Khatello ea Kelello ea Neurobiol. 2019 Feb; 10: 100148.
E hatisitsoe Inthaneteng 2019 Feb 1. doi: 10.1016 / j.ynstr.2019.100148
PMCID: PMC6430516
PMID: 30937354
inahaneloang
Boithuto bo 'maloa bo lekantse litlamorao tsa lithethefatsi tsa psychoactive ho biology ea khatello, li-neuroadaptations tse hlahisoang ke tšebeliso e mpe ea lithethefatsi ho biology ea khatello, le litlamorao tsa eona ea ho lemalla ho lemalla hape. Tlhahlobo ena e akaretsa lipatlisiso tsa batho haholo ka litlamorao tse mpe tsa lithethefatsi tse fapaneng tsa tlhekefetso (ke hore, nicotine, cannabis, psychostimulants, joala le opioids) ho axis-pituitary-adrenal (HPA) axis le likarabo tsa tsamaiso ea methapo ea kutlo. Re lekola lingoliloeng ka likarabo tse matla tsa khatello ea maikutlo tse fumanehang ho batho ba naïve kapa basebelisi ba bobebe ba boithabiso le ba sebelisang lithethefatsi tse boima kapa tse sa foleng. Re boetse re buisana ka bopaki ba liphetoho lipakeng tsa tonic, kapa mamello, kamora ho fetoha le liphetoho tsa pele le tse amanang le karabelo ea khatello ea maikutlo. Re buisana ka phello ea mamello ea tsamaiso ea khatello ea maikutlo ho basebelisi ba boima ka karabelo ea bona ho likarabo tsa cue tse amanang le lithethefatsi le khatello ea maikutlo ha li bapisoa le lithuto. Kakaretso e fanoa ka litlamorao tsa likarabo tsa glucocorticoid le ho ikamahanya le tsona ho li-cortices tsa boko le tsa pele tse amehang taolong ea ho batla lithethefatsi le ho khutlisetsa kotsi. Kamora nako, re akaretsa lintlha tse bohlokoa tsa bohlokoa, ho kenyelletsa lintlha tsa phapang tse fapaneng le ba bong, tšebeliso e mpe ea lithethefatsi, tšohanyetso le mathata le nalane ea tšebeliso ea lithethefatsi le phapang ea mekhoa, e ka bang le litlamorao tsa lithethefatsi tsena ho biology ea khatello.
1. Selelekela
Mathata a ts'ebeliso ea lithethefatsi (SUDs) a kenya moroalo o moholo sechabeng sa United States le lefats'e ka bophara. United States feela, li-SUD li hakanyetsoa ho bitsa $ 400 limilione tse likete ho libaka tse fapaneng, ho kenyelletsa le botlokotsebe, liphetho tse mpe tsa bophelo bo botle, le tlhahiso e lahlehileng (Lefapha la Bophelo le Litšebeletso tsa Botho la US, 2016). Ho bile le liphetoho tse tšosang moqoqong oa tleliniki moo bacha ba ntseng ba thulana le litlamorao tse ngata ka lebaka la tšebeliso joalokaha ho bontšitsoe ke keketseho ea lefu la sebete le amanang le joala.Tapper le Parikh, 2018), ts'ebeliso ea ts'ebeliso ea opioid (Martins et al., 2017), le likotsi tsa koloi tse amanang le matekoane (Brady le Li, 2014). Mekhoa ena kaofela e bonts'a bohlokoa ba ho shebisisa mekhoa e ka thusang phetoho ho tloha tšebeliso e mpe ea tlhekefetso ea lithethefatsi hampe.
Matšoenyeho a bophelo ba pele ho nako le mathata a eketsehang a kenyelletsang bana, ho kenyelletsa tšoaro e mpe ea bana, ke lintho tsa bohlokoa tse nkang karolo ea bohlokoa ho poteng ha lithethefatsi, ho tloha ho nts'etsopele ea likhathatso, ho lokisa, ho khutla hape le ho hlaphoheloa ho tsoa ho li-SUDs (Henoke, 2011; Le Moal le Koob, 2007; Sinha, 2008, 2001). Ha ho shebisoe haholo litlamorao tse matla tsa ts'ebeliso ea lithethefatsi ka boeona ho karabelo e matla ea khatello ea maikutlo. Leha lithuto tse 'maloa li supile tokisong e fetotsoeng lits'ebetsong tsena, ha e shebelle haholo litlamorao tsa liphetoho tsena ho ts'ebelisong ea cue, khothatso ea lithethefatsi, le ho khutlela bothateng. Ka lebaka lena, re tsepamisitse likelello litlamorao tsa tšebeliso e mpe ea lithethefatsi le methapo e meng e sa ts'oaneng le khatello ea maikutlo le litlamorao tsa eona tse amanang le khatello ea maikutlo, moputso, ho lakatsa, le kotsi ea ho boelana. Mosebetsi oa nakong e fetileng o entse lipatlisiso tsa litlamorao tse mpe tsa lithethefatsi tse fapaneng tsa tlhekefetso mefuteng ea liphoofolo ea tšebeliso e mpe le e sa foleng (Armario, 2010) le lipatlisiso tsa boithuto mabapi le netefatso ea tahi (Lijffijt et al., 2014). Kahoo, re shebana haholo le lithuto tsa batho le karabelo ea khatello ea maikutlo 'me re kenyelletsa moputso o bohareng le litsela tse khothatsang ha re buisana ka litlamorao tsa biology ea paripheral khatello ea maikutlo ho khothaletsong ea lithethefatsi le tahi. Ntle le moo, tekolo ena e akaretsa lithethefatsi tse sebelisoang ka ho fetisisa tsa nicotine, joala, cannabis, psychostimulants (ke hore, koae le amphetamines) le opioids.
1.1. Kamano lipakeng tsa peripheral and neuroadaptations tse kholo ho ts'ebeliso ea lithethefatsi
Likarabo tsa khafetsa tse ithutoang khafetsa mabapi le SUDs li kenyelletsa makala a mabeli a marang-rang a tsamaiso ea methapo ea kutlo (ANS), haholo likarabo tsa 'mele tsa kutloelo-bohloko le liphapang tsa maikutlo, le karabelo ea neuroendocrine ea hypothalamic-pituitary-adrenal (HPA) axis (bona Milivojevic le Sinha, 2018 bakeng sa tlhahlobo ea li-biomarkers tsa khatello). Bakeng sa tlhahlobo ena, re tla shebisisa mehato e tobileng ea ANS (ke hore, epinephrine / norepinephrine, phapang ea pelo [HRV]) le likarabo tsa axero ea HPA (ke hore, adrenocorticotropic hormone [ACTH], cortisol / corticosterone; bona Feie. 1 bakeng sa papiso). Litsela tsa mantlha tsa khatello ea maikutlo bathong li hlalositsoe ka botlalo litlhahlobong tse fetileng (Lovallo, 2006; Sinha, 2008) hape e kenyelletsa tšebelisano lipakeng tsa stem ea boko (Locus Coeruleus [LC]; Ventral Tegmental Area [VTA]; Substantia Nigra [SN]; Dorsal Raphe), limbic (hypothalamus, amygdala, thalamus, le Bed Nucleus ea Stria terminali [BNST] ), striatal (ventral le dorsal) le ea kahare, cterate ea ka ntle le libaka tsa preortal cortex (PFC), le sensory le motor cortices, lipotoloho tse kentseng letsoho ts'ebetsong ea lithethefatsi le khatello ea maikutlo le ho laola likarabo tsena (bona Feie. 1). Litsela tsena tse mahareng tsa khatello ea maikutlo li bile le tšusumetso e kholo ho feta lisebelisoa tsa neuroimaging litlamorao tse matla tsa lithethefatsi, ho susumetsoa ke lithethefatsi le ho ba matšoao a kotsi ea ho oela hape (Goldstein le Volkow, 2002; Longo et al., 2016; Sinha, 2013, 2008; Sinha le Li, 2007).
2. Litla-morao tse matla le tse sa foleng tsa kelello tse nang le mathata a amanang le khatello ea maikutlo
2.1. Nikotine
2.1.1. Litlamorao tse mpe tsa nikotine ho batho ba sa tsubeng le ba bobebe
Litlamorao tse mpe tsa nikotine mokokotlong oa HPA ho batho ba sa tsubeng kapa ba tsubang ("chippers") ha li e-so be le tlaleho e ngata, haholo-holo mehlala ea batho, ha e bapisoa le basebelisi ba sa foleng. Leha ho le joalo, e lumellana le bopaki ho liphoofolo tse sa itšetlehang, nicotine e eketsa maemo a corticosterone haholo-holo maemong a phahameng a nicotine dosing (Akri, 1994; Chen le al., 2008; Donny et al., 2000; Lutfy et al., 2012; Okada et al., 2003). Ka bobeli nicotine-naïve le basebelisi ba kamehla ba nicotine ba bonts'a keketseho e itšetlehileng ka litekanyetso tsa cortisol, ACTH le prolactin li tlalehiloe (bona Mello, 2010 bakeng sa tlhahlobo). Boithuto ba mochine o teng mehlaleng ea liphoofolo bo bontša hore phello ea nicotine mokokotlong oa HPA e hlahisoa haholo-holo ke nicotine e hlahisitsoeng ea norepinephrine le CRH karolong ea mantlha ea "hypothalamus"Fu et al., 1997; Matta et al., 1990; Okada et al., 2003). Liphumano tsena tse kopaneng li bonts'a nicotine e butsisa axis ea HPA ka litlamorao tsa eona tse tobileng ho hlohlelletsa catecholaminergic le cholinergic ea ANS.
Mabapi le ANS, karabelo ea "naïve kapa" light "ea catecholamine e ngotsoe haholo mefuteng ea liphoofolo, empa lithuto tse 'maloa tsa batho li ithutile litlamorao tsa nicotine ho batho ba sa tsubeng. Epinephrine e bontšitsoe ka ts'epo hore e eketseha ka mokhoa o itšetlehileng ka lethal dose ha o arabela ka nicotine (Grunberg et al., 1988; Mello, 2010; Morse, 1989; Watts, 1960), haholoholo tlasa maemo a boithatelo ba ho ikatisa (Donny et al., 2000). Nikotine e boetse e eketsa tlhahiso ea pelo liphoofolong (Watts, 1960), sepheo se 'nileng sa phetoa ho batho ba sa tsubeng (Fouls et al., 1997; Perkins et al., 2009). Mehlaleng ea batho, lithuto tse 'maloa li bontšitse hore nikotine e eketsa ts'ebetso ea pelo joalo ka ha e lekantsoe le keketseho ea maqhubu a tlase (LF; index ea ts'ebetso ea kutloelo-bohloko),' me e fokotseha khafetsa (HF; ts'ebetso ea parasympathetic) HRV, ka bobeli ho arabela ho nikotini le ha sebetsa hammoho le khatello ea maikutlo (Karakaya et al., 2007; Sjoberg le Saint, 2011).
2.1.2. Litlamorao tse mpe tsa nicotine ho batho ba sa tsubeng, ba tsubang haholo
Tsamaiso e sa feleng ea nikotine e thatafatsa litekanyetso tsa tonic ea HPA axis. Batho ba tsubang ba sa foleng ba bonts'a litekanyetso tse kholo tsa basal cortisol tse amanang le bao e seng batho ba tsubang.al'Absi, 2006). Ho basebelisi ba sa foleng, tsamaiso ea nicotine e matla le ho feta e eketsa litekanyetso tsa cortisol le ACTH (Chen le al., 2008; Mendelson et al., 2008; Pomerleau le Pomerleau, 1990; Seyler et al., 1984; Wilkins et al., 1982) ka mokhoa o itšetlehileng ka litekanyetso (Hill le Wynder, 1974; Mendelson et al., 2005). Mefuta ea liphoofolo e bonts'a hore nicotine e phahamisa corticosterone le ACTH pele ho ts'ebeliso empa, le ha nikotine e ntse e hlohlelletsa ho hlaha, karabelo ena ho nikotine e ile ea hlomphuoa ka mor'a taolo e latellanang (Chen le al., 2008); papiso e phetoang thutong ea kamano ea batho moo basebelisi ba sa ts'oaneng ba bapisoang le li-chipper (Shiffman et al., 1992). Ho khaotsa ha Nikotine ho amahanngoa le molumo o phahameng oa basiti oa HPA le karabelo e sootho ho nicotine ka bolelele bo fapaneng ba ho se thibele (XNUMX)Cohen et al., 2004; Frederick et al., 1998). Kahoo, axis ea HPA e lumellana le litlamorao tse tsosang tsa ho tsuba ho sa feleng (bona al'Absi, 2006 bakeng sa ho lekola) le, nakong ea ho ila pelehi, liphetoho tsena li baka keketseho ea ketsahalo e mpefatsang ho tlohela.
Ba tsubang haholo ba boetse ba bonts'a tšitiso tsamaisong ea ANS e sebetsang. Joalo ka mokokotlo oa HPA, tsamaiso ea nicotine e hlobaetsang e eketsa epinephrine ea batho ba tsubang, norepinephrine, khatello ea mali le lebelo la pelo (DeVito et al., 2014; Fouls et al., 1997; Hill le Wynder, 1974; Mendelson et al., 2008; Minami et al., 1999; Sofuoglu et al., 2012, 2001; Tsuji et al., 1996; Wilkins et al., 1982). Tsamaiso e matla ea nicotine e boetse e eketsa LF HRV, e fokotsa HF HRV, mme e eketsa karolelano ea LF / HF HRV (Ashare et al., 2012; Barutcu et al., 2005; Karakaya et al., 2007; Kobayashi et al., 2005; Minami et al., 1999). Likuku tsa koae li na le karabelo e matla ea khatello ea mali ho nikotini ho feta ho tsejoang ke batho ba tsubang haholo (Shiffman et al., 1992). Ho tlohela mosebetsi ka mokhoa o tsitsitseng ho bonahala ho etsa mosebetsi o tloaelehileng oa ANS joalo ka ha o bonahatsoa ke maemo a epinephrine le norepinephrine le phokotso ea LF / HF HRV (Minami et al., 1999). Nikotine, ka hona, e kenya tšebetsong tsamaiso ea khatello ea maikutlo ea ANS maemong ka bobeli a karabelo e matla le molumo o akaretsang o thibelang ho ithiba ho sa feleng.
2.2. Mekhenike
2.2.1. Litlamorao tse mpe tsa cannabis ho basebelisi ba leseli
Δ1-tetrahydrocannabinol (THC) ke karolo ea kelello ea li-cannabis. Tsamaiso ea THC e sebetsa corticosterone / cortisol le ACTH ho liphoofolo ka bobeli (Kubena et al., 1971; Martí; n-Calderón et al., 1998; Puder et al., 1982le mehlala ea batho (D'Souza et al., 2004; Hollister et al., 1970; Ranganathan et al., 2009). Ketso ea li-cannabinoids tsa exo native axis ea HPA e rarahane, e fana ka litlamorao ka bobeli (Puder et al., 1982) bokaholimo ba hlooho ea "hypothalamus" le ka libaka tse ling tsa boko, ho kenyelletsa le amygdala ea basolateral (Armario, 2010). Ho tsuba koae kapa ho tsuba ka hanong ea molomo ho hlohlelletsa pelo le litlamorao tse bonoang ho HR le plasma epinephrine (Hollister et al., 1970) le ho eketsa sekhahla sa pelo (Lindgren et al., 1981; Strougo et al., 2008; Zuurman et al., 2010).
2.2.2. Litlamorao tse mpe tsa cannabis ho basebelisi ba boima
Ts'ebetso e matla ea li-cannabis tse tsubang kapa molomo oa THC ho basebelisi ba sa foleng le tsona li bontšitsoe ho khothaletsa li-ANS le axis ea HPA. Mabapi le axis ea HPA, cortisol e eketseha ho arabela ho tsuba matekoane kapa ho fumana methapo e kenang ea methapo ho tlalehiloe (Cone et al., 1986; D'Souza et al., 2008; Ranganathan et al., 2009). Leha ho le joalo, keketseho e susumetsoang ke THC ea basebelisi ba nang le mathata e ile ea phatloha ha e bapisoa le keketseho ea cortisol ea taolo e phetseng hantle (D'Souza et al., 2008; Ranganathan et al., 2009). Ho pepesetsoa nako e telele ho THC nakong ea libeke tse peli ho fokotse kholo ea cortisol e neng e lebelletsoe kamora ts'ebetso (Benowitz et al., 1976). Patlo ena e fetileng e kopantsoe le maemo a phahameng a basal cortisol ho basebelisi ba boima ba cannabis (Cuttler et al., 2017; King et al., 2011) le ho lula maemong a phahameng le kamora ho tlohela likhoeli tse tšeletseng (Somaini et al., 2012) fana ka tlhahiso ea hore ts'ebeliso ea cannabis e tsoelang pele e amahanngoa le liphetoho tse tšoarellang tsebeng ea HPA. Ho ke ho hlokomeloe hore ho latela lithuto tsena, ha ho hlake hore na cannabis e sa foleng e sebelisa ts'ebetso ea khatello ea maikutlo kapa ka mokhoa o fapaneng. Ha lithuto tse ling li fumane hore THC ha e ame phello ea epinephrine le norepinephrine (Dumont et al., 2009), THC e etsa hore ho be le karabelo e kholo ea pelo le basebelisi ba sa foleng (Dumont et al., 2009; Haney et al., 2016; Lindgren et al., 1981; Ramesh et al., 2013; Vandrey et al., 2013), empa karabelo ena ha e fapana pakeng tsa batho ba tsubang ba boima le ba bobebe ba ho tsubang (Haney et al., 2016). Kahoo, ho pepeseha ho matla hoa likarolo tsa kelello tsa "cannabis" ho eketsa ts'ebetso ea li-axis tsa HPA le pelo e matla, empa litlamorao tsa eona tsa catecholamines tsa peripher ha li hlakile ebile ho hlokahala lipatlisiso tse ngata. Ho tlohela ho tsuba ka tšohanyetso ho boetse ho entse hore khatello ea mali e eketsehe haholo (Vandrey et al., 2011); leha ho le joalo, keketseho e amanang le ho se thibele bophelo ba motho e lieha (Haney et al., 2018).
2.3. Li-stimulants
2.3.1. Litlamorao tse mpe tsa li-stimulants ho basebelisi ba naïve kapa leseli
Cocaine e eketsa corticosterone le cortisol ka litoeba tsa cocaine-naïve (Borowsky le Kuhn, 1991; Levy et al., 1991; Moldow le Fischman, ka 1987; Saphier et al., 1993; Sarnyai et al., 1992) le batho (Heesch et al., 1995) ka mokhoa o itšetlehileng ka litekanyetso. Ka mokhoa o ts'oanang, cocaine e boetse e eketsa ACTH ho litoeba tsa banna (Borowsky le Kuhn, 1991; Kuhn le Francis, 1997; Levy et al., 1991; Moldow le Fischman, ka 1987), leha sena se ne se sa phetoe thutong e le 'ngoe ea motho (Heesch et al., 1995). Ntle le moo, ho bonahala eka CRF e ka bapala karolo ea bohlokoa ts'ebetsong ea koae. Phuputso e 'ngoe e fumane hore CRF, ha e tsamaisoa ka mokhoa o sa feleng, e thibela litlamorao tsa karabelo ea HPA (Sarnyai et al., 1992). Bong bo ka ba mookameli oa bohlokoa joalo ka ha ho bontšitsoe ke phuputso e 'ngoe e fumanoeng hore litoeba tsa basali li na le karabelo e kholo ea corticosterone ho cocaine ho feta e motona (Kuhn le Francis, 1997). Ho fumana hona ho bohlokoa haholo hobane lithuto tse ngata tsa taolo ea koae li tsepamisitse maikutlo ho liphoofolo tse tona le ho batho. Cocaine e boetse e tsosa li-ANS joalo ka ha li pakoa ke epinephrine e eketsehileng le norepinephrine mohlaleng oa phoofolo (Chiueh le Kopin, 1978) le sekhahla se phahameng sa pelo mohlaleng oa motho (Vongpatanasin et al., 2004). Mefuteng ea batho, cocaine e eketsa HR haholo mme e fokotsa ts'ebetso ea ts'ebetso ea methapo ea kutlo ea kelello ha e bonahatsoa ke HF HRV e theotsoeng (Vongpatanasin et al., 2004).
Sehlopha se seng sa li-stimulants, amphetamines, se na le litlamorao tse tšoanang ho axis ea HPA le adrenergic system. Hoa tšoana le cocaine, amphetamines e eketsa cortisol e arabela ka motho (de Wit et al., 2007; dos Santos et al., 2011; Halbreich et al., 1981; Jacobs et al., 1989; Nurnberger et al., 1984; LM Oswald et al., 2005; Sachar et al., 1980; Söderpalm et al., 2003; Wand et al., 2007; White et al., 2006le disampole tsa litoeba (Knych le Eisenberg, 1979; Swerdlow et al., 1993). Batho ka bomong ba nang le nalane ea ho sebelisa methamphetamine bonyane makhetlo a tšeletseng, empa ba neng ba sa itšetleha, ba ne ba eketsehile ka cortisol ho arabela taolo ea methamphetamine (Harris et al., 2006, 2003). CRF le li-neurotransmitters tse ling li buisana le keketseho e bakoang ke cannabis ea cortisol (Armario, 2010; Swerdlow et al., 1993). Ntle le liketso tsa eona ho axis ea HPA, amphetamine e boetse e tsosa karabelo ea adrenergic joalo ka bopaki ba norepinephrine e eketsehang, khatello ea mali (Nurnberger et al., 1984, khatello ea mali (Nurnberger et al., 1984), le sekhahla sa pelo (de Wit et al., 2007). Amphetamine e sebetsa hantle ka mokhoa o hlakileng oa li-ANS tsa ba nang le boiphihlelo, empa ba sa ts'epa, basebelisi ba methamphetamine joalo ka ha ba thathamisitsoe ke norepinephrine metabolite, 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) (Harris et al., 2006).
2.3.2. Liphetho tse matla le tse sa foleng tsa li-stimulants ho basebelisi ba itšetlehileng
Lithuto tse 'maloa li bontšitse hore koae e eketsa secretion ea corticosterone (bona Marinelli le Piazza, 2002 bakeng sa tlhahlobo). Bathong, basebelisi ba cocaine ba sa foleng ba boetse ba bonts'a maemo a phahameng a cortisol le ACTH ha a fanoa ka koae (bona Manetti et al., 2014 bakeng sa tlhahlobo) le maemo a phahameng a basort ea cortisol (Haney et al., 2001) tseo ka bobeli li sa fetoloang ke ho ila (McDougle et al., 1994; Mendelson et al., 1988) kapa ea fokotsoang ka ho khaotsa ho tsuba koae (Buydens-Branchey et al., 2002). Tsamaiso ea cocoaine e boetse e matlafalitse karabelo ea adrenergic ho kenyeletsa le maemo a catecholamine (Sofuoglu et al., 2001, khatello ea mali, le sekhahla sa pelo (Esele, 2001;; bona Foltin et al., 1995 bakeng sa tlhahlobo; Kollins le Rush, 2002; Kosten et al., 1996; Lynch et al., 2008, 2006; Reid et al., 2006; Walsh et al., 2009) lethalotheoCollins et al., 2007; Foltin et al., 2003; Lynch et al., 2006). Boithuto bo bong bo bontšitse hore ho pepesehela khafetsa ka makhetlo a mangata khafetsa ho arabela ho tsitsa ha pelo bakeng sa koae ka likarabo tse matla haholo tse etsahalang nakong ea likokoana-hloko tsa cocaine tse behiloeng leihlo.Kollins le Rush, 2002; Walsh et al., 2009, 2000). Boithuto bo bong bo fumane hore, kamora ho phahama ha litlamorao tsa phello ea pelo le pelo, karabelo ea pelo le methapo e fana ka maikutlo a hore batho ba mamelle maemo a ho itlopa lijo.Bitmead le Bitmead, 1984; Foltin et al., 2003; Ward le al., 1997). Reed le basebetsi-mmoho ba (1984) karohano ea karabelo ea HR ka ho bapisa sebaka se ka tlase-ko-sekoahelong le keketseho e akaretsang ba bonts'a hore keketseho ea karabelo ea pelo le methapo e kanna ea ba ka lebaka la karabelo e hlakileng ea tsamaiso ea ho rala mekhahlelo ea maemo. Nakong ea ho itima lijo ka matla, norepinephrine metabolite MHPG e eketseha ha khatello ea mali ea systolic e le teng ha motho a arabela cocaine ea intranasal (McDougle et al., 1994). Methati ea pelo ea basal e phahame ho basebelisi ba cocaine ba sa foleng.Sharma le al., 2016).
Litlamorao tsa amphetamines maemong a cortisol ho basebelisi ba sa foleng li rarahane. Basebelisi ba kamehla ba 3,4-methylenedioxymethamphetamine (MDMA kapa "ecstasy") ba ne ba e-na le maemo a phahameng a cortisol ho feta leseli, basebelisi ba morao-rao kapa lits'ebetso tse sa sebeliseng (Parrott et al., 2014). Phuputso e 'ngoe e fumane hore ts'ebeliso ea amphetamine ha u ntse u le kalafong ea placebo e ne e amahanngoa le boemo bo tlase haholo ba cortisol kamora tsamaiso ea taolo ho batho ba itšetlehileng ka amphetamine ka naltrexone (Jayaram-Lindströ et al., 2008); leha ho le joalo, phuputso e 'ngoe e fumane hore methamphetamine e eketsehang cortisol le ACTH ho basebelisi ba nang le boiphihlelo ba sa tsebeng letho. Kameho ea li-amphetamine maemong a basal ea HPA axis ha e hlake hantle. Boithuto bo bong bo fumane hore batho ba sa sebeliseng kalafo ba batlang methapo e meng ea methamphetamine ba ne ba le tlase (Carson et al., 2012) kapa ha ho na phapang lipakeng tsa basal cortisol (Zorick et al., 2011) bapisoa le lithuto tse laoloang. Boithuto ba morao-rao ba lipatlisiso bo fumane ho se tšoane lipakeng tsa batho ba nang le ts'ehetso ea methamphetamine le lithuto ka mor'a libeke tse 'ne ba tlohele. Batho ba itšetlehileng ka Methamphetamine ba fetotse molumo o nang le kutloelo-bohloko ka ho eketseha ha LF HRV, ba fokotse HF HRV, le tekanyo e phahameng ea LF / HF, 'me tšebeliso e kholo e lumellana hantle le ea morao-rao (Henry et al., 2012). Ho hlokahala lipatlisiso tse ling ho utloisisa litlamorao tseo li-amphetamine li nang le tsona ho batho ba ts'ehetsang ba bang ka botlalo.
2.4. ho noa joala
2.4.1. Litlamorao tse mpe tsa joala ho lino tse bobebe / batho ba naïve
Joala bo hlohlelletsa axis ea HPA ho basebelisi ba sa its'epahalleng. Likhoto, joala bo bontšitsoe ho eketsa maemo a plasma corticosterone le ACTH ka mokhoa o sa fetoheng.Allen et al., 2011; Richardson et al., 2008). Ho batho, keketseho e ts'oanang ea cortisol e hlokometsoe ho arabela taolong ea joala e mpe (Frias et al., 2000; Gianoulakis et al., 1996; Mendelson le Stein, ka 1966; Välimäki et al., 1984; WJ et al., 1995). Ho bonahala litlamorao tsa joala mokokotlong oa HPA li hlaha haholoholo ka lebaka la liketso tsa joala mokokotlong oa "hypothalamus"Armario, 2010). Mabapi le ts'ebetso ea ANS, mehlala ea liphoofolo e bontšitse karabelo e phahameng ea epinephrine le karabelo ea norepinephrine ho tsamaiso e kenelletseng ea joala (Livezey et al., 1987; Perman, 1960) hape, joalo ka se hlokometsoeng ka maqhubu a HPA ho batho, a fumane hore joala bo ferekanya karabelo ea khatello ea maikutlo ha liphoofolo li kopana le khatello ea maikutlo. Ho batho, likarabo tsa noradrenaline le tsona li ile tsa phahamisoa le ho phahamisoa kamora metsotso e 30 kamora ho noa joala ba 0.9 g / kg mme ba lula ba le holimo kamora 4 h (Howes le Reid, 1985). Tsamaiso e mpe ea tahi e bonahala e ama methapo ea pelo le maikutlo a mofuthu a kutloelo-bohloko. Tsamaiso e mpe ea tahi e lekanang le litekanyetso tse ngata e fokotseha khafetsa HRV e phahameng ebile e eketsa lebelo la maqhubu a tlase a pelo le phallo e phahameng ea methapo ea pelo, index ea kutloelo-bohloko ho ts'ebetsong ea parasympathetic (Romanowicz et al., 2011). Ka kopanelo, liphetho tsena li tsamaellana le lithuto tsa liphoofolo mme li fana ka maikutlo a hore joala bo eketsa axis ea HPA le ts'ebetso ea ANS ho batho ba noang joala haholo mme e ka mpefatsa karabelo ea khatello ha e tsamaisoa haufi le moferefere.
2.4.2. Litlamorao tse mpe tsa joala mehlaleng e lemaletseng joala
Ho itlopa joala ho sa feleng ho fetola maemo a HPA le tsamaiso ea ANS ka ts'ebetso e phetoang hangata ke tšebeliso e ngata ea joala. Boemo ba "cortisol ba basal" bo phahame ka ho loma banna ba boima (Blaine et al., 2018; Thayer et al., 2006) le basali (Wemm et al., 2013). Ntle le moo, keketseho e lebelletsoeng ea cortisol ho arabela taolong ea joala e ile ea koaheloa haholo ha e bapisoa le ba noang bobebe / ba itekanetseng ba sechaba (King et al., 2006). Maemo a HRV a basal a bonahala a theoha haholo ho banna ba noang haholo, ho bonts'a ts'ebetso ea li-ANS (Thayer et al., 2006). Hape, batho ba neng ba noele haholo lilemong tse hlano tse fetileng ba bile le karabelo e fokolang ea cortisol ho setho sa joala ho bao e neng e le ba noang haholo.King et al., 2016).
Joala bo phahamisa maemo a cortisol ho liphoofolo tse itšetlehileng ka bobeli (Richardson et al., 2008) le batho (Adinoff et al., 2003; Feller et al., 2014; Mendelson le Stein, ka 1966; Stoke, 1973). Ha motho a tlohela joala, ho ikhula ho boetse ho amana le litekanyetso tse eketsehileng tsa basal cortisol (Mendelson le Stein, ka 1966) le phokotso ea phallo ea diurnal e theotsoeng (Adinoff et al., 1991; Lipalesa tsa Risher-et et.., 1988). Cortisol modumo le eona e batla e eketseha nakong ea ho nooa haholo (Wand le Dobs, 1991). Le ha maemo a basal cortisol a fokotseha nakong ea ho itšila nako e telele (Motaghinejad et al., 2015), ho itima lijo ho tsitsitseng ho amahanngoa le litekanyetso tsa basal cortisol tse ngata ha li bapisoa le taolo e phetseng hantle (Starcke et al., 2013). Ts'ebetso ea ts'ebetso ea ANS ho batho ba ikemiselitseng joala le eona e ameha ke joala. Botaoa ba boiketsetso bo ne bo amahanngoa le keketseho ea MHPG (Borg et al., 1981) mme, ha batho ba its'epahallang ba kena ho tlosoang haholo, maemo a MHPG a fokotseha ha nako e ntse e eketseha ea seno sa ho qetela (Hawley et al., 1994). Le ha e sa lekoe ka kotloloho karabong ea tahi e matla, ts'ebetso ea HRV e sebetsang e boetse e fetoloa ka kotlolloho ka ho ts'epa joala. Tlhahlobo ea meta e fumane hore ho itšetleha ka joala, ho sa tsotelehe boemo ba kalafo, ho amana le ho fokotseha ha maemo a basel HF HRV (Quintana et al., 2013). Ka kopanelo, liphetho tsa lithuto tsena li supa li-neuroadaptations ho HPA le karabelo ea ANS ka ts'ebeliso e tsitsitseng le ts'ebeliso e sa felletseng hoo ho nang le karohano kapa ho haella ha karabelo ea phasic empa litekanyetso tse phahameng tsa tonic ho basebelisi ba nang le taolo le litšebelisano.
2.5. Li-opioids
2.5.1. Litlamorao tse mpe tsa li-opioid ho basebelisi bao eseng bao hape ba bobebe
Ho fapana le lithethefatsi tse ling tsa tlhekefetso, li-opioids li bonahala li na le litlamorao tse fapaneng ho biology ea khatello ho penteng joalo ka batho. Ho litoeba, morphine e eketsa ACTH le corticosterone (Buckingham le Cooper, 1986; Eisenberg, 1985; Suemaru et al., 1989) athe, ho batho, morphine e nyenyefatsa karabo ea HPA (Delitala et al., 1983; George et al., 1974; Rittmaster et al., 1985; Zis et al., 1984). Naloxone, mohanyetsi oa opioid, o eketsa maemo a ACTH le cortisol bathong (Grossman et al., 1986; Naber et al., 1981) le likolobe (Richard et al., 1986; Rushen et al., 1993). Ho na le bopaki ba hore li-opioids li ama ka kotloloho axis ea HPA (Vuong et al., 2010) ho hatella likarabo tsa HPA axis. Tšusumetso ea li-opioid ho ANS e rarahane, karabelo e fokotsehileng ea axero ea HPA ho CRF, morphine e bile le tšusumetso e fokolang ho karabelo ea epinephrine le norepinephrine (Rittmaster et al., 1985). Le ha opioids e theola sekhahla sa pelo le khatello ea mali (Suemaru et al., 1989), HRV e phahameng haholo e bontšitsoe e fokotsehile ke li-opioid (Latson et al., 1992).
2.5.2. Litlamorao tse sa feleng tsa li-opioids litsamaisong tsa khatello maemong a itšetlehileng
Mohlaleng oa batho, li-opioid le agioists tsa opioid, ho kenyeletsoa methadone le buprenorphine, maemo a cortisol a hlakileng (Cami et al., 1992; Mendelson et al., 1975; Nava et al., 2006; Walter et al., 2011, 2008) le litekanyetso tsa basal cortisol li batla li phahame ho basebelisi ba itšetlehileng ka opioid ha ba bapisoa le taolo e phetseng hantle (Walter et al., 2011). Phuputso e 'ngoe ea pejana e fumane hore cortisol e ne e sa fetoloe ke tsamaiso ea heroin (Mendelson et al., 1975); mme patlisiso e sa tsoa feta e fumane hore diacetylmorphine, mofuta oa litlhare oa heroin o laetsoeng kalafo ea tlhokomelo, o fokotse maemo a cortisol haholo ho feta methadone (Walter et al., 2011). Ho tlosoa ho opioids ho tsamaisana le keketseho ea bohlokoa ea tonic maemong a ACTH le cortisol ho sa tsotelehe hore na e hlahisitsoe ke phephetso ea naloxone (Gerra et al., 2003) kapa e etsahetse ka tlhaho ha nako e ntse e feta (Shi et al., 2009). Ts'ebetso e matla ea li-opioid tsa methapo e amahanngoa le spike ea mantlha ea sekhahla sa pelo e lateloang ke phokotso e liehang ea sekhahla sa pelo (Kennedy et al., 2015; Rook et al., 2006). Mokhoa o tšoanang oa liphetho o fumanoe bakeng sa litlamorao tse amanang le ho khaola tsamaisong ea SAM. Ka ho khetheha, epinephrine, norepinephrine, LF HRV, le khatello ea mali li eketseha ka karabelo ho ho tlosoa ha eonaxone (Hoffman et al., 1998; Kienbaum et al., 1998; McDonald et al., 1999).
Motheong oa tlhahlobo e hlahisitsoeng likarolong tse fetileng, Lethathamo 1 e akaretsa tataiso ea likarabo tsa phasic HPA axis le likarabo tsa ANS taolong e mpe ea sehlahisoa se seng le se seng sa kelello sa tlhekefetso ho naïve / e sa senyeheng le ho ikamahanya le likarabo ho likarabo tsena ka basebelisi ba boima le ba ts'ehetsang ba amanang le taolo.
Lethathamo 1
Ntho | Karabelo e matla ea lithethefatsi | Binge / Disordered vs. Naïve / E sa senyehang * | ||
---|---|---|---|---|
HPA | ANS | HPA | ANS | |
Nicotine | ↑ | ↑ | ↓ | ↓ |
Cocaine | ↑ | ↑ | ? | ? |
Amphetamine | ↓ ↓ | ↑ | ? | ? |
Cannabis | ↑ | ↑ | ↓ | ↑ |
ho noa joala | ↑ | ↑ | ↓ | ↑ |
Li-opioids | ↓ | ↑ | ? | ? |
Tlhokomeliso: Ketsahalong ea tsamaiso ea methapo ea kutlo, LF HRV e supa karabelo ea ts'ebetso ea kutloelo-bohloko ea kutloelo-bohloko, athe HF HRV e bonts'a karabelo ea karohano. Mona, re ne re shebile ts'ebetso ea ts'ebetso ea methapo e nang le kutloelo-bohloko ka hare ho tsamaiso ea methapo ea kutlo.
* Litlamorao tse bohloko tsa lithethefatsi mokokotlong oa HPA le li-ANS lithutong tse sa sebelisoeng / tse bobebe (tšebeliso e seng ea beke le beke ka maemo a tlase haholo) ha li bapisoa le basebelisi ba hlotsoang ka botlalo.
↑ e bonts'a ts'ebetso; ↓ e bontša ho fokotsa; ↑ ↓ e bonts'a liphetho tse tsoakiloeng; = e bontša likarabo tse tšoanang; ? e bonts'a libaka tsa lipatlisiso tsa nako e tlang.
3. Liphetoho tse amanang le lithethefatsi ho biology ea khatello, moputso, takatso le takatso ea ho khutlela morao
Likarolo tse fetileng le Lethathamo 1 e totobatsa litlamorao tse matla tsa lithethefatsi tse tloaelehileng tsa psychoactive ho biology ea khatello le litlamorao tse matla tsa tšusumetso bakeng sa nicotine, cannabis, stimulant, le joala, le litlamorao tse nyahamisang tsa li-opioid tse mpe ho batho. Habohlokoa le ho feta, tšebeliso e ngata ea lithethefatsi tse sa khaotseng le tse sa foleng li fetola likarabo tsena tsa khatello, li supa liphetoho tse bohlokoa ho biology ea khatello. Ha tšebeliso ea lithethefatsi e ntse e eketseha khafetsa le botebo, litloaelo tsa maqhubu a HPA le litsela tsa ANS li bonts'a e le liphetoho maemong a basel, empa le likarabelong tsa phasic lithethefatsi, khatello le phephetso (bona al'Absi, 2006 bakeng sa ho hlahlojoa ha nikotine; Ashare et al., 2012;; bona Blaine le Sinha, 2017 bakeng sa tlhahlobo ea joala; McKee et al., 2011; McRae-Clark et al., 2011). Ka lehlakoreng le leng, keketseho ea basal e amanang le ho khaola e amanang le cortisol e amana le ho senyeha hoa kelello (Errico et al., 2002). Ka lehlakoreng le leng, mathata ana a ts'ebeliso ea kelello a ka mpefatsa moea oa ho lemalla Bernardin et al., 2014; Besson le ho lebala, 2016; Spronk et al., 2013 bakeng sa lipuisano).
Bopaki bona bo eketsehang bo tiisa potso ea hore na liphetoho tse joalo ho baeloji ea khatello ke litlamorao feela tsa tšebeliso ea lithethefatsi, kapa haeba li ka sebetsa e le liphetoho tse amanang le lithethefatsi tse ka bapalang tlhoko ea ts'ebeliso e mpe ea lithethefatsi le ho khutlisetsa kotsi ho basebelisi ba sa foleng. Ho se ho bile le lilemo tse mashome tse shebaneng le mesolimbic striatal dopaminergic pathways e le ea bohlokoa bakeng sa litlamorao tse matlafatsang tsa lithethefatsi tsa psychoactive. Le ha tloaelo ea ho tloaela maemo a striatal e ka tsamaisa tšusumetso e matla ea lithethefatsi, bopaki bo bong ba positron emission tomography (PET) bo bontša hore keketseho ea lithethefatsi tse matlafatsang tsa cortisol e amana haholo le ho lokolloa ha dopamine ka striatum (Booij et al., 2016; Cox et al., 2009; Wand et al., 2007) le likhokahano tsa cortisol tse bakoang ke lithethefatsi li amahanngoa le ho taoa ho tlatsetsang ho baithaopi ba phetseng hantle (Oswald et al., 2005). Ka mokhoa o ts'oanang, ts'ebetso ea khatello ea maikutlo ho baithaopi ba phetseng hantle e boetse e bontšitsoe ho eketsa phetisetso ea dopamine ho striatum le PFC (Nagano-Saito et al., 2013; Pruessner et al., 2004), le likarabo tsa cortisol ho khatello ea kelello le khatello ea kelello li bolela esale pele moputso ka mor'a taolo ea amphetamine (Hamidovic et al., 2010). Ka ts'ebetso ea ts'ebetso ea matla a ts'ebetso ea matla a khoheli (fMRI), ts'ebetso ea khatello ea kelello e baka ts'ebetso e matla ea ts'ebetso, haholo-holo ka har'a ventri striatum empa eseng dorsal striatum e amanang le likhatiso tse se nang khatello ea maikutlo ho baithaopi ba phetseng hantle (Sinha et al., 2016). Hape, ts'ebetso ho cortex ea ventromedial prefrontal cortex le rostral anterior cingrate cortex e ne e le ponelopele ea ho sebetsana ka katleho le maemo a tlase a ts'ebeliso ea joala. Tumellanong le liphumano tsena, liphuputso tse ling tsa fMRI li bonts'itse likarabo tsa khatello ea maikutlo ho batho ba kengoang ke koluoa ea ketsahalo ea boea bo kahare bo sa bonahaleng libakeng tsa maoto le tsa pele (Carroll et al., 2017; Ginty, 2013) tse bohlokoa bakeng sa ho laola boitšoaro bo susumetsoang le ho sebetsana ka katleho le maemo. Patlisiso e 'ngoe ea PET e tlaleha tahlehelo ea phetisetso ea dopamine le ho lokolloa ha dopamine ho bakuli ba sebelisang lithethefatsi hampe ho tsamaellana le tšebeliso e mpe ea lithethefatsi hammoho le keketseho e khothalletsoang ea ho hloleha hoa lithethefatsi le kalafo (Martinez et al., 2011; Martinez le Narendran, 2010). Hore na liphetoho tsena tsa dopamine tse tlotsitsoeng li amana le likarabo tse tlotsitsoeng ka glucocorticoid ho lithethefatsi kapa khatello ea maikutlo ha e so ka e fuputsoa ka botlalo. Le ha ho le joalo, datha tsena li totobatsa hore ts'ebetso ea ts'usumetso ea lithethefatsi ea khatello ea maikutlo le lits'oaetso tsa dopaminergic e sebetsa hantle haholo mme e fana ka maikutlo a hore ka bobeli ba ka bapala karolo litlamorao tsa ts'ebeliso ea lithethefatsi kelellong, le khotellong e matla ea lithethefatsi.
Liphumano tse tsoang liphuputsong tse 'maloa tse laoloang hantle tsa laboratori tse batlang kalafo kapa tse se nang kalafo le bakuli ba hlekefetsang lithethefatsi tse sebelisang lithethefatsi hampe li bonts'itse khatello ea khatello ea kelello cortisol le karabelo ea axs ea ANS ho khatello ea maikutlo le litheko tsa lithethefatsi hammoho le cortisol e phahameng ea basal le HR hammoho le litšitiso. Likarabo tsa HRV (Lethathamo 2;; bona Sinha, 2008 'me Milivojevic le Sinha, 2018 bakeng sa tlhahlobo). Likarabo tse joalo li rereloa hore ho ka ba le kotsi e kholo ea ho khutla kamora kalafo, 'me li etsahala ka takatso e kholo ea lithethefatsi nakong ea khatello ea maikutlo le ts'ebetso ea lithethefatsi.Ashare et al., 2012; McKee et al., 2011; Milivojevic le Sinha, 2018; Sinha, 2011; Sinha et al., 2006). Cortisol e foufalitsoeng e tsosang takatso ea khatello ea maikutlo le eona e bolela esale pele ka khothaletso ea joala e nooang ea ho noella joala ho itlopa joala, ba noang haholo (Blaine et al., 2018). Kahoo, lithuto tsena li hokahanya tloaelo le liphetoho lipakeng tsa khatello ea maikutlo le khatello ea maikutlo, ka hona li fana ka maikutlo a hore ho hlokahala hore sepheo sa tsona e be mats'oao a kotsi le khatello e matla empa hape le kholisong ea kalafo (Milivojevic le Sinha, 2018).
Lethathamo 2
Ntho | Tonic / Sebaka sa Basal | Khatello ea Khatello ea Kelello | Lits'oants'o tsa lithethefatsi | |||
---|---|---|---|---|---|---|
HPA | ANS | HPA | ANS | HPA | ANS | |
Nicotine | ↑ | ↑ | ↓ | ↑ = | ? | ↑ |
Cannabis | ↑ | ↑ | ↓ | ? | ↓ | ↑ |
Cocaine | ↑ | ↑ | ↓ | ↑ = | ↑ = | ↑ = |
Amphetamine | ↑ ↓ = | ↑ | ↓ | = | ? | ? |
ho noa joala | ↑ | ↑ | ↓ | ↓ = | ? | ↑ |
Li-opioids | ↑ | ↑ | ↓ ↓ | ↓ | ↑? | ↑ |
Tlhokomeliso: Papiso ea litekanyetso tsa tonic le litla-morao tse matla tsa phasic le khatello ea litheko tsa lithethefatsi leseling la HPA le li-ANS maemong a sa laoloang a bophelo bo botle a sa foleng, ho itlopa joala / ho hlekefetsa lithethefatsi (eseng ka ho itšoaetsa ho tlola kapa ho intša). Ts'ebetsong ea tsamaiso ea methapo e ikemetseng, LF HRV e bonts'a karabelo ea ts'ebetso ea kutloelo-bohloko ea ts'ebetso, athe HF HRV e bonts'a karabelo ea karohano. Mona, re ne re shebile ts'ebetso ea ts'ebetso ea methapo e nang le kutloelo-bohloko ka hare ho tsamaiso ea methapo ea kutlo.
↑ e bonts'a ts'ebetso; ↓ e bontša ho fokotsa; ↑ ↓ e bonts'a liphetho tse tsoakiloeng; = e bontša likarabo tse tšoanang; ↑? = bopaki bo fokolang, o hloka lipatlisiso tse ngata; ? e bonts'a libaka tsa lipatlisiso tsa nako e tlang.
Motheong oa tekolo e hlahisitsoeng likarolong tse fetileng, re hlahisa mohlala oa ho bonts'a khatello ea khatello ea khatello ea lithethefatsi ho Feie. 2. Se fumanoeng pejana se fana ka maikutlo a fepa pele-pele phello ea litlamorao ho biology ea khatello ea maikutlo. Biology ea rona ea khatello ea maikutlo e reretsoe ho re thusa ho ikamahanya le mathata a bophelo empa, ka lebaka la ts'ebeliso e mpe ea lithethefatsi le ts'ebeliso e mpe, ts'ebetso ena e mahlonoko ea likokoana-hloko e holofetse ebile e senyehile. Ka lebaka leo, basebelisi ba lithethefatsi ba boima le ba sa foleng ba kotsing ea ho angoa hampe, ho sithabela le ho sebetsana le khatello ea maikutlo. Ho feta moo, ka likarabo tse sithabetsang kapa tse "mamellehang" tsa khatello ea maikutlo ts'ebelisong ea lithethefatsi, litekanyetso tse kholo tsa ts'ebeliso ea lithethefatsi lia hlokahala ho boloka allostasis, ka tsela eo ho khanna potoloho ea ts'ebeliso e mpe ea lithethefatsi le khatello ea khatello ea maikutlo e tsoelang pele ho khothaletsa khatello e matla ea lithethefatsi le ho khutlela kotsing.
4. Lintho tse amang litlamorao tsa lithethefatsi ho likarabo tsa khatello ea maikutlo
4.1. Litholoana tsa lithethefatsi mabapi le ho arabela ho khatello ea maikutlo
Re shebile haholo phello ea lithethefatsi ts'ebetsong ea axis ea HPA le SAM likarolong tse fetileng; leha ho le joalo, bopaki bo sa aneleng ke bakuli le likhopolo tse ngata tsa ts'ebeliso ea lithethefatsi li supa taba ea hore khatello ea maikutlo hangata e etella ts'ebeliso, ka hona e ka fetola karabelo ho khatello ea maikutlo. Mohlaleng oa tlhahlobo ea tlhahlobo ena, liphuputso li bonts'itse hore tsamaiso e le 'ngoe ea lithethefatsi tse nang le khatello ea maikutlo e sitisa mokhoa o tloaelehileng oa karabo ea khatello ea maikutlo (Van Hedger et al., 2017). Mohlala, ha joala kapa methamphetamine e fanoa ka mor'a khatello ea maikutlo, sethethefatsi se sitisa karabelo ea cortisol ho khatello ea kelello le ea bongaka (Bana et al., 2010; Söderpalm et al., 2003). Joala bo fanoang hang ka mor'a hore khatello ea maikutlo e lelefatse lintho tse mpe tse mpe ebe e eketsa ho lakatsa ho arabela ho khatello ea maikutlo (Bana et al., 2011). Ha tekanyetso e tlase ea THC e ne e fanoa ka mor'a khatello ea maikutlo, khatello ea maikutlo le eona e ile ea tšoaetsoa; leha ho le joalo, litekanyetso tse phahameng tsa THC, ts'oaetso e mpe e ile ea eketseha, 'me khatello ea mali e ile ea phatloha (Bana et al., 2017). Ka mokhoa oa motho oa laboratori oa ho tsuba ho tsubang hape, ho pepesetsoa khatello ea maikutlo ho ile ha eketsa melemo ea ho tsuba, e amanang le cortisol (McKee et al., 2011). Leha ho le joalo, litlamorao tsena li ka ipapisa le mofuta oa lithethefatsi tse tsamaisitsoeng. Ka opioids, tsamaiso ea cortisol e ile ea fumanoa e fokotsa ho lakatsa ho bakuli ba sebelisang tekanyetso e tlase ea heroin (Walter et al., 2015). Ho fumana sena mohlomong ha ho makatse ha ho fanoa ka hore li-opioid li na le tšusumetso ho sistem ea HPA athe lintho tse ling tsa tlhekefetso li na le ts'ebetso e sebetsang. Patlisiso e eketsehileng e hlokahala ho utloisisa ka botlalo tšusumetso e kopanetsoeng ea lithethefatsi le khatello ea karabelo ea tsamaiso ea khatello.
4.2. Lintho tse amanang le lithethefatsi tse susumetsang karabo ea khatello ea maikutlo
Ho na le lintlha tse ngata tsa ho fupara (mohlala, khafetsa le boholo ba tšebeliso ea lithethefatsi tsa morao-rao, ho potlaka le boholo ba tšebeliso ea lithethefatsi tse matla, tekanyetso ea lithethefatsi tse fanoang le ho hlahlojoa, mofuta oa lithethefatsi ka sehlopheng se pharaletseng sa lithethefatsi, tsela ea tsamaiso) li ka ba le tšusumetso e ka bang teng ho matla a litlamorao tsa lithethefatsi ho likarabo tsa khatello ea maikutlo. Haholo-holo, Allain et al. (2015) buisanang ka karolo ea khafetsa ea tšebeliso ea lithethefatsi le ho potlaka ha tšebeliso nakong ea khatello ea methapo e le likarolo tsa bohlokoa tsa ho batla lithethefatsi le ho ba kotsing ea ho lemalla. Liphetho tsa boithatelo ba hore lithethefatsi li sebelisoa hangata hakae le topography ea tšebeliso e ka susumetsa litlamorao tsa lithethefatsi ka bobeli, likarabo tse amanang le lithethefatsi le tšusumetso ea lithethefatsi bakeng sa ts'ebeliso e tsoelang pele ea lithethefatsi.
Phuputsong e 'ngoe, King le basebetsi-'moho ba fumane hore lino tse phahameng tsa joala (0.8 g / kg) li eketsa litekanyetso tsa cortisol ho lino tse bobebe ha tekanyetso e tlase ea joala (0.4 g / kg) e sa ka ea etsa joalo mme hore ba noang haholo ba bonts'a likarabo tsa cortisol e sa bonahaleng (King et al., 2006). Ka hlakoreng le leng, Blaine et al. (2018) e bonts'a litekanyetso tse tlase tsa joala tse nooang ka tlasa moea oa tšusumetso ea boitšoaro bo eketsang cortisol ho basebelisi ba sa lekanang le ba ho itlopa joala. Lingoloa tse hlahlojoang mona li sebelisa mekhoa e fapaneng ea tsamaiso, ho kenyelletsa ho kenella kahare, ho kenella kahare, molomo le boits'ebetso. Tsela e 'ngoe le e' ngoe e na le liphapang moeling oa ho amoheloa ho ka bang le litlamorao tse fapaneng ho ntlafatseng lits'ebetso tsa khatello (Gourlay le Benowitz, 1997). Tlhatlhobo e 'ngoe ea bohlokoa ke phello ea nalane ea nalane ea ts'ebeliso ea lithethefatsi ho likarabo tse mpe tsa lithethefatsi. Ka mohlala, Ramchandani et al. (2002) o fumane hore ho eketseha ho nooang khoeling e fetileng pele a nka karolo ho ithuteng ho ile ha bolela esale pele karabelo e matla ea kelello le karabelo ea kelello ka mor'a taolo e kenelletseng ea joala. Boholo ba lipatlisiso tse entseng lipatlisiso ka litlamorao tsa lithethefatsi lits'ebetsong tsa khatello ea maikutlo li laetse hore batho ba lule nako e itseng pele ba nka karolo ho ithuteng; leha ho le joalo, batho ba bang ba kanna ba khetha ho qala ho itlopa bolutu pele ba nka karolo, ka hona, ba ka ba le likarabelo tse fapaneng taolong ea lithethefatsi ho latela bolelele ba bona ba ho khaotsa. Ka mokhoa o tšoanang, ha ho fanoa ka tšusumetso ea ho tlohela chelete mokokotlong oa HPA, ho ka etsahala hore karabelo ea khatello ea maikutlo ho tsamaiso ea lithethefatsi le eona e ka fapana ho latela boemo ba bona ba ho tlohela.
4.3. Lintho tse susumetsang karabelo ho khatello ea maikutlo
Histori ea Lelapa: Liphuputso tse ling li fana ka maikutlo a hore lintlha tse nkang karolo, joalo ka nalane ea lelapa ea ts'ebeliso ea joala, le tsona li ka bapala karolo. Barupeluoa ba sa ts'epahaleng ba nang le nalane ea malapa a mathata a tšebeliso ea joala ba bontšitse phokotso e tlisoang ke joala ho cortisol le ACTH ho amanang le batho ba se nang nalane e joalo ea lelapa (Schuckit et al., 1996; Zimmermann et al., 2004). Ka kopanelo, liphuputso tse tsoang liphuputsong tsena li fana ka maikutlo a hore batho bao e ka bang koluoa ea liphatsa tsa lefutso ba se ba bonts'itse mekhoa ea ts'ebetso joaloka basebelisi ba itšetlehileng ka eona.
Ts'ebeliso e Mpe ea Lithethefatsi: Boholo ba lithuto tsa lipatlisiso tse boletsoeng sehloohong sena li bua haholo ka mehlala e neng e itšetlehile ka moriana o le mong; leha ho le joalo, batho ba bangata ba batlang kalafo bakeng sa mathata a tšebeliso ea lithethefatsi ba tlaleha ho sebelisa mefuta e mengata e fapaneng ea lithethefatsi kapa ba nang le nalane ea ho itšepa linthong tse ling. Batho ba sebelisang matekoane ba sebelisa litlamorao tse matlafatsang tsa tšebeliso ea nicotine (Perkins et al., 2009). Tsamaiso e kopaneng ea koae le koae e baka karabelo e atileng ea pelo le ts'ebetso e mpe ea kelello ha e bapisoa le phello ea lithethefatsi tse le 'ngoe (Foltin et al., 1995, 1993; 1987; Foltin le Fischman, 1990). Boithuto bo bong bo fumane hore ts'ebeliso e kopaneng ea li-cannabis le MDMA e hlahisa karabelo e ntlafalitsoeng ea subjective le khatello ea methapo ho lithethefatsi (Dumont et al., 2009; Kollins et al., 2015). Liphumano tse fumanehang laboratoring ea rona li bonts'a hore nalane ea ho ts'epa matekoane ka joala kapa tšebeliso ea koae e sebelisa dysregulates HPA axis e arabela likhatellong tse amanang le lithethefatsi (Fox et al., 2013). Nikotine e eketsa joala ba ho itaola (Barrett et al., 2006) le, ka litekanyetso tse tlase tsa nikotine, e eketsa tlhahiso ea dopamine e entsoeng joala ho VTA (Tizabi et al., 2002). Ntle le sena, ha re tsebe letho ka tšusumetso ea mathata a polysubstance kapa nalane e meng ea lithethefatsi ea nakong e fetileng e na le axis ea HPA le karabelo ea ANS lithethefatsi.
bong: Karabelo ea lithethefatsi le eona e ka fapana ka bong. Basali, ka kakaretso, ba tloaetse ho tlaleha maikutlo a tebileng ka litlamorao tsa lithethefatsi ha ba bapisoa le banna. Mohlala, basali ba tloaetse ho bonts'a kutloisiso e kholo ho litlamorao tse mpe tsa tsamaiso ea methapo e ka hare ha e bapisoa le banna (DeVito et al., 2014; Sofuoglu le Mooney, 2009), mme banna ba tloaetse ho bonts'a tebello e kholo ea moputso oa mantlha oa tsamaiso ea methapo ea kutlo (nikotine (Perkins et al., 2009). Ha ba arabela cocaine, basali ba ile ba tlaleha matšoenyeho a maholo ka mor'a ts'ebetso (Kosten et al., 1996) hape ea fokotsoa (Lynch et al., 2008) ha ho bapisoa le banna. Banna ba tloaetse ho fuoa lithethefatsi tse ngata tse tlisoang ke dopamine tse phahameng haholo libakeng tsa litereke mme ba tlaleha litlamorao tse tšoanang tsa lithethefatsi ha li bapisoa le basali (Munro le al., 2006). Litlamorao tsa lithethefatsi tsena ho basali le tsona li ka fapana ho ea matsatsing. Motsoako oa joala o fapana ho ea matsatsing, ka hore tekanyo e potlakileng ea ho felisoa e bonoa karolong ea methating e bohareng ha e bapisoa le mekhahlelo ea pele ea lipolao le maqhubu a popelo.Sutker et al., 1987). Basali ba mokhatlong oa potoloho ea potoloho ea bona ba bontšitse karabelo e fokotsehileng ea koae (Sofuoglu et al., 1999), nicotine (DeVito et al., 2014), le amphetamine (Toka le de Wit, 1999) ha ho bapisoa le ba potaneng ea bona ea litšoantšo. Leha thuto e le 'ngoe e fumane litlamorao tse fokolang tsa thobalano le ho ilela khoeli ka ho arabela cocaine ea intranasal (Collins et al., 2007). Liphetho tsena tse kopaneng li fana ka maikutlo a hore li-steroids tsa neuroactive, joalo ka estrogen le progesterone, li bapala karolo ea bohlokoa ho metabolism le litlamorao tsa tsamaiso ea lithethefatsi.
Mothati oa Ntšetso-pele le Bohloko ba Pelehi: Ho na le bopaki ba hore reactivity e sithabetsang ea kelello ke ponelopele ea tšebeliso ea lintho tsa pele (Evans et al., 2012; Huizink et al., 2006), le hore batho ba nang le karabelo ea cortisol e sohlokehileng ba kotsing e eketsehileng ea ts'ebeliso ea lithethefatsi (Lovallo, 2006). Leha ho le joalo, ha ho hlake hore na karabelo ena e phositsoeng e eketsoa ke ho pepesehela lithethefatsi le hore na ke maemong afe a ntlafatso a leng batho ba kotsing e kholo ea ho itšireletsa. Ho pepeseha mahlomola a bophelo ba pele ho nako ho tseba litšusumetso holima axis ea HPA (Lovallo, 2013) mme e eketsa menyetla ea hore batho bana ba tla ba le mathata a ho lemalla hamorao bophelong (Doan et al., 2014;; bona Henoke, 2011 bakeng sa tlhahlobo; Gerra et al., 2014). Mathata a bophelo ba pele ho nako a amahanngoa le karabelo ea dopamine ho amphetamine ho ventral striatum (Oswald et al., 2014) le litheko tse tlase tsa bohlooho libakeng tse maoto le matsoho ho batho ba alafang lits'oants'o tsa ts'ebeliso ea lithethefatsi mme hape a re nako e khuts'oane ea ho khutla, ho sa tsotelehe mofuta oa lithethefatsi (Van Dam et al., 2014). Bathong ba itšetlehileng ka koae, mathata a bophelo ba peleng a eketsa karabelo ea cortisol le khatello ea maikutlo leha ho ne ho sena taolo e ntle ea ho tseba hore na karabelo ee e fosahetse (Flanagan et al., 2015). Phuputso ea morao-rao e fumane hore litsietsi tsa bophelo ba pelenyana li fetisitse phello ea ho tlosoa hoa karabelo ea tsamaiso ea khatello ho khatello ea maikutlo (al'Absi et al., 2018). Leha ho le joalo, ke liphuputso tse fokolang tse ileng tsa leka mekhatlo ena ka mokhoa o ikhethileng ho arabela khatello ea maikutlo, 'me ke ba seng bakae ba ntseng ba lekola phello ea mathata a bophelo ba pele ho arabela ts'ebetsong ea lithethefatsi.
5. Liphetho le mekhoa ea nako e tlang
Ho ja lithethefatsi tse nang le kelello tse nang le mafu a kelello ho na le litlamorao tse mpe tse tseleng ea khatello ea kelello. Litla-morao tsena li tšoana le litlamorao tse amanang le lithethefatsi khatello ea mantlha le meputso ea ho fetola mekhoa e mebe e amanang le lithethefatsi, neuroendocrine, le 'mele. Khafetsa, litekanyetso tse phahameng tsa ts'ebeliso ea lithethefatsi li fetola khatello ea maikutlo le likarabo tsa moputso ho tsa tonic le phasic le lipatlisiso tsa morao-rao li fana ka maikutlo a hore liphetoho tse joalo li amana haholo le mamello, ho tlosoa le ho tahoa ha lithethefatsi hammoho le ho bolela esale pele tšebeliso ea lithethefatsi tsa hona joale le phallo e tlang. Tlhahlobo ena e fana ka maikutlo a hore lintho tse lemalloang, leha li fapana ka sepheo sa ts'ebetso ea neurobiological ea ts'ebetso, li ts'oana le ho ba le phello e kholo le e matla litseleng tsa khatello ea maikutlo, ho ama likarabo tsa khatello ea maikutlo, takatso le tšebeliso ea lithethefatsi.
Leha ho le joalo, ho lokela ho hopoloa hore ho na le meeli ho se ka phethoang ho tsoa lingoliloeng tsa hajoale le libaka tsa bohlokoa bakeng sa lipatlisiso tsa nako e tlang. Boholo ba lithuto tse tšohliloeng mona li shebile ka ho felletseng ho barupeluoa ba naïve / basebelisi ba bobebe kapa basebelisi ba nako e telele / ba itšetlehileng ka bona; ke ba fokolang feela ba bapileng mefuta eohle ea basebelisi. Bakeng sa tse bapisang linthong tsohle, tšebeliso e sa foleng hangata e amahanngoa le ho fifatsoa ha ts'ebetso ea ts'ebetso ea lithethefatsi ea litsamaiso tsa khatello (Holdstock et al., 2000; King et al., 2006; Stormark et al., 1998; Thayer et al., 2006); leha ho le joalo, sena ha se hlakisoe ka botlalo lithethefatsing tse ngata. Patlisiso e eketsehileng ho bapisa basebelisi ba bobebe le basebelisi ba boima ho hlokahala ho utloisisa li-neuroadaptations tse etsahalang tsamaisong ea lithethefatsi ka botlalo. Ho feta moo, liphuputso tse ngata li bapisa khatello ea maikutlo ho basebelisi ba lithethefatsi tse sa feleng le taolo e phetseng hantle ke karolo e bohareng. Kahoo, e ke ke ea tsejoa hore na khatello ea maikutlo ea basebelisi ba boima e bakoa ke ho pepesehela lintho kapa ho li lebisa ts'ebelisong ea lithethefatsi nakong e tlang. Mohlomong, ebile kannete ho ka etsahala hore ebe phello ke ho lumellana. Batho ba nang le karabelo e sithabetsang ea khatello ea maikutlo, ka lebaka la tsieleho ea pele kapa nalane ea lelapa, ba na le monyetla oa ho sebelisa lithethefatsi hampe, tseo ka nako e 'ngoe li fetolang karabelo ea bona ea khatello. Kahoo, lipatlisiso tsa nako e telele, joalo ka tšebetso e kholo eo ke eona thuto ea Adolescent Brain Cognitive Development (ABCD), e bohlokoa bakeng sa ho khetholla haeba ts'ebeliso ea lithethefatsi e baka litloaelo le ts'ebeliso ea khatello ea maikutlo kapa e phahamisa khatello ea khatello ea maikutlo e neng e le teng pele. Chaplin le basebetsi mmoho le tsona makasineng ena e ikhethileng ba sebetsana le mekhatlo ena ea nakoana ponelopeleng e ntle ea likarolo tsa nts'etsopele tsa kamano lipakeng tsa tšebeliso ea lithethefatsi le ho se sebetsane ha khatello ea maikutlo.
Liphetoho tse amanang le lithethefatsi tsamaisong ea khatello ea maikutlo li ka hlaha khafetsa. Ka ho shebella ka boqhetseke pheletsong e 'ngoe ea khanya kapa ka lehlakoreng le leng, re kanna ra se ke ra ts'oara mahlaseli a felletseng a karabelo ea khatello ea maikutlo linthong tse lemalloang. Mefuta ea liphoofolo ho isa bohōleng bo itseng e ka sebetsana le tšebeliso ena empa, joalo ka ha e bonoa ho opiates (Armario, 2010), karabelo ea khatello ea methapo ea lithethefatsi e ka fapana liphoofolong le bathong. Tlhahlobo ea nako e tlang e lokela ho kopanya liphumano ho mefuta eohle. Kamora nako, ho se tšoane ho itseng, ho seng ho boletsoeng ka holimo, ho ka potlakisa kapa ho theola butle-butle tsoelo-peleng ena.
Leha ho na le likheo ka har'a lingoliloeng, liphuputso tsena ka kakaretso li fana ka maikutlo a hore ho se sebetse ha likarabo tsa khatello ea maikutlo ho ka sebetsa e le matšoao a ka thusang liteko tsa thibelo le sepheo sa nts'etsopele ea lipallo tsa kalafo (Greenwald, 2018; Milivojevic le Sinha, 2018). Maiteko a thibelo a lebisang batho ba nang le mabaka a itseng a kotsi a tsejoang ho ama khatello ea maikutlo (mohlala, mathata a bophelo ba peleho, liphatsa tsa lefutso, nalane ea lelapa) a ka fokotsa monyetla oa hore batho bana ba ka ba le bothata ba tšebeliso ea lithethefatsi. Mabapi le boiteko ba kalafo ho batho ba nang le mathata a ho lemalla, kalafo tse fumanehang li sebetsa hantle ka tsela e ikhethileng. Ho na le bopaki ba pejana ba hore ho kenella hoa meriana ho shebileng tsamaiso ea adrenergic ho ka fokotsa takatso ea ho tsosoa ke lithethefatsi le khatello ea maikutlo (Fox le Sinha, 2014; Fox et al., 2012; Le et al., 2011; Milivojevic le Sinha, 2018). Mekhoa ea kalafo e sebetsanang le taolo ea litakatso tse amanang le khatello ea maikutlo e ka ntlafatsa katleho ea kalafo e teng. Kahoo, ho tseba li-biomarkers tse ikhethang tse amanang le likarabo tsa khatello ea maikutlo ho ka re lumella ho tseba mekhoa e meng ea kalafo e lebisang ho karabelo ea khatello ea maikutlo ho ntlafatsa liteko tsa kalafo.
dithuso tsa ditjhelete
Mosebetsi ona o tšehelitsoe ka lithuso tse tsoang ho National Institutes of Health Health numbers, R01-AA013892, R01-AA020504, PL1-DA024859, le T32-DA007238.
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