Bopaki ba ts'oaetso ea tsoekere: liphello tsa boitšoaro le tsa methapo ea metsoako ea metsoako e feteletseng (2008)

Neurosci Biobehav Rev. 2008; 32 (1): 20-39. Epub 2007 Mots'eanong 18.

Avena NM1, Rada P, Hoebel BG.

inahaneloang

Potso ea liteko ke hore na tsoekere e ka fetoha ntho e hlekefetsang kapa ea lebisa mofuteng oa tlhaho oa bokhoba. "Ho lemalla lijo" ho bonahala ho utloahala hobane litsebi tsa boko tse ileng tsa iphelisa ka meputso ea tlhaho le tsona li hlahisoa ke lithethefatsi tse lemalloang. Tsoekere e bohlokoa haholo joaloka ntho e lokollang li-opioid le dopamine mme ka hona ho ka lebelloa hore e ka ba le matla a ho eketsa. Tlhahlobo ena e akaretsa bopaki ba ho itšetleha ha tsoekere mohlaleng oa phoofolo. Ho sekasekoa likarolo tse 'ne tsa bokhoba ba joala. “Ho itlopa lijo”, “ho itlosa”, “ho lakatsa” le ho tsosa maikutlo ka tsela e 'ngoe le e' ngoe ho fanoa ka litlhaloso tse sebetsang mme li bonts'oa ka boits'oaro ka ho itlopa lijo tse tsoekere e le mothusi. Boitšoaro bona bo amana le liphetoho tsa methapo ea kutlo bokong le tsona li hlaha le lithethefatsi tse lemalloang. Liphetoho tsa Neural li kenyelletsa liphetoho ho dopamine le opioid receptor e tlamang, polelo ea enkephalin mRNA le tlhahiso ea dopamine le acetylcholine ho li-nucleus accumbens. Bopaki bo tšehetsa khopolo-taba ea hore maemong a itseng likhoto li ka itšepa tsoekere. Sena se ka fetolela maemong a mang a batho joalokaha ho boletsoe ke lingoliloeng tse mabapi le mathata a ho ja le botenya.

Keywords: Ho itlopa joala ho ja, dopamine, acetylcholine, opioid, li-bokellase tsa nucleus, ho tlosa, ho lakatsa, maikutlo a boitšoaro

1. PUSELETSOE

Litsamaiso tsa Neural tse bileng teng ho susumetsa le ho tiisa ho fepa le ho ja lijo le tsona li ile tsa qala ho batla lithethefatsi le ho itaola. Taba ea hore tse ling tsa lithethefatsi tsena li ka baka ho lemalla ho hlahisa menyetla ea hore lijo tse ling le tsona li ka baka tšenyo. Batho ba bangata ba re ba ikutloa ba tlameha ho ja lijo tse tsoekere, ka tsela e tšoanang le eo makhoba a nooang a ka ikutloa a tlameha ho a nwa. Ka hona, re qapile mohlala oa liphoofolo ho etsa lipatlisiso tsa hore na ke hobaneng ha batho ba bang ba thatafalloa ke ho ja lijo tse matlafatsang, joalo ka lino tse tsoekere.

Mohlaleng ona oa phoofolo, likhoto ke lijo tse hloloheloang letsatsi le leng le le leng bakeng sa 12 h, ebe ka mor'a ho lieha ha 4 h nakong ea tsona e tloaelehileng e tsamaisoang ke likerese, li fuoa 12-h ho fumana tharollo ea tsoekere le chow. Ka lebaka leo, ba ithuta ho noa tharollo ea tsoekere haholo, haholo ha e qala ho ba teng letsatsi le leng le le leng.

Kamora khoeli khoeling ena ea ho fepa ka nako e telele, liphoofolo li bonts'a boitsoaro bo ts'oanang le litlamorao tsa lithethefatsi tsa tlhekefetso. Tsena li khethollotsoe e le "ho itlopa lijo", ho bolelang makhetlo a mangata a sa tloaelehang a ho ja, a kang "ho tlohela" ho bontšitsoeng ke matšoao a ho tšoenyeha le khatello ea maikutloColantuoni et al., 2001, 2002), le "ho lakatsa" ho lekantsoeng nakong ea ho itšila tsoekere e le karabelo e ntlafalitsoeng bakeng sa tsoekere (Avena et al., 2005). Ho boetse ho na le matšoao a "main-sensitization" le "maikutlo a fetohang" ho tsoa ho tsoekere ho ea lithethefatsi tsa tlhekefetso (Avena et al., 2004, Avena le Hoebel, 2003b). Ha ke fumane mekhoa ena e tloaelehileng ho ts'ebeliso ea lithethefatsi ka bopaki bo tšehetsang bo tsoang litsing tse ling tsa mesebetsi (Gosnell, 2005, Grimm et al., 2005, Widman et al., 2005), potso e latelang ke hore na hobaneng sena se etsahala.

Tšobotsi e tsebahalang ea lithethefatsi tse lemalloang ke bokhoni ba tsona ba ho baka keketseho e pheta-phetoang ea nako le nako ea extracellular dopamine (DA) ho li-nucleus accumbens (NAc) (Di Chiara le Imperato, 1988, Hernandez le Hoebel, 1988, Wise et al., 1995). Re fumana hore likhoto tse nang le phihlello ea tsoekere li tla nooa ka mokhoa o tšoanang o tlosang DA ho NAc nako le nako, joalo ka phello ea khale ea lintho tse ngata tsa tlhekefetso (Avena et al., 2006, Rada le al., 2005b). Sena se lebisa phetohong ea polelo kapa ho fumaneha ha li-receptors tsa DA (Colantuoni et al., 2001, Spangler et al., 2004).

Ho fihlella tsoekere e kenelletseng ho boetse ho sebetsa ka tsela ea li-opioid bokong. Ho na le liphetoho lits'ebetsong tsa opioid joalo ka polelo e fokotsehileng ea enkephalin mRNA ho li-accumbens (Spangler et al., 2004). Matšoao a ho khaotsa ho bonahala a bonahala haholo ka lebaka la liphetoho tsa opioid kaha ho tlosoa ho ka fumanoa le opioid antagonist naloxone. Khaello ea lijo e boetse e lekane ho fana ka matšoao a ho khaola a kang opiate (Avena, Bocarsly, Rada, Kim le Hoebel, a sa hatisoe, Colantuoni et al., 2002). Sebaka sena sa ho tlohela se kenyelletsa bonyane lipontšo tse peli tsa neurochemical. Taba ea pele ke ho fokotseha ha li-extracellular DA ho li-accumbens, 'me ea bobeli ke ho lokolloa ha acetylcholine (ACh) ho li-encneurons tsa accumbens. Liphetoho tsena tsa methapo ea kutlo ha motho a e-ja lijo tse nang le tsoekere ka nako e telele li tšoana le tsa "opiates".

Khopolo eo e thehiloe hore nako le nako, ho ja tsoekere ho feta tekano ho ka ba le litlamorao tsa dopaminergic, cholinergic le opioid tse tšoanang le psychostimulants le opiates, nyane ka boholo. Phello e akaretsang ea liphetoho tsena tsa methapo ea kutlo e bonolo, empa e hlalositsoe hantle, ke ho its'epaha (Hoebel et al., 1999, Leibowitz le Hoebel, 2004, Rada le al., 2005a). Tlhahlobo ena e hlophisa lithuto ho laboratori ea rona mme e kopanya liphetho tse amanang le tsona tse fumanoeng ke ba bang ba sebelisang mehlala ea liphoofolo, liak'haonte tsa bongaka le ho nahana ka kelello ho araba potso: tsoekere, maemong a mang e ka "ba lekoa"?

TLHOKOMELISO

Thutong ena eohle re sebelisa mantsoe a 'maloa le litlhaloso tseo ho tsona ho seng tumellano ea bokahohleng. Patlisiso ea bokhoba ba litloaelo li shebana le lithethefatsi tsa tlhekefetso, joalo ka morphine, cocaine, nikotine le joala. Leha ho le joalo, haufinyane tjena ho na le "litlatsetso" tse fapaneng ho batho bao e seng lithethefatsi, ho kenyeletsoa papali ea chelete, thobalano, le tlhahlobisong ena, lijo.Bancroft le Vukadinovic, 2004, Comings et al., 2001, Petry, 2006). Poleloana “bokhoba” e fana ka maikutlo a ho itšetleha ka kelello ka hona ke bothata ba kelello kapa ba kelello, eseng feela bokuli ba 'mele. “Bokhoba” hangata bo sebelisoa ka mokhoa o ts'oanang le lentsoe "ho itšetleha"Nelson et al., 1982) joalo ka ha ho hlalositsoe ke DSM-IV-TR (Mokhatlo oa Mahlale oa Amerika, 2000). Re tla sebelisa poleloana e itšetlehileng ka moelelo oa eona o akaretsang ho hlalosa sephetho sa lithuto tsa liphoofolo tse etsisang tšibollo ea lithethefatsi tsa batho molemong ka mong oa tsona o moholo (Koob le Le Moal, 2005).

Ho itšetleha ka lithethefatsi ho bontšoa ka boitšoaro bo qobelloang, ka linako tse ling bo sa laoleheng, bo etsahalang ka litšenyehelo tsa lits'ebetso tse ling mme bo matlafala ka phihlello e phetoang. Ho ikokobetsa ho thata ho bontša ka mokhoa o kholisang liphoofolong tsa liphoofolo, empa ho khothalelitsoe mokhoa oa ho sebelisa liphoofolo. Re sebelisitse meetso e ntlafalitsoeng ka litoeba ho ithuta ho itšetleha ka lithethefatsi mme ra li feto-fetola hore li leke matšoao a ho itšetleha ka tsoekere.

Ho itlopa lijo

Tlhahlobo ea bokhoba ba ho lemalla e ka aroloa ka mekhahlelo e meraro (Mokhatlo oa Mahlale oa Amerika, 2000, Koob le Le Moal, 1997). Ea pele, ho itlopa joala, ho hlalosoa e le kholo ea ho ja haholo ka nako e le 'ngoe, hangata ka mor'a nako ea boithaopo kapa ho tlatlapuoa ka likhoka. Ts'ebetso e ntlafalitsoeng ka mokhoa oa ho loma e ka hlaha ho tsoa ho maikutlo le mamello ho thepa ea kutlo ea ntho e hlekefetsang e etsahalang ka ho tsamaisoa hangata. Sensitization, e hlalositsoeng ka botlalo ka tlase, ke keketseho ea ho arabela ka khothalletso e hlahisoang khafetsa. mamello ke phokotso ea butle-butle ea karabelo, hoo ho hlokahalang hore ntho e eketsehileng e hlahise phello e tšoanang (McSweeney et al., 2005). Ka bobeli li nahanoa ho susumetsa litlamorao tse matla, tse matlafatsang tsa lithethefatsi tsa tlhekefetso mme li bohlokoa qalong ea potoloho ea bokhoba ba lithethefatsi kaha ka bobeli li ka eketsa ho arabela le ho ja haholo (Koob le Le Moal, 2005).

Ho khaotsa

Matšoao a ho tlohela a bonahala ha ntho e hlekefelitsoeng e se e sa fumanehe kapa e thibetsoe ka lik'hemik'hale. Re tla tšohla ho khaotsa ho latela ho tlosoa ha opiate, e nang le matšoao a hlalositsoeng ka mokhoa o hlakileng (Martin et al., 1963, Way et al., 1969). Ho tšoenyeha ho ka hlalosoa ka ts'ebetso le ho lekanngoa liphoofolong tse sebelisang mofuta o phahameng oa tlatsetso, moo liphoofolo tse tšoenyehileng li ka qobang ho qeta nako li le matsohong a bulehileng ka tlung.Faele et al., 2004). Teko ena e netefalitsoe haholo bakeng sa matšoenyeho ka kakaretso (Pellow et al., 1985) le matšoenyeho a susumetsoang ke ho tlosoa hoa lithethefatsi (File le Andrews, 1991). Ho sithabela ha boitšoaro ka har'a liphoofolo le hona ho ka kenngoa, ntle le ho bua ka maikutlo, ho sebelisa liteko tse qobelloang, tse lekang boiteko ba ho sesa bapisoa le ho thellisa tse thellang (Psolt et al., 1978). Ha matšoao a ho khaola opiate a behelloa ka ntle le naloxone, ho fana ka maikutlo a hore ho se sebetse hoa li-opioid receptors ke hona ho bakang. Ha matšoao a tšoanang a hlahisoa ka mokhoa o ikemetseng nakong ea thobalano, motho a ka nahana hore ke ka lebaka la ho haelloa ke ts'usumetso ea sistimi e 'ngoe ea opioid.

Ho lakatsa

Mokhahlelo oa boraro oa bokhoba, ho lakatsa, o hlaha ha tšusumetso e ntlafatsoa, ​​hangata kamora nako ea ho itšila (Vanderschuren le Everitt, 2005, Weiss, 2005). "Ho lakatsa" e ntse e le polelo e sa hlalosoang hantle e atisang ho sebelisoa ho hlalosa takatso e matla ea ho sebelisa lithethefatsi ho batho (Bohlale, 1988). Ka lebaka la ho haella ha lentsoe le betere, re tla sebelisa lentsoe "ho lakatsa" joalo ka ha ho hlalosoa boiteko bo eketsehang ba ho fumana ntho ea tlhekefetso kapa litabatabelo tsa eona ka lebaka la ho lemalla le ho ila. "Ho lakatsa" hangata ho bua ka tšusumetso e fetelletseng, e ka lekanngoeng le maemo a sebetsang. Haeba ho tila ho etsa hore phoofolo e eketse khatello ea eona ea lever, motho a ka e nka e le sesupo sa khothatso e ntlafalitsoeng.

Sensitization

Ntle le litekanyetso tse boletsoeng ka holimo tsa tlhahlobo, maikutlo a boits'oarong ho nahanoa hore a koala likarolo tse ling tsa ts'ebeliso ea lithethefatsi (Vanderschuren le Kalivas, 2000). Boitšoaro ba boitšoaro bo tsamaisoa ka mokhoa o tšoanang e le phokotso ea letho mabapi le ts'ebetso ea taolo e pheta-phetoang ea lithethefatsi. Mohlala, kamora litekanyetso tse ngata tsa amphetamine tse lateloang ke ho ila, lethal e le phephetso, le nang le phello e fokolang ho liphoofolo tsa nave, le baka tšenyo e kholo (Antelman le Caggiula, 1996, Glick le ba bang, 1986). Liphoofolo tse lemohuoang nthong e le 'ngoe hangata li bonts'a maikutlo a sefapano, a hlalosoang e le karabelo e eketsehang ea locomotor ho sethethefatsi kapa ntho e fapaneng. Boitšoaro ba maikutlo bo ka boela ba bonahala ka boits'oaro bo kopanyang (Piazza et al., 1989). Liphoofolo tse lemosetsoeng moriana o le mong li ka bonts'a ho ja ho eketsehileng ha sethethefatsi se seng. Ka mantsoe a mang, lithethefatsi tse ling li sebetsa e le “tsela ea ho ea” ho e mong. Mohlala, liphoofolo tse lemositsoeng hore amphetamine li bontša ho nyoloha ka sekhahla hoa tšebeliso ea koae (Ferrario le Robinson, 2007), le liphoofolo tse lemosetsoeng nicotine ho jella joala bo bongata ha bo bapisoa le liphoofolo tse se nang maikutlo (Blomqvist et al., 1996). Boitšoaro bona bo nahanoa hore bo tla etsahala ha lithethefatsi tse fapaneng li kenya ts'ebetsong mokhoa o tšoanang oa neural, hape ke lona lebaka le etsang hore bakuli ba bangata ba hloke ho khaotsa lithethefatsi ka botlalo e le boemo ba kalafo bakeng sa ba lemaletseng lithethefatsi.Bohlale, 1988).

Potso ea pele e botsoang ke tlhahlobo ena ke hore na litšobotsi tsena tsa ts'ebetso e hlalositsoeng ka ts'ebetso ea ts'ebeliso ea thepa li ka fumanoa ka phihlello ea tsoekere nako le nako. Potso ea bobeli e hlahloba litsamaiso tsa neural ho fumana hore na tsoekere e ka ba le litlamorao joang joalo ka lithethefatsi tsa tlhekefetso.

3. LITLHAKISO TSA BOKHONOLOFU LE TSOANG PULA-MOSOTHO ETSA TLHALOSO EA MOTSOALLE OA LITLHAKISO TSE KHOLO

Ho fetela hohle bokong ba boko bo hlahisoang ke ho ja lijo le lithethefatsi ho fana ka maikutlo a hore mefuta e fapaneng ea li-reinforcers (ea tlhaho le ea maiketsetso) e tsosa tse ling tsa lits'ebetso tse tšoanang tsa neural (Hoebel, 1985, Hernandez le Hoebel, 1988, Kelley et al., 2002, Le Magnen, 1990, Volkow le Bohlale, 2005, Bohlale, 1988, 1989). Ho na le libaka tse 'maloa bokong tse kentsoeng tšebetsong ea ho fepa le ho ja joala haholo.Hernandez le Hoebel, 1988, Kalivas le Volkow, 2005, Kelley et al., 2005, Koob le Le Moal, 2005, Mogenson le Yang, 1991, Bohlale, 1997, Yeomans, 1995), le li-neurotransmitters tse ngata, hammoho le lihormone, li ithutoe libakeng tsena le tse amanang le boko (Harris et al., 2005, Kalivas, 2004, Leibowitz le Hoebel, 2004, Schoffelmeer et al., 2001, Stein le Belluzzi, 1979). Tlhahlobo ena e tla shebana le DA, opioids le ACh ka khetla ea NAc, ho fihlela joale, ke li-neurotransmitter tseo re fumaneng li kenya letsoho le litlamorao tse matlafatsang tsa tšebeliso ea tsoekere nako le nako.

3.A. Dopamine

Ho thehiloe hantle hore lithethefatsi tse lemalloang li kenya li-neuron tse nang le DA libakeng tsa bokong tse sebetsanang le ho matlafatsa boitšoaro. Sena se bontšitsoe lithethefatsi tse tlisoang ka mokhoa o hlophisitsoeng (Di Chiara le Imperato, 1988, Radhakishun et al., 1983), le bakeng sa lithethefatsi tse kentsoeng kapa tse kenngoeng sebakeng seo (Hernandez le Hoebel, 1988, Mifsud et al., 1989). Morero oa "mesolimbic DA" ho tloha sebakeng sa "ventral tegmental" (VTA) ho ea ho NAc hangata o kenella mesebetsing ea ntlafatso (Bohlale le Bozarth, 1984). NAc e bohlokoa bakeng sa likarolo tse 'maloa tsa "moputso" ho kenyelletsa ho batla lijo le matlafatso a ho ithuta, khothatso, khothatso ea ts'usumetso le ho supa phetoho ea ts'usumetso (Bassareo le Di Chiara, 1999, Berridge le Robinson, 1998, Salamone, 1992, Schultz et al., 1997, Bohlale, 1988). Neurotransmitter efe kapa efe e ka kotloloho kapa ka kotloloho e tsosetsang 'mele ea lisele tsa DA ho VTA e matlafatsa boitaolo ba lehae, ho kenyeletsoa le li-opioid tse kang enkephalin (Glimcher et al., 1984), li-peptide tse se nang opioid tse kang neurotensin (Glimcher et al., 1987) le lithethefatsi tse ngata tsa tlhekefetso (Bozarth le Bohlale, 1981, Gessa et al., 1985, McBride et al., 1999). Lithethefatsi tse ling tse lemalloang le tsona li sebetsa liteisheneng tsa DA (Cheer et al., 2004, Mifsud et al., 1989, Nisell et al., 1994, Westerink et al., 1987, Yoshimoto et al., 1992). Kahoo, ntho efe kapa efe e bakang khafetsa ho lokolloa ha DA kapa e fokotsa ho khutlisoa ha DA litsing ka litsamaiso tsena e ka ba moemeli oa tlhekefetso.

Lijo tse fapaneng li ka lokolla DA ho NAc, ho kenyelletsa labop, tsoekere, saccharin le oli ea poone (Bassareo le Di Chiara, 1997, Hajnal et al., 2004, Liang et al., 2006, Mark et al., 1991, Rada le al., 2005b). Ho nyoloha ha DA ea kantle ho naha ho ka mpefatsa lijo ka likhoto tse fokolisitsoeng ke lijo (Hernandez le Hoebel, 1988). Leha ho le joalo, liphoofolong tse khotsofetse, tokollo ena ea DA e bonahala e itšetleha ka ntho e ncha hobane e batla e fumaneha khafetsa, leha lijo li fumaneha habonolo (Bassareo le Di Chiara, 1997, Rada le al., 2005b). Mokhelo, o hlalositsoeng ka tlase (Karolo ea 5.C.), ke ha liphoofolo li felloa ke lijo le ho fepa tsoekere nako le nako.

DA ea extracellular e fokotseha ka karabelo ea ho tlosoa hoa lithethefatsi (Acquas et al., 1991, Acquas le Di Chiara, 1992, Rada et al., 2004, Rossetti et al., 1992). Matšoao a ho khaotsa ho lithethefatsi tsa dopaminergic ha a hlalosoe hantle ho feta a ileng a bonoa nakong ea ho khaoloa ha opiates. Ka hona, ho kanna ha ba bonolo ho lemoha matšoao a ho tlohela ha u sebelisa lijo tse lokollang bobeli ba DA le li-opioid. Tsoekere ke e 'ngoe ea lijo tse joalo.

3.B. Li-opioids

Li-peptide tsa opioid li hlahisoa haholo ho ts'ebetso ea li-limbic hape li hokahane le lits'ebetso tsa DA libakeng tse ngata tsa forebrain (Haber le Lu, 1995, Levine le Billington, 2004, Miller le Pickel, 1980). Lisebelisoa tsa endio native opioid li hlahisa tse ling tsa litlamorao tsa ts'ebetso ea matlafatso ka ho sebelisana le lits'ebetso tsa DA (Bozarth le Bohlale, 1986, Di Chiara le Imperato, 1986, Leibowitz le Hoebel, 2004). Opioid peptide enkephalin ho NAc e amana le moputso (Bals-Kubik et al., 1989, Bozarth le Bohlale, 1981, Maqheku, 1982, Spanagel et al., 1990) hape e ka etsa hore li-receptor tsa mu le tsa delta li eketse tokollo ea DA (Spanagel et al., 1990). Morphine e fetola mofuta oa polelo ea peptide ea endo native opioid ha e ntse e eketsa tlhahiso ea li-peptide ea opioid ho NAc (Przewlocka et al., 1996, Spangler et al., 2003,Turchan et al., 1997). Li-opioids le tsona ke likarolo tsa bohlokoa tsa sistimi ena e le li-cotransmitter tse nang le GABA libakeng tse ling tsa khumo le dorsal striatal.Kelley et al., 2005).

Tšebeliso e pheta-phetoang ea li-opiates, kapa lithethefatsi tse ling tse seng tsa opiate, li ka baka tšusumetso ea mu-opioid receptor libakeng tse 'maloa, ho kenyelletsa NAc (Koob et al., 1992, Ho lokolloa, 2001). Mohanyetsi oa mu-receptor o kentsoeng ho NAc o tla bona melemo ea heroin (Vaccarino et al., 1985), 'me ka mokhoa o hlophisitsoeng lithethefatsi tse joalo li sebelisitsoe e le kalafo bakeng sa ho lemalla joala le ts'ebeliso ea heroine (Deas et al., 2005, Hlahisa et al., 2003, Martin, 1975, O'Brien, 2005, Volpicelli et al., 1992).

Ho kenella ha lijo tse matlafatsoang ho na le litlamorao ka li-opioid tsa khale libakeng tse fapaneng (Dum et al., 1983, Mercer le Holder, 1997, Tanda le Di Chiara, 1998), le ente ea li-mu-opioid agonists ho NAc e eketsa ho ja lijo tse matlafatsang tse nang le mafura kapa tsoekere (Zhang et al., 1998, Zhang le Kelley, 2002). Ka lehlakoreng le leng, bahanyetsi ba opioid, ba fokotsa ho kenella ha lijo tse monate le ho khutsisa lijo tse ratehang, tse ratoang, esita le litekanyetso tse sa sebetseng tšebelisong e tloaelehileng ea chow.Glass et al., 1999). Khokahano ena ea opioid-palatability e tšoauoa hape ke likhopolo tseo ho tsona matlafatso a khetholloang ho tsamaiso ea dopaminergic bakeng sa ts'usumetso ea ts'usumetso le "opingid" kapa "monate" ea likarabo tsa hedonic (Berridge, 1996, Robinson le Berridge, 1993, Stein, 1978). Bopaki ba hore li-opioid ho NAc li susumetsa maikutlo a hedonic bo tsoa ho data e bonts'ang hore morphine e ntlafatsa litekanyetso tsa tatso ea sefahleho ea "rats" bakeng sa tharollo e monate molomong (Pecina le Berridge, 1995). Kamano e pakeng tsa "ho batla" le "ho rata" e boetse e khothalletsoa ke lithuto ho batho (Finlayson et al., 2007).

3.C. Acetylcholine

Lits'ebetso tse 'maloa tsa cholinergic bokong li kentsoe tšebetsong ea lijo le lithethefatsi, hape li amana le DA le opioids (Kelley et al., 2005, Rada et al., 2000, Yeomans, 1995). Ho tsepamisa maikutlo ho li-interneurons tsa ACh ho NAc, tsamaiso ea methapo ea morphine e fokotsa ho fetoha ha ACh (Smith le al., 1984), ntho e netefalitsoeng ke Ka vivo Microphilona ho litoeba tse sebetsang ka bolokolohi (Fiserova et al., 1999, Rada le al., 1991a, 1996). Li-interneuron tsa Cholinergic ho NAc li ka khetha ka mokhoa o ikhethileng oa mofuta oa polelo ea enkephalin le tokollo ea peptide (Kelley et al., 2005). Nakong ea ho khaotsa morphine, extracellular ACh e eketseha ho NAc ha DA e le tlase, ho fana ka maikutlo a hore naha ena ea methapo e ka ameha likarolong tse qholotsang tsa ho tlohela (Pothos et al., 1991, Rada le al., 1991b, 1996). Ka mokhoa o ts'oanang, nicotine le ho itlopa joala ka bobeli li eketsa extracellular ACh, ha li ntse li theola DA ho NAc (De Witte le al., 2003, Rada et al., 2001, 2004). Boemo bona ba ho tlohela bo ka kenyelletsa khatello ea maikutlo ka boitshwaro, hobane li-Mon-receptor agonists tse kentsoeng ho NAc li ka baka khatello ea maikutlo teko e qobelloang ea ho sesa (Chau le al., 1999). Karolo ea ACh ea ho tlosoa ha lithethefatsi e bontšitsoe hape ka li-inhibitors tse tsamaisitsoeng tsa acetylcholinesterase, tse ka fanang ka matšoao a ho tlohela ho liphoofolo tse sa its'epahalleng (Katz le Valentino, 1984, Turski et al., 1984).

ACh ho NAc le eona e kentsoe tšebelisong ea lijo. Re lumela hore phello ea eona e akaretsang ea 'mino oa mokokotlo ke ho thibela ho fepa li-receptor tsa M1 kaha ente ea lehae ea motsoako oa motsoako o kopanetsanang o tla thibela phepelo, mme phello ena e ka thibeloa ke pirenzapine e itseng ea M1 (Rada le Hoebel, e sa phatlalatsoang). Ho fepa satiety ho eketsa extracellular ACh ho NAc (Avena et al., 2006, Mark et al., 1992). Ho rata tatso e nang le maemo ho boetse ho eketsa ACh ho NAc mme ka nako e ts'oanang e theola DA (Mark et al., 1991, 1995). D-fenfluramine e kopantsoeng le phentermine (Fen-Phen) e eketsa extracellular ACh ho NAc ka tekanyetso e thibelang ho ja le ho itaola ka mokhoa oa cocaine (Glowa et al., 1997, Rada le Hoebel, 2000). Likhoto tse nang le liphoso tse tlisoang ke chefo ea ACh ke li-hyperphagic tse amanang le likhoto tse sa tlosoang (Hajnal et al., 2000).

Bolelele ba DA / ACh bo laoloa ka karolo ke mekhoa ea hypothalamic bakeng sa ho fepa le ho satiety. Norepinephrine le galanin, e khothalletsang ho ja ha e kenngoe ka har'a patsi ea "patisi" (PVN), e ka tlase e bokellang ACh (Hajnal et al., 1997, Rada et al., 1998). Phapang ke neuropeptide-Y, e khothalletsang ho ja ha e kenngoe PVN, empa e sa eke tokollo ea DA kapa ea theola ACh (Rada et al., 1998). Tumellanong le khopolo, motsoako o hlahisang serotonin le ente ea CCK ho PVN o eketsa li-accumbens ACh (Helm et al., 2003).

Ho khahla haholo hore ha DA e le tlase ebile e le ACh e phahameng, ho bonahala eka sena ha e thelle, empa ho e-na le hoo e fetoha naha e phehellang (Hoebel et al., 1999), joalo ka nakong ea khatello ea maikutlo (Zangen et al., 2001, Rada et al., 2006), ho tlosa lithethefatsi (Rada le al., 1991b, 1996, 2001, 2004) le khaolo e latsoang tatso (Mark et al., 1995). Re phethela ka hore ha ACh e sebetsa joaloka post-synaptic M1 agonist e na le litlamorao tse fapaneng le DA, ka hona e ka sebetsa joalo ka "brake" mesebetsing ea dopaminergic (Hoebel et al., 1999, Rada et al., 2007) ho baka satiety ha DA e phahame le khatello ea maikutlo ha DA e le tlase.

4. HO BA LE MAHALA A HO SEBETSA HO BONAHALA LE HO SEBETSA HO SEBETSA, HO FIHLELA SUGAR

Taba ea ho ba lekhoba la tsoekere haesale e sebelisoa ka lilemo tse ngata. Litlaleho tsa kliniki tsa "ho lemalla tsoekere" e bile sehlooho sa libuka tse rekisoang haholo ebile ho shebane le mananeo a tummeng a lijo (Appleton, 1996, DesMaisons, 2001, Katherine, ka 1996, Rufus, 2004). Litlalehong tsena, batho ba hlalosa matšoao a ho tlohela ha ba itima lijo tse nang le tsoekere haholo. Ba boetse ba hlalosa takatso ea lijo, haholo-holo ea lik'habohaedreite, chokolete le tsoekere, tse ka etsang hore motho a boele a be le ho ja ka potlako. Sena se lebisa mokhatlong o mobe oa ho iphekola o nang le lijo tse monate tse ka bakang botenya kapa bothata ba ho ja.

Leha tšenyo ea lijo e ratoa haholo mecheng ea litaba mme e khothalelitse ho ipapisa le neurochemistry ea boko (Hoebel et al., 1989, Le Magnen, 1990), ketsahalo ena e sa tsoa ithutoa ka mokhoa o hlophisehileng ka laboratoring.

Joalokaha ho hlalositsoe kakaretso ea Karolo ea 1, re sebelisa kemiso ea ho fepa e etsang hore likhoto li ikopanye le tharollo ea tsoekere, ebe re latela mekhoa ea ts'ebeliso ea lithethefatsi e hlahisitsoeng Karolong ea 2 le tlhahlobo bakeng sa boits'oaro bo amanang le boitšoaro le methapo e fanoeng Karolong ea 3. Likhoto li fuoa 12-h letsatsi le leng le le leng ho fumana tharollo ea metsi a 10% sucrose (25% glucose litekong tse ling) le lab chow, e lateloang ke 12 h ea bohloka bakeng sa libeke tse tharo kapa ho feta (ke hore, Daily Intermittent Tsoekere le Chow). Tsena likhakanyo li bapisoa le lihlopha tsa taolo tse kang Ad libitum Sugar le Chow, Ad libitum Chow, kapa Daily Intermittent Chow (12-h hlekloha e lateloang ke phihlello ea 12-h ho lab chow). Bakeng sa lihlopha tsa phallo ea nako le nako, ho fumaneha ha nako ho lieha nako ea ho sebetsa ea phoofolo e le ho khothaletsa ho fepa, hangata ho tlang pele ho potoloho e lefifi. Likhoto tse bolokiloeng ho "Daily Intermittent Sugar" le "Chow regimen" li kena maemong a tšoanang le ts'ebeliso ea lithethefatsi maemong a fapaneng. Tsena li arotsoe ka boits'oaro (Karolo ea 4) le li-neurochemical (Karolo ea 4) tse ts'oanang le ts'ebeliso ea lithethefatsi.

4.A. “Ho itlopa lijo”: Ho tšela tsoekere letsatsi le leng le le leng le ho ja haholo

Ho phahamisa takatso ea matla ke tšobotsi ea lithethefatsi tsa tlhekefetso. Sena e kanna ea kopanya mamello, eo ho eona ntho e sebelisoang hampe e hlokahalang ho hlahisa litlamorao tse tšoanang (Koob le Le Moal, 2005), le sensitization, joalo ka sensomotor sensitization, moo ntho e hlahisang ts'ebetso e ntlafalitsoeng ea ts'ebetso (Vezina et al., 1989). Boithuto bo sebelisang boits'oaro ba lithethefatsi hangata bo fokotsa phihlello ea lihora tse 'maloa ka letsatsi, nakong eo liphoofolo li tla iphelisa hangata ka linako tse fapaneng tse fapaneng e le ts'ebetso ea tekanyetso e amohetseng (Gerber le Wise, 1989) le ka tsela e bolokang DA ea kantle ho naha e phahame ka holim'a motheo, kapa "ntlha e tsosang" ho NAc (Ranaldi et al., 1999, Wise et al., 1995). Bolelele ba phihlello ea letsatsi le letsatsi bo bontšitsoe hore bo ama ka mokhoa o tebileng boits'oaro bo latelang ba tsamaiso. Mohlala, cocaine e ngata e tsamaisoa ka nako ea metsotso e 10 ea pele ea thupelo ha phihlello bonyane bonyane 6 h ka letsatsi (Ahmed le Koob, 1998). Linako tse lekanyelitsoeng tsa ho fihlella, ho theha "li-binges", li bile molemo, hobane mokhoa oa boits'oaro o hlaha o ts'oana le oa mosebelisi oa lithethefatsi ea "qobelloang" (Markou et al., 1993, Mutschler le Miczek, 1998, O'Brien et al., 1998). Le ha lithethefatsi, joalo ka koae, li fanoa ka mokhoa o sa lekanyetsoang, batho kapa liphoofolo tse sebetsang li tla ipeha maemong a pheta-phetoang kapa ho "phephetsa" (Bozarth le Bohlale, 1985, Deneau et al., 1969). Leha ho le joalo, phihlello e kenelletseng ea liteko tse ntlafalitsoeng e molemo ho feta ad libitum phihlello bakeng sa liteko tsa tlhahlobo, hobane ho na le monyetla oa hore phoofolo e ka nka bonyane e le 'ngoe e kholo qalong ea nako ea ho fumaneha ha lithethefatsi. Ho feta moo, nako ea thibelo ea lijo e ka ntlafatsa tšebeliso ea lithethefatsi (Carr, 2006, Carroll, 1985) mme o bonts'itsoe ho hlahisa li-neruoadaptations tse tlatselletsang tsamaisong ea DA ea machoaccumbens (Pan et al., 2006).

Liphumano tsa boitšoaro ka tsoekere li ts'oana le tse bonoang ka lithethefatsi tsa tlhekefetso. Likhoto li fepa tsoekere e tsoang kamehla letsatsi le leng le le leng 'me li eketsa tsoekere ea tsona' me li eketsa tsoekere ea bona nakong ea hora ea pele ea phihlello ea letsatsi le letsatsi, eo re e hlalosang e le "ho itlopa" (Colantuoni et al., 2001). Liphoofolo le ad libitum ho fihlella tharollo ea tsoekere ho tloaetse ho e noella letsatsi lohle, ho kenyelletsa le nako ea bona e sa sebetseng. Lihlopha tsena ka bobeli li eketsa takatso ea tsona ea lijo, empa liphoofolo tse fihlellang tse lekanyelitsoeng li ja tsoekere e ngata ho isa ho 12 h ad libitum- liphoofolo tse tsoetsoeng li entsoe ka 24 h. Tlhatlhobo e qaqileng ea sebopeho sa lijo e sebelisang maemo a sebetsang (tekanyo e tsitsitseng ea 1) e senola hore liphoofolo tse fokolang li ja tsoekere e ngata qalong ea phihlello, le lijo tse kholo, tse fokolang tsa tsoekere nakong eohle ea phihlello, ha li bapisoa le liphoofolo tse noang tsoekere. ad libitum (Feie. 1; Avena le Hoebel, ba sa ngolisoe). Likhoto tse fepisitsoeng Daily Intermittent tsoekere le Chow li laola ho ja ha tsona ka ho theola takatso ea tsona ea ho fepa lik'hilojule tse eketsehileng tse fumanoang tsoekere, tse hlahisang boima ba 'mele bo tloaelehileng (Avena, Bocarsly, Rada, Kim le Hoebel, bo sa ngolisoe, Avena et al., 2003b, Colantuoni et al., 2002).

Setšoantšo sa 1 

Tlhahlobo ea lijo tsa likhoto tse peli tsa baemeli ba lulang likamoreng tse sebetsang. Eo e bolokiloeng ho Daily Intermittent Sucrose le Chow (mela e metšo) e ne e le tsoekere e ntseng e eketseha ea tsoekere ha e bapisoa le e 'ngoe e fuoeng Ad libitum Sucrose le Chow (mela e putsoa). Hour 0 ke 4 ...

4.B. “Ho ikhula”: Matšoenyeho le khatello ea maikutlo e hlahisoang ke opioid-antagonist kapa ho hloka lijo

Joalokaha ho hlalositsoe Karolong ea 2, liphoofolo li ka bonts'a matšoao a ho khaotsa ho sebelisa opiate kamora ho pepesetsoa khafetsa ha ntho ea tlhekefetso e tlosoa, kapa recaptor e nepahetseng ea synaptic e koetsoe. Mohlala, mohanyetsi oa opioid a ka sebelisoa ho thusa ho tlosa chelete boemong ba ho itšetleha ka opiate (Espejo et al., 1994, Koob et al., 1992). Ho litoeba, ho ikhula ho opangate ho baka matšoao a matla a somatic (Martin et al., 1963, Way et al., 1969), o fokotseha ka mocheso oa mmele (Ary et al., 1976), mabifi (Kantak le Miczek, 1986), le matšoenyeho (Schulteis et al., 1998), hammoho le bokuli bo susumetsoang ke dysphoria le khatello ea maikutlo (De Vries le Shippenberg, 2002, Koob le Le Moal, 1997).

Matšoao ana a ho khaotsa opioid a hlokometse kamora ho fihlella ha tsoekere nako le nako ha ho khaoloa ho laoloa hape ka mohanyetsi oa opioid, kapa ha lijo le tsoekere li tlosoa. Ha ho fanoa ka tekanyetso e phahameng ea opioid antagonist naloxone (3 mg / kg, sc), matšoao a ho khaotsa, joalo ka menoang, ho thothomela hoa pele le ho thothomela hoa hlooho.Colantuoni et al., 2002). Liphoofolo tsena le tsona lia tšoenyeha, joalo ka ha li fokotsoa ke nako e sebelisitsoeng letsohong le pepesitsoeng la moalo o phahameng haholo (Colantuoni et al., 2002) (Feie. 2).

Setšoantšo sa 2 

Nako e sebelisitsoeng matlong a bulehileng a mochini o moholo oa tlatsetso. Lihlopha tse 'ne tsa likhoto li ile tsa bolokoa lijong tsa tsona tsa khoeli e le' ngoe ebe li fuoa naloxone (3 mg / kg, sc). Sehlopha sa Daily Intermittent Glucose le Chow se qetile nako e nyane ka matsoho a bulehileng ...

Ho sithabela maikutlo ka boitšoaro bo botle ho boetse ho fumanoe nakong ea ha ho tlosoa likhakanyo tsa vexone nakong ea litheko tsa nakoana tse tsoekere. Thutong ena, likhoto li ile tsa fuoa tlhahlobo ea ho sesa ea metsotso e mehlano moo ho neng ho lekantsoe boitšoaro le ho sesa. Ebe likhoto li arotsoe ka lihlopha tse 'ne tse fepiloeng Daily Intermittent Sucrose le Chow, Daily Intermittent Chow, Ad libitum Sucrose le Chow, kapa Ad libitum Chow matsatsi a 5. Ka letsatsi la 21, ka nako eo likhoto tse fepeloang nakoana li neng li tla fumana tsoekere le / kapa chow, likhoto tsohle li ne li kenngoa ka lexxone (22 mg / kg, sc) ho etsa qeto ea ho tlohela ebe li kenngoa ka metsing hape bakeng sa teko e 'ngoe. Sehlopheng se neng se filoe Daily Intermittent Sucrose le Chow, boits'oaro ba ho baleha bo ile ba hatelloa haholo ha bo bapisoa le Ad libitum Sucrose le Chow le Ad libitum Chow (Feie. 3; Kim, Avena le Hoebel, ba sa ngolisoe). Phokotso ena ea boiteko ba ho phonyoha e ileng ea nkeloa sebaka ke ho phaphamala ka metsing ho bontša hore likhoto li bile le khatello ea maikutlo nakong ea ho ikhula.

Setšoantšo sa 3 

Likhoto tse bolokiloeng ho Daily Intermittent Sucrose le Chow ha li sisinyehe ho feta lihlopha tse laolang tlhahlobo e qobelloang ea ho sesa nakong ea khaolo ea naloxone. * p <0.05 ha e bapisoa le Ad libitum Sugar le Chow le Ad libitum Chow lihlopha. ...

Matšoao a ho khaola opiate le 'ona a hlaha ha lijo tsohle li tlosoa bakeng sa 24 h. Hape, sena se kenyelletsa matšoao a kang a ho oma meno, ho thothomela phatla le ho thothomela hoa hlooho (Colantuoni et al., 2002) le matšoenyeho joalo ka ha a lekantsoe le mofuta o phahameng oa tlatsetso (Avena, Bocarsly, Rada, Kim le Hoebel, o sa hatisoe). Ho itlhahisa ka boithatelo ho ntšitsoeng tsoekere ho tlalehiloe ho sebelisa mocheso oa 'mele o theohileng joalo ka mokhoa oa (Widman et al., 2005). Hape, matšoao a boitšoaro bo mabifi a fumanoe nakong ea ho khaotsa lijo tse kenyelletsang phihlello ea tsoekere nako le nako (Galic le Persinger, 2002).

4.C. “Ho Rata”: Ho arabela ka mokhoa o ntlafatsang bakeng sa tsoekere ka mor'a ho itlotsa

Joalokaha ho hlalositsoe Karolong ea 2, "ho lakatsa" liphoofolo tse sebetsang ka tlung ho ka hlalosoa e le tšusumetso e matla ea ho fumana ntho e hlekefelitsoeng (Koob le Le Moal, 2005). Kamora ho iketsetsa lithethefatsi tsa tlhekefetso ebe ka mor'a moo ba qobelloa ho hana, hangata liphoofolo li phehella ho arabela ka mokhoa o sa lefelloeng (ke hore, ho hanyetsa karabelo), le ho eketsa karabelo ea tsona bakeng sa lits'ebetso tse neng li amana le moriana o hola ka nako (ke hore, ho kenella kahare) (Bienkowski et al., 2004, Grimm et al., 2001, Lu et al., 2004). Ho kenyelletsa moo, haeba moriana o ka boela oa fumaneha hape, liphoofolo li tla nka tse fetang kamoo li neng li etsa ka teng pele ho thipa (ka mantsoe a reng, "phello ea tlholeho") (Sinclair le Senter, 1968). Keketseho ena ea tšusumetso ea ho fumana ntho ea tlhekefetso e ka tlatsetsa ho oeleng hape. Matla a "ho lakatsa" a bonahatsoa ke liphetho tse bonts'ang hore ka linako tse ling liphoofolo li tla tobana le litlamorao tse mpe ho fumana ntho e hlekefetsang joalo ka koae kapa joala (Deroche-Gamonet et al., 2004, Dickinson et al., 2002, Vanderschuren le Everitt, 2004). Matšoao ana a liphoofolo tse sebelisang maiketsetso a tšoana le a batho bao ho bonahatsoang ha tšusumetso ea nakoana e amanang le lithethefatsi tsa tlhekefetso ho eketsa litlaleho tsa boithati le monyetla oa ho oela hape (O'Brien et al., 1977, 1998).

Re sebelisitse "phello ea ho nyahlatsa" ho etsa lipatlisiso ka tšebeliso ea tsoekere ka mor'a ho khaotsa likhoto tse neng li ntse li ja tsoekere. Kamora ho fihlella tsoekere letsatsi le leng le le leng la 12-h, tsoekere ea likhoto bakeng sa tsoekere e fetang 23% tekong kamora liteko tse peli tse fetileng tsa ho ila seo ba neng ba se etsa pele (Feie. 4; Avena et al., 2005). Sehlopha se nang le ts'ebeliso ea letsatsi ka leng ea 0.5-h letsatsi le letsatsi ha sea ka sa bontša phello. Sena se fana ka sehlopha sa taolo e kopanetsoeng eo ho eona likhoto li tloaetseng tatso ea sucrose, empa li sa e je ka tsela e lebisang phelisong. Liphetho li supa phetoho tšusumetsong ea tsoekere e tsoelang pele libeke tse peli tsa ho ila, e lebisang keketsong e matlafalitsoeng.

Setšoantšo sa 4 

Kamora matsatsi a 14 a ho tlohela tsoekere, likhoto tse neng li na le phihlello ea letsatsi le letsatsi ea 12-h li eketsehile haholo ho hatella glucose ho 123% ea karabelo pele ho ts'ebeliso, ho bonts'a sepheo se eketsehileng sa tsoekere. Sehlopha se nang le phihlello ea letsatsi le letsatsi ea 0.5-h se entse ...

Ntle le moo, joalo ka litlhare tse hlalositsoeng ka holimo, tšusumetso ea ho fumana tsoekere e bonahala e "incubate", kapa e hola, ka bolelele ba ho ithiba (Shalev et al., 2001). Sebelisa boemo bo sebetsang, Grimm le basebetsi-mmoho (2005) fumana hore ho batla ka mokhoa o nepahetseng (ho hatella ka mokhoa o nyelisang le ho sesa ka sefahleho) hoa eketseha nakong ea ho itšila likhotong kamora ho fihlella tsoekere ka matsatsi a 10. Ho makatsang ke hore ho arabela sefubeng ho ne ho le kholo ka mor'a matsatsi a 30 a ho khaotsa ho tsuba ha ho bapisoa le beke e le 1 kapa letsatsi le le leng. Liphetho tsena li supa ho hlaha butle butle ha liphetoho tsa nako e telele ho potoloha ea neural e susumetsoang ka lebaka la ho itaola le ho inehela tsoekere.

4.D. "Tsebiso ea sefapano": Karabelo e eketsehang ea li-locomotor ho li-psychostimulants nakong ea ho ila tsoekere

Ho susumetsoa ke tšebeliso ea lithethefatsi ho ka bapala karolo ea bohlokoa ntlafatsong ea taolo ea lithethefatsi 'me ea ameha e le sesosa sa tlatsetso tlatsong ea lithethefatsi (Robinson le Berridge, 1993). Ka teko e tloaelehileng ea maikutlo, phoofolo e amohela lithethefatsi letsatsi le letsatsi hoo e ka bang beke, ebe ts'ebetso ea emisa. Leha ho le joalo, bokong ho na le liphetoho tse tšoarellang, esita le tse ntseng li hola kamora beke kapa ho feta ha tekanyetso e tlase ea phehisano ea lithethefatsi e hlahisa hyperlocomotion (Kalivas le al., 1992). Ntle le moo, maikutlo a sefapano ho tloha lithethefatsing se seng ho ea ho se seng a bontšitsoe ka lithethefatsi tse 'maloa tsa tlhekefetso, ho kenyelletsa le amphetamine sensitizing rats to cocaine or phencyclidine (Greenberg le Segal, 1985, Kalivas le Weber, 1988, Pierce le Kalivas, 1995, Schenk et al., 1991), k'habeche ea linotsi e natefeloa ke joala (Itzhak le Martin, 1999), le heroin e nang le cannabis (Pontieri et al., 2001). Lithuto tse ling li fumane phello ena ka lintho tse seng lithethefatsi. Kameho ea maikutlo a boitšoaro bohareng ba cocaine le khatello ea maikutlo li bontšitsoe (Antelman le Caggiula, 1977, Covington le Miczek, 2001, Prasad et al., 1998). Hape, keketseho ea takatso ea lijo (Bakshi le Kelley, 1994) kapa boits'oaro ba thobalano (Fiorino le Phillips, 1999, Nocjar le Panksepp, 2002) li hlokometsoe ho liphoofolo tse nang le nalane ea ho lematsa lithethefatsi.

Rona le ba bang re fumane hore Intermittent tsoekere e jang matsoai le lithethefatsi tsa tlhekefetso. Likhohla tse utluoang ka ente ea amphetamine ea letsatsi le leng le le leng (3 mg / kg, ip) e na le khatello ea mali beke e le 'ngoe ka mor'a ho latsoa tatso ea 10% (Avena le Hoebel, 2003a). Ka lehlakoreng le leng, likhoto li fepile Daily Intermittent Sugar le Chow li bonts'a maikutlo a sefapano ho amphetamine. Ka ho khetheha, liphoofolo tse joalo li na le phello e matla ha li arabela tekanyetso e tlase, e phephetsang ea amphetamine (0.5 mg / kg, ip) e sa nang le phello ho liphoofolo tsa naïve, le kamora matsatsi a 8 a ho tlohela tsoekere (Feie. 5; Avena le Hoebel, 2003b). Likhoto tse bolokiloeng lenaneong lena la phepo empa li tsamaisoa ka saline li ne li se na khatello ea mali hape, ebile litoeba li ne li se lihlopheng tsa taolo (Daily Intermittent Chow, Ad libitum Sugar le Chow, Ad libitum Chow) ba fuoe lethal dose la phephetso ea amphetamine. Ho kenella ka mokhoa o kenelletseng ka mokhoa o kenelletseng le hona ho khatholla maikutlo ka koae (Gosnell, 2005) hape e thusa nts'etsopele ea ntlafatso ea maikutlo ho DA agonist quinpirole (Foley et al., 2006). Kahoo, sephetho le bo-ramahlale ba bararo ba fapaneng ba li-labourist tse tharo tse fapaneng ba tšehetsa thuto ea hore ts'ebetso ea DA e khahlisoa ke phihlello ea tsoekere, joalo ka ha ho bonahatsoa ke maikutlo a fapakaneng. Sena ke sa bohlokoa ho tloha ha mesolimbic dopaminergic neurotransication e phetha karolo ea bohlokoa litlamorao tsa boits'oaro ba maikutlo le tšusumetso ea maikutlo (Robinson le Berridge, 1993), hape e ka kenya letsoho ho ho lemalla le ho hlonama ka tlhekefetso ea lithethefatsi.

Setšoantšo sa 5 

Ts'ebetso ea locomotor ka k'haraveneng ea lifoto e reriloeng e le liperesente tsa likheo tsa mantlha tsa borashe ka letsatsi 0. Liroto li ile tsa bolokoa matsatsi a 21 litsing tse boletsoeng tsa lijo. Likhoto tse bolokiloeng ho Daily Intermittent Sucrose le Chow li bile le khatello e matla matsatsi a robong hamorao ka karabelo ...

4.E. “Phello e ntle”: Ho eketsa joala haholo nakong ea ho itšoaetsa tsoekere

Liphuputso tse ngata li fumane hore ho tsepamisa maikutlo ho moriana o le mong ho ka lebisa ho ho se sebetse hantle feela, empa hape le ho natefeloa hoa moriana kapa ntho e 'ngoe e latelang (Ellgren et al., 2006, Henningfield et al., 1990, Hubbell et al., 1993, Liguori et al., 1997, Nichols et al., 1991, Piazza et al., 1989, Vezina, 2004, Vezina et al., 2002, Volpicelli et al., 1991). Re bua ka ketsahalo ena e le "maikutlo a fetisang maikutlo". Libukeng tsa bongaka, ha sethethefatsi se seng se isa ho se seng, sena se tsejoa e le "phello ea". Ho bohlokoa haholo ha sethethefatsi se molaong (mohlala, nicotine) se sebetsa e le tsela ea ho sebelisa lithethefatsi tse seng molaong (mohlala, k'hok'heine) (Lai et al., 2000).

Likhoto tse bolokiloeng phihlelong ea tsoekere nako le nako ebe li qobelloa ho hana, hamorao li bonts'a tšebeliso e matla ea tahi ea 9% (Avena et al., 2004). Sena se fana ka maikutlo a hore ho fihlela tsoekere nako le nako e ka ba tsela ea ho sebelisa joala haholo. Ba bang ba bontšitse hore liphoofolo tse ratang tatso e monate li tla ikhalemela koae ka lebelo le phahameng (Carroll et al., 2006). Joalo ka maikutlo a sefapano sa locomotor a hlalositsoeng kaholimo, motheo oa ts'ebetso ena ke liphetoho tse ka bang teng bokong, joalo ka liphetoho tsa DA le mohlomong mesebetsi ea opioid.

5. LITLHAKISO TSA BOPHELO TSA BOPHELO BA LITLHAKISO TSE SEBETSOENG KE LITLHAKISO TSA BOPHELO

Boithuto bo hlalositsoeng ka holimo bo fana ka maikutlo a hore ho fihlella tsoekere ka nako e telele ho ka hlahisa mekhoa e mengata e ts'oanang le e bonoang litlamong tse itšetlehileng ka lithethefatsi. Karolong ena, re hlalosa lipatlisiso tsa methapo e ka etsang hore tsoekere e be bonolo. Ho isa moo liphetoho tsena tsa boko li tšoanang le litlamorao tsa lithethefatsi tsa tlhekefetso, e tiisa taba ea hore tsoekere e ka tšoana le ntho ea tlhekefetso.

5.A. Ho ja lijo tse nang le tsoekere tse ngata D1, D2 le mu-opioid receptor e tlamang le polelo ea mRNA

Lithethefatsi tsa tlhekefetso li ka fetola li-receptor tsa DA le li-opioid libakeng tsa mesolimbic bokong. Lithuto tsa mahlale a limela tse khethiloeng D1, D2 le D3 bahanyetsi ba li-receptor le lithibelo tsa lefutso ba senotse hore litumelo tsohle tse tharo tsa li-receptor li sebetsana le litlamorao tse matlafatsang tsa tlhekefetso. Ho na le melaoana ea tsamaiso ea D1 receptors (Unterwald et al., 1994) le keketseho ea D1 receptor bindingAlburgs et al., 1993, Unterwald et al., 2001) ha a araba koae. Ka lehlakoreng le leng, D2 letsoalo la receptor le tlase ho NAc ea litšoene tse nang le nalane ea tšebeliso ea koae (Moore et al., 1998). Lithethefatsi tsa tlhekefetso li ka hlahisa liphetoho liphatlalatsong tsa mofuta oa li-receptors tsa DA. Morphine le cocaine li bontšitsoe hore li fokotse li-accumbens D2 receptor mRNA (Georges et al., 1999, Turchan et al., 1997), le keketseho ea D3 receptor mRNA (Spangler et al., 2003). Tsena li fumana le liphoofolo tse sebelisang laboratori li tšehetsa lithuto tsa tliliniki, tse senotseng hore D2 li-receptors li laoloa ka tlase ho lithethefatsi tsa koae (Volkow et al., 1996a, 1996b, 2006).

Ho bile le liphetoho tse tšoanang mabapi le phihlello ea tsoekere nako le nako. Autoradiography e senola eketsehile D1 ho NAc le ho fokotseha D2 receptor binding striatum (Feie. 6; Colantuoni et al., 2001). Sena se ne se amana le likhoto tse fepisitsoeng ka chow, kahoo ha ho tsejoe hore na ad libitum tsoekere le eona e ne e tla bontša phello ena. Ba bang ba tlalehile ho fokotseha ha D2 "receptor binding" NAc ea likhoto tse nang le lithibelo tse kenelletseng tsa ho sucrose le chow ha li bapisoa le likhoto tse fepelitsoeng limited feela (Bello et al., 2002). Likhoto tse nang le tsoekere e tsoang nako e telele le phihlello ea tsona le tsona li fokotsehile ho D2 receptor mRNA ho NAc bapisoa le ad libitum chow laolaSpangler et al., 2004). maemo a mRNA a D3 receptor mRNA ho NAc e eketsoa ho NAc le caudate-putamen.

Setšoantšo sa 6 

Liphetoho tse kenang tsa tsoekere tse fetolang litheko tsa DA tse amohelang boemo ba striatum. D1 li-receptor binding (konopo e kaholimo) e eketseha mokokotlong oa NAc le khetla ea liphoofolo e pepesitsoeng ho Daily Intermittent Glucose le Chow (li-baa tse ntšo) ka matsatsi a 30 ha ho bapisoa le taolo ...

Mabapi le li-receptor tsa opioid, binding ea mu-receptor ea eketseha ha e arabela cocaine le morphine (Bailey et al., 2005, Unterwald et al., 2001, Vigano et al., 2003). Mu-opioid receptor e tlamang e boetse e ntlafatsoa haholo kamora libeke tse tharo lijong tsa tsoekere tse tlang, ha li bapisoa le ad libitum chow. Phello ena e bonoe ka har'a khetla ea "ger", "cingate", hippocampus le locus coeruleus (Colantuoni et al., 2001).

5.B. Tšusumetso ea "tsoekere" e ka kenngoang tsoekere e tloaelehileng

Enkephalin mRNA ka har'a striatum le NAc e fokotsehile ka lebaka la liente tse phetoang hape tsa morphine (Georges et al., 1999, Turchan et al., 1997, Uhl et al., 1988). Liphetoho tsena ka har'a lits'ebetso tsa opioid li ts'oana le tse bonoang lithutong tsa batho tse itšetlehileng ka koae.Zubieta le al., 1996).

Likhoto tse nang le phihlello ea tsoekere e kenang nako le nako li bonts'a phokotso e kholo ho enkephalin mRNA, leha ho le thata ho ahlola bohlokoa ba eona ba ts'ebetso (Spangler et al., 2004). Phokotso ena ea enkephalin mRNA e tsamaellana le liphumano tse fumanoeng ho likhoto tse nang le phihlello e fokolang ea letsatsi le letsatsi ea lijo tse nang le mafura a mangata,Kelley et al., 2003). Ho nka ho fokotseha hona ha mRNA ho fella ka hore pepide e nyane ea encephalin e thelisoe 'me e lokolloe, e ka ikarabella bakeng sa keketseho e khotsofatsang ea li-receptor tsa mu-opioid, joalo ka ha ho boletsoe kaholimo.

5.C. Ho ja tsoekere letsatsi le leng le le leng khafetsa ho hlahisa dopamine ka makhetlo a mangata

E 'ngoe ea mathata a matla a methapo ea methapo pakeng tsa phihlello ea tsoekere le lithethefatsi tsa tlhekefetso e fumanoe e sebelisoa Ka vivo microsalysis ho lekanya extracellular DA. Keketseho e phetoang khafetsa ea extracellular DA ke letšoao la lithethefatsi tse sebelisoang hampe. DA ea kantle ho naha e eketseha ho NAc ho araba lithethefatsi tseo ka bobeli tse lemalloang (De Vries le Shippenberg, 2002, Di Chiara le Imperato, 1988, Everitt le Wolf, 2002, Hernandez le Hoebel, 1988, Hurd et al., 1988, Picciotto le Corrigall, 2002, Pothos et al., 1991, Rada le al., 1991a) le susumetso e amanang le lithethefatsi (Ito et al., 2000). Ho fapana le lithethefatsi tsa tlhekefetso, tse fanang ka litlamorao ho tokollo ea DA nako le nako ha li fuoa (Pothos et al., 1991, Wise et al., 1995), litlamorao tsa ho ja lijo tse natefeloang ke ho lokolloa ha DA li nyamela ka ho pheta-pheta ha lijo li se li sa sebetse, ntle le haeba phoofolo e le lijo tse se nang thuso (Bassareo le Di Chiara, 1999, Di Chiara le Tanda, 1997, Rada le al., 2005b). Kahoo ka tsela e tloaelehileng ho fepa ho fapane haholo le ho sebelisa lithethefatsi hobane karabelo ea DA nakong ea phepo e felisoa.

Leha ho le joalo, 'me sena se bohlokoa haholo, likhoto li fepa tsoekere e kenang letsatsi le letsatsi' me ho hlakile hore li lokolla DA letsatsi le leng le le leng joalokaha e lekantsoe ka matsatsi a 1, 2 le 21 a phihlello (Feie. 7; Rada le al., 2005b). E le taolo, likhoto li fepa tsoekere kapa chow ad libitum, likhoto tse nang le phihlello ea nakoana ho li-chow feela, kapa likhoto tse latsoang tsoekere makhetlo a mabeli feela, li hlahisa karabelo ea DA e sa hlatsuoang joalo ka ha e le lijo tse sa natsoeng. Liphetho tsena li ts'ehetsoa ke liphetho tsa phetoho lipokellong tsa DA le seteishene sa DA ka likhoto tse bolokiloeng kemisong ea phetisetso ea tsoekere nako le nako (Bello et al., 2003, Hajnal le Norgren, 2002). Ka bobeli, liphetho tsena li supa hore phihlello ea nako le nako ea tsoekere le chow e baka keketseho khafetsa ea DA ea kantle ho naha ka mokhoa o ts'oanang le lithethefatsi tsa tlhekefetso ho fapana le lijo.

Setšoantšo sa 7 

Likhoto tse nang le phihlello ea nako le nako ea ho lokolla tsoekere e tsoaloang ke DA ka lebaka la ho nwa sucrose bakeng sa metsotso e 60 ka letsatsi la 21. Dopamine, joalo ka ha e lekantsoe Ka vivo microdialysis, keketseho bakeng sa likhoto tsa Daily Intermittent Sucrose le Chow (mekotla e bulehileng) ka matsatsi a 1, 2 le 21; ka papiso, ...

Potso e khahlisang ke hore na litla-morao tsa ts'ebetso e hlokometsoeng ka phihlello ea tsoekere nako le nako li bakoa ke thepa ea eona e morao kapa hore tatso ea tsoekere e ka lekana. Ho etsa lipatlisiso ka litlamorao tsa tsoekere, re sebelisitse phepelo ea sham. Likhoto tse ntseng li fepa ka fistula e tsoang ka mpeng li ka monya lijo empa li sa li hlatse ka botlalo (Smith, 1998). Ho fepa ka Sham ha ho felise ka ho felletseng litlamorao tsa ho ingestive (Berthoud le Jeanrenaud, 1982, Sclafani le Nissenbaum, 1985), leha ho le joalo e lumella liphoofolo ho latsoa tsoekere ha li ntse li bolokile khalori feela.

Liphetho tsa ho fepa tsoekere sham bakeng sa hora ea pele ea ho fihlella letsatsi le leng le le leng li bonts'a hore DA e lokolloa ho NAc, le kamora ho qeta libeke tse tharo tsa ho itlopa lijo letsatsi le letsatsi, hobane feela e le ka lebaka la tatso ea sucrose (Avena et al., 2006). Ho fepa sham ha ho ntlafatse ho tsoakoa ha DA e tloaelehileng ea tsoekere. Sena se ts'ehetsa mosebetsi o mong o bonts'ang hore palo ea ho lokolloa ha DA ho NAc e lekana le mahloriso a sucrose, eseng palo e sebelisitsoeng (Hajnal et al., 2004).

5.D. Ho ntšoa ha li-acetylcholine tsa Accumbens ho lieha nakong ea lijo tse nang le tsoekere le ho felisoa nakong ea lijo tsa sham

Ho fepa Sham ho senotse litholoana tse khahlisang le ACh. Joalokaha ho hlalositsoe Karolong ea 3.C., Abenbens ACh e eketseha kahara lijo ha e fepa butle mme e ea emisa (Mark et al., 1992). Motho a ka bolela esale pele hore ha phoofolo e nka lijo tse ngata haholo, joalo ka lijo tsa pele tsa tharollo ea tsoekere le chow, ho lokolloa ha ACh ho lokela ho lieha ho fihlela ts'ebetso ea satiation e qala joalo ka ha ho bonts'oa ho felisoa ha lijo butle-butle. Sena ke se ileng sa bonoa; Ho lokolloa ha ACh ho etsahetse ha lijo tsa "ho itlopa" tsa pele li se li le haufiRada le al., 2005b).

Ka mor'a moo re ile ra lekanya ho lokolloa ha ACh ha phoofolo e ne e ka nka lijo tse ngata tsa tsoekere ha e ntse e fepa sham. Ho reka se ka hare ho mpa ho fokolitse ho lokolloa ha ACh (Avena et al., 2006). Sena se ka boleloa ho latela mohopolo oa hore ACh hangata e bohlokoa molemong oa ho satiation (Hoebel et al., 1999, Mark et al., 1992). E boetse e fana ka maikutlo a hore ka ho itlhatsoa, ​​motho o felisa karabelo ea ACh e hanyetsang DA. Kahoo ha "ho itlopa joala" ka tsoekere ho tsamaisana le ho itlhatsoa, ​​boits'oaro bo matlafatsoa ke DA ntle le ACh, e joalo ka ho sebelisa lithethefatsi hape ho tšoana le ho ja ka tloaelo.

5.E. Sekhahla sa ho tlosa tsoekere se nyolla dopamine / acetylcholine ho leka-lekana ho li-accumbens

Matšoao a boitšoaro a ho khaotsa lithethefatsi hangata a tsamaea le liphetoho lipakeng tsa DA / ACh ho lekaleng la NAc. Nakong ea ho tlosa, DA e fokotseha ha ACh e ntse e eketseha. Ho se leka-lekane hona ho bontšitsoe nakong ea ho khaotsa ho ts'oeroeng ke lik'hemik'hale ka lithethefatsi tse 'maloa tsa tlhekefetso, ho kenyelletsa morphine, nikotine le joala (Rada et al., 1996, 2001, 2004). Ho ila ntho e hlekefelitsoeng ho boetse ho lekane ho etsa hore motho a khaotse ho bona. Mohlala, likhoto tse qobelloang ho ila morphine kapa joala li fokotsehile ka ntle ho DA ho NAc (Acquas le Di Chiara, 1992, Rossetti et al., 1992) le ACh e eketseha nakong ea ha ho itšehla thajana ho morphine (Fiserova et al., 1999). Le ha ho itlhahisa ho lithethefatsi tsa anxyolitic (diazepam) tse hlahisoang ke mohanyetsi oa bendodiazepine-receptor ha e nyenyefatse extracellular DA, e lokolla li-AUD, tse ka tlatsetsang ho itšetleheng ha benzodiazepine (Rada le Hoebel, 2005)

Likhoto tse nang le phihlello ea nakoana le tsoekere le chow li bonts'a ho se leka-lekane ha morphine e amanang le methapo ho DA / ACh nakong ea ho ikhula. Sena se hlahisitsoe ka mekhoa e 'meli. Joalokaha ho bontšitsoe Feie. 8, ha ba fuoa naloxone ho fana ka maikutlo a ho tlosoa hoa opioid, ho na le phokotseho ea tokollo ea DA hammoho le keketseho ea tokollo ea ACh (Colantuoni et al., 2002). Ntho e ts'oanang e etsahala kamora 36 h ea ho haelloa ke lijo (Avena, Bocarsly, Rada, Kim, Hoebel, e sa phatlalatsoang). Mokhoa o mong oa ho toloka ho tlosoa hoa tlhokahalo ke ho fana ka maikutlo a hore kantle ho lijo ho lokolla li-opioid, phoofolo e na le bothata bo tšoanang ba ho khaotsa ho bonoa ha li-receptor tsa mu-opioid tse laoloang li koaloa ka naloxone.

Setšoantšo sa 8 

DA ea extracellular (graph e kaholimo) e fokotsehile ho isa ho 81% ea mantlha kamora hore a kenngoe lejoxone (3 mg / kg, sc) ka likhoto tse nang le nalane ea Daily Intermittent Sucrose le Chow. Acetylcholine (graph e tlaase) e nyolohetse ho 157% ka litekanyetso tse tšoanang tsa phallo ea tsoekere. ...

6. TLHOKOMELISO LE LITLHAKISO TSA CLINICAL

Lijo ha se joalo ka ntho ea tlhekefetso, empa ho itlopa lijo le maemo a hlekefetsang ho fetoha. Ho ipapisitsoe le boits'oaro bo shebiloeng le bo amanang le methapo ea kutlo lipakeng tsa litlamorao tsa phihlello ea tsoekere le lithethefatsi tsa tlhekefetso, re fana ka maikutlo a hore tsoekere, joalo ka ha e tloaelehile, leha ho le joalo e fihlela mekhoa ea tlhekefetso mme e kanna ea "lemalla" batho ba bang ha e jeoang ka mokhoa o "kulang joalo ka". Qeto ena e matlafatsoa ke liphetoho tsa methapo ea methapo ea methapo e tšoanang le lithethefatsi le tsoekere. Litlamorao tseo re li bonang li nyane ka boholo ho feta tse hlahisoang ke lithethefatsi tsa tlhekefetso joalo ka koae kapa morphine; le ha ho le joalo, taba ea hore boits'oaro bona le phetoho ea methapo ea kutlo li ka khothaletsoa ka matlafatso ea tlhaho lia khahla. Ha ho hlake ho tsoa mohlaleng ona oa phoofolo haeba ho fihlella tsoekere ka nako e telele ho ka baka ho se tsotelle mesebetsi ea sechaba joalokaha ho hlokoa ke tlhaloso ea ho its'etleha ho DSM-IV-TR (Mokhatlo oa Mahlale oa Amerika, 2000). Ebile ha ho tsejoe hore na likhoto li tla tsoela pele ho itlhahisa tsoekere ho sa tsotellehe litšitiso tsa 'mele, joalo ka ho mamella bohloko ho fumana tsoekere, joalo ka likhoto tse ling li etsa cocaine (Deroche-Gamonet et al., 2004). Le ha ho le joalo, letoto la liteko le senola ho tšoana lipakeng tsa tšusumetso ea tsoekere le tšusumetso ea lithethefatsi le ts'ebetso ea methapo ea kutlo, joalo ka ha li hlalositsoe Khaolong ea 4 le ea 5, li fa tumelo ea mohopolo oa "ho lemalla tsoekere", e fana ka tlhaloso e hlakileng, 'me e fana ka tlhahlobo mohlala.

6.A. Bulimia amanosa

Mokhoa oa ho fepa oa Daily Intermittent tsoekere le Chow o arolelana likarolo tse ling tsa boitšoaro ba batho ba fumanoeng ba e-na le bothata ba ho ja kapa ho ba le bulimia. Hangata likokoana-hloko li fokotsa ho ja haholo hoseng ebe li itlopa joala haholo mantsiboea, hangata lijong tse bonolo.Drewnowski et al., 1992, Gendall le al., 1997). Hamorao bakuli bana ba hlatsoa lijo, ebang ke ka ho li hlatsa kapa ka ho li sebelisa haholo, kapa maemong a mang ka ho ikoetlisa ka thata (Mokhatlo oa Mahlale oa Amerika, 2000). Bakuli ba Bulimic ba na le maemo a tlase a β-endorphin (Brewerton et al., 1992, Wall et al., 1986), e ka khothalletsang ho ja ka ho rata kapa ho lakatsa lipompong. Ba boetse ba fokotsehile li-receptor tsa mu-opioid ka har'a insula ha li bapisoa le taolo, e lumellanang le boits'oaro ba morao-rao ba ho itima lijo (Bencherif et al., 2005). Sena se fapane le keketseho e bonoang ho likhoto ka mor'a ho itlopa. Ho itlopa lijo ka leqhubu le ho haella ha lijo ho ka hlahisa liphetoho mokhoeng oa li-opioid receptors, tse thusang ho nts'etsapele mekhoa ea ho itlopa lijo.

Re sebelisitse lijo tsa sham ho etsisa tlhoekiso e amanang le bulimia. Ho fumana ho hlalositsoe Karolong ea 5.C., ho fihlella ha tsoekere nako le nako ho hlahisa DA khafetsa ho latela tatso ea tsoekere, ho ka ba bohlokoa ho utloisisa mekhoa e tlamang e amanang le bulimia. DA e bile le tšusumetso ho bulimia ka ho e bapisa le hypothalamic boithati, eo hape e lokollang DA ntle le likhalori (Hoebel et al., 1992). Bakuli ba Bulimic ba na le tšebetso e tlase ea DA joalo ka ha ho bonts'oa tlhahlobisong ea li-metabolites tsa DA maro a lesapo la mokokotlo, e leng se bonts'a karolo ho DA likarabo tsa bona tse sa tloaelehang lijong (Jimerson le al., 1992).

Mananeo a tšoanang ka botlalo a boitšoaro le ho feto-fetoha ha maikutlo ha boko le ho itlopa joala le tšebeliso ea lithethefatsi tse hlalositsoeng kaholimo li tšehetsa taba ea hore botenya le mathata a ho ja, joalo ka bulimia le anorexia, li kanna tsa ba le "bokhoba" ho batho ba bang (Davis le Claridge, 1998, Gillman le Lichtigfeld, 1986, Marrazzi le Luby, 1986, Mercer le Holder, 1997, Riva et al., 2006). Khopolo ea ho lemalla likoloi ka boeona e rerile hore mathata a mang a ho ja e ka ba temallo ho li-opioids tsa khale (Heubner, 1993, Marrazzi le Luby, 1986, 1990). Ka tšehetso, ho hloka takatso ea takatso ea lijo ka mokhoa oa ho itlopa lijo le ho ipolaisa tlala ho ka tsosa tšebetso ea opioid ea nako e telele (Aravich et al., 1993).

Bakuli ba bulimic ba tla itlopa lijo tse ngata haholo tse seng monate (Klein et al., 2006), ho fana ka maikutlo a hore ba fumana melemo ho khothatso e monate ea orosensory. Re bontšitse hore tlhoekiso e siea DA e sa qheleloe ka thipa e amanang le stiety e amanang le ACh ho li-accumbens (Karolo ea 5.D.). Boemo ba methapo ena ea kutlo bo ka etsa hore ho ja ho fetelletseng. Ntle le moo, liphumano tse nkang lijo tse tsoekere tse tsoekere ka nako e telele li kopana le amphetamine le tse khothalletsang tšebeliso ea lino tse tahang (Karolo ea 4.D. le 4.E.) li kanna tsa amana le ho hlonama pakeng tsa bulimia le tlhekefetso ea lithethefatsi (Holder et al., 1994).

6.B. Ho Nona Haholo

Tsoekere le botenya

Ho nona ke e 'ngoe ea lisosa tse ka sehloohong tsa lefu tse ka thibeloang Amerika (Mokdad et al., 2004). Boithuto bo 'maloa bo hokahane le ho eketseha ha maemo a botenya le keketseho ea tšebeliso ea tsoekere (Bray et al., 1992, Elliott et al., 2002, Howard le Wylie-Rosett, 2002, Ludwig et al., 2001). Lefapha la Temo la Amerika le tlalehile hore tšebeliso ea lino tse tahang ka ho ikatisa e eketsehile ka hoo e ka bang 500% lilemong tse 50 tse fetileng (Putnam le Allhouse, ka 1999). Ho ja tsoekere ho ka lebisa ho palo e eketsehang ea / le tumellano ea li-receptor tsa opioid, tseo ka tsona li lebisang ho keneng tsoekere le ho feta mme li ka tlatsetsa bothateng.Fullerton et al., 1985). Ho joalo, likhoto tse bolokiloeng lijong tsa phepelo ea tsoekere e tsoakiloeng li bonts'a liphetoho tsa "opioid receptor" (Karolo ea 5.A.); leha ho le joalo, kamora khoeli e le 'ngoe lijong li sebelisa 10% sucrose kapa 25% tsoekere, liphoofolo tsena ha li na boima ba mmele (Colantuoni et al., 2001, Avena le Hoebel, 2003b), leha ba bang ba tlalehile lefu la metabolic (Toida et al., 1996), tahlehelo ea mafura (Levine et al., 2003) le keketseho ea boima ba 'mele ho likhoto tse fepeloeng ke sucrose (Bock et al., 1995, Kawasaki et al., 2005) le tsoekere (Widman et al., 2005). Boholo ba lithuto tsa ho ja tsoekere le boima ba 'mele ha li sebelise lijo tse hohelang,' me phetolelo ea botena ba motho e thata.Levine et al., 2003). Joalokaha ho hlalositsoe Karolong ea 4A., ho bonahala hore likhoto ka sebopeho sa rona li lefella likhalori tsa sucrose kapa tsoekere ka ho fokotseha ho kenella haholo (Avena, Bocarsly, Rada, Kim le Hoebel, e sa phatlalatsoang). Ba nona ka sekhahla se tloaelehileng (Colantuoni et al., 2002). Sena se kanna sa se be joalo ka tsoekere eohle.

Fructose e tsoekere e ikhethang e nang le litlamorao tse fapaneng tsa 'mele ho feta tsoekere kapa sucrose. Fructose e kenella ka tlase ho mala, athe tsoekere e potoloha e tlosa insulin ho manyeme (Sato et al., 1996, Vilsboll et al., 2003), fructose e hlohlelletsa motsoako oa insulin empa ha e e lokolle (Curry, 1989, Le le Tappy, 2006, Sato et al., 1996). Insulin e fetola tšebeliso ea lijo ka ho thibela ho ja (Schwartz et al., 2000) le ka ho eketseha ha leptin (Saad et al., 1998), eo le eona e ka thibelang takatso ea lijo. Lijo tsa sirapo e nang le "cuctose" e ngata li ka fokotsa ho potoloha ha insulin le leptin (Teff et al., 2004), ho kenya letsoho ho eketsa boima ba 'mele. Kahoo, ho ja lijo tsa fructose ho ka 'na ha se ke ha fella ka tekanyo ea satiety eo hangata e ka bang teng le lijo tse nang le khalori e ngata ea tsoekere kapa sucrose. Kaha sirapo e nang le lero le phahameng la "fructose" e fetohile sebaka se ka sehloohong sejong sa Amerika.Bray et al., 2004) mme e haelloa ke litlamorao ho insulin le leptin, e kanna ea ba moemeli ea ka hlahisang botenya ha e fuoa litokollo khafetsa. Hore na matšoao a ho itšetleha ka fructose a bonahala kapa ha a fanoe nako le nako ha a e-so lokela ho tsejoa. Leha ho le joalo, ho latela liphetho tsa rona tse bonts'ang hore tatso e monate e lekane ho etsa hore ho lokolloe khafetsa ha DA ho NAc (bona Karolo ea 5.C.), re fana ka maikutlo a hore tatso efe kapa efe e monate e jeoang ka mokhoa o joalo o joalo ke moemeli oa ho hlahisa matšoao ea ho its'epa.

Mafura le botenya

Ha re ntse re khethile ho shebisisa tsoekere, potso e hlaha ea hore na lijo tse seng monate, tse monate li ka hlahisa matšoao kapa ho its'epa. Bopaki bo tsoakiloe. Ho bonahala eka matšoao a mang a ho itšetleha a bonahala ka mafura, athe a mang ha a so ka a bontšoa. Ho itlopa joala ho litoeba ho etsahala ka mokhoa o sa tsitsang oa ho fumana mafura a mangata (ho khutsufatsa hoa meroho), cookies tse mafura a monate (Boggiano et al., 2005, Corwin, 2006), kapa mafura a monate (Berner, Avena le Hoebel, a sa ngolisoe). Phihlello e phetoang hape, lipakeng tsa litokollo tsa oli ho DA ho NAc (Liang et al., 2006). Joalo ka tsoekere, ho itlopa lijo tse nang le mafura a mangata ho tsebahala ho ama ts'ebetso ea opioid ka har'a li-accumbens ka ho fokotsa enkephalin mRNA, e leng tšusumetso e sa bonoeng ka phihlello e mpe (Kelley et al., 2003). Hape kalafo e nang le baclofen (GABA-B agonist) e fokotsang tšebeliso ea lithethefatsi, e boetse e fokotsa ho ja ka thata tsa mafura (Buda-Levin et al., 2005).

Sena sohle se bolela hore ho itšetleha ka mafura ke monyetla oa nnete, empa ho tlohela ho itlopa lijo tse ngata ha ho bonahale joalo ka tsoekere. Le Magnen (1990) O ile a tseba hore naloxone e ka etsa hore ho se ke ha eba likhoto lijong tsa mofuta oa lijo tsa kofi, tse nang le lijo tse nang le mafura a mangata le tsoekere (mohlala, chisi, likuku, li-chocolate tsa chokolete). Leha ho le joalo, ha re e-so bone matšoao a ho nena ka boeona kapa ho itlhahisa ho sa khaotseng ka likhoto tse fepisitsoeng mafura a hloekileng (ho khutsufatsoa hoa meroho) kapa motsoako oa mafura a tsoekere, leha e le hore sephetho se joalo se phatlalalitsoe ke ba bang. Ho boetse ho hlokahala lithuto tse ling ho utloisisa ka botlalo phapang pakeng tsa ho baka le tsoekere la mafura le litlamorao tsa tsona boits'oarong. Joalo ka ha litlelase tse fapaneng tsa lithethefatsi (mohlala, dopamine agonists vs. opiates) li na le lipontšo tse ikhethileng tsa boits'oaro le 'mele, e kanna ea ba li-macronutrients tse fapaneng le tsona li ka hlahisa lipontšo tse ikhethileng tsa ho tlohela. Kaha takatso ea mafura kapa tšusumetso ea maikutlo lipakeng tsa ho ja mafura le lithethefatsi tsa tlhekefetso e se e sa ngolloa liphoofolong, tsoekere ke hona feela ntho e fumanehang eo ho itlopa joala, ho e tlosa, ho khothaletsang takatso le ts'usumetso ea maikutlo ohle li bontšitsoeng ( Karolo ea 4 le ea 5).

Pono ea boko

Liphumano tsa morao-rao tse sebelisang positron emission tomography (PET) le imagonance imaging imaging e sebetsang (fMRI) bathong li tšehelitse mohopolo oa hore boitšoaro bo bobe ba ho ja, ho kenyelletsa le bo bonoang boteng, bo ka ba le ho ts'oana le ts'ebeliso ea lithethefatsi. Liphetoho tse amanang le takatso ea letšoao la fMRI li se li supiloe ho arabela lijo tse fumanehang habonolo, tse ts'oanang le takatso ea lithethefatsi. Phetoho ena e etsahetse hippocampus, insula, le ho caudate (Pelchat et al., 2004). Ka mokhoa o ts'oanang, litekolo tsa PET li senola hore lithuto tse khahlisang li bontša phokotso ea striatal D2 ho fumaneha ha li-receptor tse amanang le boima ba 'mele ba taba (Wang et al., 2004b). Phokotso ena ho D2 li-receptors lithutong tse batenya haholo ho tšoana le phokotso e tlalehiloeng lithutong tse lemaletseng lithethefatsi.Wang et al., 2001). Ho kenya letsoho ha mokhoa oa DA ho putsa le ho matlafatsa ho lebelletse khopolo ea hore liphetoho tse teng tšebetsong ea DA lithutong tse tlotsitsoeng li li lahla tšebeliso e ngata ea lijo. Ho pepesehela lijo tse fumanehang habonolo, tse kang likuku le ice cream, ho kenya tšebetsong likarolo tse ngata tsa boko ho kenyeletsa le ho kenella kahare kahare le "cortex" e nepahetseng ea 'mele.Wang et al., 2004a), e ka eketsang khothatso ea ho fumana lijo (Rolls, 2006).

7. KHOTSO

Ho latela pono ea ho iphetola ha lintho, ho molemong oa batho hore ba be le takatso ea tlhaho ea lijo bakeng sa ho iphelisa. Leha ho le joalo, takatso ena e ka ferekana, 'me batho ba itseng, ho kenyeletsa bakuli ba batenya le ba feteletseng ba ka ba le ts'ehetso e mpe ea lijo tse fumanehang hantle tse sitisang bophelo bo botle. Mohopolo oa "bokhoba ba lijo" o kentsoe indastering ea lijo ka motheong oa litlaleho tse ka tlatsetso, litlaleho tsa kliniki le lithuto tsa linyeoe tse hlalositsoeng libukeng tsa ho ithusa. Ho eketseha ha botenya, hammoho le ho hlaha ha lipatlisiso tsa saense tsa ho tšoana ho teng lipakeng tsa lithethefatsi tsa tlhekefetso le lijo tse fumanehang habonolo ho file mohopolo ona. Bopaki bo lekiloeng bo tšehetsa khopolo ea hore, maemong a mang, ho fihlela tsoekere nako le nako ho ka lebisa ho boits'oaro le liphetoho tsa methapo e tšoanang le litlamorao tsa ntho e hlekefetsang. Ho latela bopaki bo liphatseng, ho fihlella tsoekere butle-butle ho khona ho hlahisa "ho itšetleha". Sena se ile sa hlalosoa ka ts'ebetso ke liteko tsa ho itlopa lijo, ho itlosa bolutu, ho lakatsa le ho faposa maikutlo ho amphetamine le joala. Sengoloa se fuoang batho ba bang ba nang le bothata ba ho ja ka thata kapa ho ba le bulimia sea hlolla, empa hore na ke taba e ntle ho bitsa sena “bokhoba ba lijo” bathong ke potso ea mahlale le ea sechaba e sa ntseng e lokela ho arajoa. Seo tlhahlobo ena e se bonts'ang ke hore likhoto tse nang le phihlello ea lijo le tharollo ea tsoekere li ka bonts'a sehlopha sa boitšoaro le liphetoho tsa kelello tse tšoanang le litoeba tse ithaopileng ho ithaopa. Ka tlatsetso, hona ke bopaki ba hore tsoekere e ka lemalla.

lumela hore baa fokola

Patlisiso ena e tšehelitsoe ke USPHS e fane ka MH-65024 (BGH), DA-10608 (BGH), DA-16458 (botsoalle le NMA) le Lane Foundation.

Mongolo o botlaaseng ba leqephe

Boitlhotlhollo ba Mohoeletsi: Ena ke faele ea PDF ea mongolo o ngotsoeng ka letsoho o sa amoheloang o amoheletsoeng bakeng sa ho hatisoa. Joaloka tšebeletso ho bareki ba rona re fana ka phetolelo ena ea pele ea mongolo o ngotsoeng ka letsoho. Mongolo o ngotsoeng ka letsoho o tla ba le ho kopitsa, ho kenya lihlopha le ho hlahloba bopaki bo hlahang pele o hatisoa ka mokhoa oa oona oa ho qetela. Ka kopo hlokomela hore nakong ea mekhoa ea tlhahiso ea lihlahisoa e ka fumanoa e ka amang litaba, le litsebiso tsohle tsa molao tse sebetsang koranteng e amanang le eona.

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