背景:酒精使用障碍(AUD)与导致酒精戒断综合征(AWS)的精神和躯体疾病有关,30%的AWS病例导致危及生命的震颤谵妄(DTs)。目前,研究不支持在DT中使用任何一种生物标志物。神经营养因子影响神经调节,在AUD的发病机制中发挥作用,AWS,和DTs。
方法:这篇综述旨在总结与神经营养因子和S100B在神经可塑性中相关的实验和临床数据,以及AUD背景下的神经变性,AWS,和DTs。这项工作使用了根据与系统审查和荟萃分析(PRISMA)声明的首选报告项目一致的方案选择的出版物。
结果:BDNF水平可能是复发易感性的良好候选生物标志物,因为它在消费期间显着减少,在禁欲期间逐渐增加。GDNF通过其在多巴胺能神经元功能中的整体作用影响AUD,并消除饮酒行为的回归。NGF保护神经元免受乙醇诱导的细胞毒性损伤,并影响脑损伤后认知缺陷的恢复。酒精暴露后NT-3水平降低,并参与AUD认知下降的代偿机制。NT-4影响氧化应激,这与长期饮酒有关。S100B被用作脑损伤的生物标志物,AUD中血清水平升高,并且可以保护5-HT神经元免受酒精引起的损害。
结论:BDNF,GDNF,NT-3,NT-4,NGF,和S100B可能是戒断综合征的有价值的标志物。特别是,最相关的是它们与谵妄并发症的发生有关.然而,关于AWS和DT中一些神经营养因子的数据很少,这表明需要进一步研究。
BACKGROUND: Alcohol use disorder (AUD) is related to mental and somatic disorders that result in alcohol withdrawal syndrome (AWS), with 30% of AWS cases leading to life-threatening delirium tremens (DTs). Currently, studies do not support using any one biomarker in DTs. Neurotrophins affect neuromodulation, playing a role in the pathogenesis of AUD, AWS, and DTs.
METHODS: This review aims to summarize experimental and clinical data related to neurotrophins and S100B in neuroplasticity, as well as neurodegeneration in the context of AUD, AWS, and DTs. This work used publications that were selected based on the protocol consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.
RESULTS: The BDNF level could be a good candidate biomarker for relapse susceptibility, as it is significantly reduced during consumption and gradually increases during abstinence. GDNF influences AUD through its integral role in the function of dopaminergic neurons and ablates the return to alcohol-drinking behavior. NGF protects neurons from ethanol-induced cytotoxic damage and affects recovery from cognitive deficits after brain damage. The NT-3 level is decreased after alcohol exposure and is involved in compensatory mechanisms for cognitive decline in AUD. NT-4 affects oxidative stress, which is associated with chronic alcohol consumption. S100B is used as a biomarker of brain damage, with elevated levels in serum in AUD, and can protect 5-HT neurons from the damage caused by alcohol.
CONCLUSIONS: BDNF, GDNF, NT-3, NT-4, NGF, and S100B may be valuable markers for withdrawal syndrome. In particular, the most relevant is their association with the development of delirium complications. However, there are few data concerning some neurotrophins in AWS and DTs, suggesting the need for further research.