Cholesterol and fatty acids in cocaine addiction relapse

描述（由申请人提供）：该项目的目标是确定我们的初步发现是否可以在更大的人群样本中复制，即胆固醇和某些多不饱和脂肪酸（PUFA）的低循环水平与脱毒可卡因成瘾者的复吸率之间存在显着关联。还将尝试确定某些因素（例如不良的营养习惯）是否会导致某些患者的胆固醇值或脂肪酸谱发生改变。 胆固醇和多不饱和脂肪酸在成瘾性疾病中的作用尚未得到研究，但我们的数据可以根据最近的文献来理解，这些文献表明低胆固醇水平与许多精神疾病（包括抑郁症、自杀和暴力）之间存在关联。胆固醇不会穿过血脑屏障，但有人认为它可能是多不饱和脂肪酸变化的标志。越来越多的证据表明，某些多不饱和脂肪酸含量低也与多种精神疾病有关。一些PUFA是神经元突触膜的主要成分并影响神经元功能。临床前研究表明，PUFA 会影响在奖励机制中发挥作用的多巴胺和 5-HT 的功能。 将对入住药物滥用住院病房的 120 名可卡因成瘾者进行研究。在病房期间，他们将接受胆固醇及其亚组分以及整个脂肪酸系列的评估。出院后，他们将被转移到药物滥用诊所，并进行为期 12 个月的跟踪评估。主要结果指标是每月通过定性尿液和自我报告的使用情况确定的复发时间。心理社会功能、可卡因渴望和饮食摄入量也将每月进行监测。每三个月测定一次胆固醇和脂肪酸。 如果我们的初步研究结果得到证实，那么使用脂肪酸补充剂或改变饮食习惯可能对预防可卡因成瘾者的复吸具有重大潜力。

DESCRIPTION (provided by applicant): The goal of this project is to determine whether our preliminary findings of significant associations between low circulating levels of cholesterol and of some polyunsaturated fatty acids (PUFAs) and the relapse rate of detoxified cocaine addicts can be replicated in a larger population sample. Attempts will be also made to determine whether some factors such as poor nutritional habits contribute to the presence of altered cholesterol values or fatty acid profiles in some patients. The role of cholesterol and PUFAs has not been investigated in addictive disorders but our data can be understood in light of recent literature suggesting the existence of associations between low cholesterol levels and a number of psychiatric disorders including depression, suicide and violence. Cholesterol does not cross the blood-brain barrier but it has been suggested that it could be a marker for changes in PUFAs. There is mounting evidence that low levels of some PUFAs are also associated with a variety of psychiatric disorders. Some PUFAs are main components of neuronal synaptic membranes and influence neuronal function. Preclinical studies have demonstrated that PUFAs influence the function of dopamine and 5-HT that play a role in reward mechanisms. One hundred and twenty cocaine addicts admitted to a Substance Abuse Inpatient Unit will be studied. While on the ward, they will undergo assessments of cholesterol and its subfractions and of the entire fatty acids series. After discharge, they will be transferred to a Substance Abuse clinic where follow-up assessments will be conducted for 12 months. The primary outcome measures will be time to relapse as determined monthly by qualitative urine and selfreported use. Psychosocial functioning, cocaine craving and dietary intake will also be monitored monthly. Cholesterol and fatty acids will be determined every 3 months. If our preliminary findings are confirmed, the use of fatty acids supplements or changes in dietary habits could have a significant potential in the prevention of relapse in a subgroup of cocaine addicts.