烟草使用障碍的外周生物标志物:系统综述

D. Newton
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引用次数: 0

摘要

烟草使用障碍(TUD)是全球主要的卫生保健负担,每年导致700万人死亡。TUD几乎没有批准的戒烟辅助药物,所有这些药物都与一年内的高复发率有关。TUD严重程度、治疗反应和复发风险的生物标志物在确定理想应答者和指导额外治疗资源方面具有很高的潜在临床应用价值。方法:使用生物标记物、磷酸二羟丙酮、胆红素、肌醇、可替宁、促肾上腺皮质激素、皮质醇、垂体-肾上腺系统、同型香草酸、多巴胺、促阿片黑素皮质素、脂质、脂质代谢等与烟草使用障碍交叉参考的术语进行MEDLINE检索。结果:检索得到424条结果,其中57条符合纳入标准。最常研究的生物标志物是与尼古丁代谢、下丘脑-垂体-肾上腺轴(HPA)和心血管(CVD)风险相关的生物标志物。尼古丁代谢与依赖的严重程度和治疗反应最相关,而HPA轴和CVD标志物与依赖和复发风险的相关性较弱。结论:尼古丁代谢物比、皮质醇和动脉粥样硬化标志物似乎是最有希望进一步研究的先导生物标志物,尽管文献主体仍处于初步阶段。需要进行纵向、重复测量的研究,以确定观察到的关联的方向性,并确定这些生物标志物的真正预测能力。未来的研究还应努力研究共病精神疾病人群,以确定某些生物标志物的效用差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Peripheral Biomarkers of Tobacco-Use Disorder: A Systematic Review
Introduction: Tobacco use disorder (TUD) is a major worldwide healthcare burden resulting in 7 million deaths annually. TUD has few approved cessation aids, all of which are associated a high rate of relapse within one year. Biomarkers of TUD severity, treatment response, and risk of relapse have high potential clinical utility to identify ideal responders and guide additional treatment resources. Methods: A MEDLINE search was performed using the terms biomarkers, dihydroxyacetone phosphate, bilirubin, inositol, cotinine, adrenocorticotropic hormone, cortisol, pituitary-adrenal system, homovanillic acid, dopamine, pro-opiomelanocortin, lipids, lipid metabolism all cross-referenced with tobacco-use disorder. Results: The search yielded 424 results, of which 57 met inclusion criteria. The most commonly studied biomarkers were those related to nicotine metabolism, the hypothalamic-pituitary-adrenal (HPA) axis, and cardiovascular (CVD) risk. Nicotine metabolism was most associated with severity of dependence and treatment response, where as HPA axis and CVD markers showed less robust associations with dependence and relapse risk. Conclusions: Nicotine-metabolite ratio, cortisol, and atherogenicity markers appear to be the most promising lead biomarkers for further investigation, though the body of literature is still preliminary. Longitudinal, repeated-measures studies are required to determine the directionality of the observed associations and determine true predictive power of these biomarkers. Future studies should also endeavour to study populations with comorbid psychiatric disorders to determine differences in utility of certain biomarkers.
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