Oxycodone, Neonatal Opioid Withdrawal Syndrome, and Adult Abuse Liability

在过去的十年里，阿片类药物的使用和滥用急剧上升，导致了 出生时依赖阿片类药物的婴儿。这些婴儿中的许多人将经历新生儿阿片类药物 戒断综合征(NOWS)，因为他们的身体从高水平的阿片类药物中撤出 母胎循环。虽然在执行和执行方面有了显著的改进 管理NOWS婴儿的标准化治疗方案仍然具有重要意义 对产前阿片类药物暴露的长期影响的关切。此外，目前还不清楚 NOWS的严重程度是否与成人结局有关。动物研究可以是 有助于识别潜在的长期漏洞以及 神经发育可能会增加风险。产前羟考酮的临床前资料 接触是有限的，这是不幸的，因为这种特殊的阿片类药物在 育龄妇女。我们最近开发了一种产前阿片类药物的动物模型 在受孕前开始使用羟考酮自我给药的暴露 并在整个怀孕期间持续存在。我们的初步发现显示了剂量依赖性的变化。 子代体重增加和出生后早期出现的超声波发声 句号。此外，我们还记录了转录调控因子的显著变化。 这些子代出生后第1天的MeCP2。目前的一系列研究将确定 大脑区域对MeCP2的特定影响在整个发育过程中持续存在，以及这些影响的程度 影响通过母亲摄取和/或出生后戒断体征(具体目标1)进行调节。 研究还将确定母体摄入量与出生后戒断症状之间的关系 以及成年人滥用药物的责任和冲动行为，因为这些代表了两种潜在的 临床结果中建议的漏洞(特定目标2)。最后，这些研究将 确定当女性突然停止使用时是否观察到类似的结果 怀孕(强制禁欲)或从羟考酮转变为美沙酮或 丁丙诺啡，阿片类药物替代治疗中的两种常见药物(特定目标3)。 总体而言，这些研究将确定产妇自愿摄入 羟考酮、新生儿停药迹象和长期结局，并检验假设 这些效应是由MeCP2表达变化引起的表观遗传事件引起的。

The dramatic rise in opioid use and misuse over the past decade has resulted in an upsurge of infants born dependent upon opioids. Many of these babies will experience neonatal opioid withdrawal syndrome (NOWS) as their bodies withdraw from high levels of opioids in the maternal-fetal circulation. While there has been significant improvement in implementing and standardizing treatment protocols for managing NOWS infants, there remain significant concerns regarding the long-term impact of prenatal opioid exposure. Moreover it is unclear whether the severity of NOWS has any relationship with adult outcomes. Animal studies can be useful in identifying both potential long-term vulnerabilities as well as underlying changes in neurodevelopment that may confer increased risk. Preclinical data on prenatal oxycodone exposure are limited which is unfortunate given the widespread use of this particular opioid by women of reproductive age. We have recently developed an animal model of prenatal opioid exposure that utilizes self-administration of oxycodone with use beginning prior to conception and continuing throughout pregnancy. Our initial findings demonstrate dose-dependent changes in offspring body weight gain and ultrasonic vocalizations that emerge during the early postnatal period. In addition, we have documented significant changes in the transcriptional regulator MeCP2 on postnatal day 1 in these offspring. The current set of studies will determine whether brain region specific effects on MeCP2 persist across development and to what extent these effects are mediated by maternal intake and/or and postnatal withdrawal signs (Specific Aim 1). Studies will also determine the relationship between maternal intake, postnatal withdrawal signs and adult substance abuse liability and impulsive behavior, as these represent two potential vulnerabilities suggested in clinical findings (Specific Aim 2). Finally, these studies will determine whether similar outcomes are observed when females abruptly stop use during pregnancy (forced abstinence) or are transitioned from oxycodone to either methadone or buprenorphine, two common medications used in opioid replacement therapy (Specific Aim 3). Overall, these studies will determine the relationship between voluntary maternal intake of oxycodone, neonatal signs of withdrawal and long-term outcomes and test the hypothesis that these effects are due to epigenetic events induced by changes in MeCP2 expression.