘脑-垂体-肾上腺轴、免疫系统和炎症、脑源性神经营养因子、神经发生和神经可塑性、社会疼痛和社会奖励，以及预期和安慰剂效应。更好地了解阿片类药物系统调节可改善抑郁症状的不同机制，最终有助于为难以治疗的抑郁症患者开发安全有效的替代疗法。
Opioid receptors are widely expressed in the brain, and the opioid system has a key role in modulating mood, reward processing and stress responsivity. There is mounting evidence that the endogenous opioid system may be dysregulated in depression and that drug treatments targeting mu, delta and kappa opioid receptors may show antidepressant potential. The mechanisms underlying the therapeutic effects of opioid system engagement are complex and likely multi-factorial. This chapter explores various pathways through which the modulation of the opioid system may influence depression. These include impacts on monoaminergic systems, the regulation of stress and the hypothalamic-pituitary-adrenal axis, the immune system and inflammation, brain-derived neurotrophic factors, neurogenesis and neuroplasticity, social pain and social reward, as well as expectancy and placebo effects. A greater understanding of the diverse mechanisms through which opioid system modulation may improve depressive symptoms could ultimately aid in the development of safe and effective alternative treatments for individuals with difficult-to-treat depression.