Blunted Opiate Modulation of Hypothalamic-Pituitary-Adrenocortical Activity in Men and Women Who Smoke
Blunted Opiate Modulation of Hypothalamic-Pituitary-Adrenocortical Activity in Men and Women Who Smoke
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DOI：
10.1097/psy.0b013e31818434ab
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发表时间：
2008-10-01
影响因子：
3.3
通讯作者：
Westra, Ruth
中科院分区：
文献类型：
--
作者：
Al'Absi, Mustafa;Wittmers, Lorentz E.;Westra, Ruth
目的：探讨尼古丁依赖在多大程度上改变内源性阿片类药物对下丘脑-垂体-肾上腺皮质（HPA）轴功能的调节。内源性阿片类药物在调节情绪、疼痛和药物奖励方面发挥着重要作用。它们还调节 HPA 功能。之前的研究表明，依赖吸烟者的 HPA 对心理压力的反应异常。方法：吸烟者和非吸烟者（总共 n = 48 名参与者）使用双盲设计完成了两次疗程，期间服用安慰剂或 50 毫克纳曲酮。血液和唾液样本、心血管和情绪测量是在静息吸收期、暴露于两种有害刺激后以及延长的恢复期内获得的。在两次治疗中均评估了热痛阈值和耐受性。参与者还对 90 秒冷加压测试期间的疼痛进行了评分。结果：阿片类药物阻断增加促肾上腺皮质激素、血浆皮质醇和唾液皮质醇水平；这些增加因暴露于有害刺激而增强。与不吸烟者相比，吸烟者的这些反应减弱。吸烟者报告的疼痛往往比不吸烟者少，而女性在两种疼痛手术中报告的疼痛更多。尽管疼痛的性别差异仅在非吸烟者中显着。结论：我们得出结论，尼古丁依赖与阿片类药物对 HPA 的调节作用减弱有关。这种失调可能在之前观察到的依赖吸烟者对压力的反应迟钝中发挥了作用。
Objective: To examine the extent to which nicotine dependence alters endogenous opioid regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis functions. Endogenous opiates play an important role in regulating mood, pain, and drug reward. They also regulate the HPA functions. Previous work has demonstrated an abnormal HPA response to psychological stress among dependent smokers. Methods: Smokers and nonsmokers (total n = 48 participants) completed two sessions during which a placebo or 50 mg of naltrexone was administered, using a double-blind design. Blood and saliva samples, cardiovascular and mood measures were obtained during a resting absorption period, after exposure to two noxious stimuli, and during an extended recovery period. Thermal pain threshold and tolerance were assessed in both sessions. Participants also rated pain during a 90-second cold pressor test. Results: Opioid blockade increased adrenocorticotropin, plasma cortisol, and salivary cortisol levels; these increases were enhanced by exposure to the noxious stimuli. These responses were blunted in smokers relative to nonsmokers. Smokers tended to report less pain than nonsmokers, and women reported more pain during both pain procedures. although sex differences in pain were significant only among nonsmokers. Conclusions: We conclude that nicotine dependence is associated with attenuated opioid modulation of the HPA. This dysregulation may play a role in the previously observed blunted responses to stress among dependent smokers.