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Neonatal opioid exposure:public health crisis and novel neuroinflammatory disease

Neural Regeneration Research 2021年第3期16卷 430-432页

作者： Vikram Vasan yuma kitase Jessie C.Newville Shenandoah Robinson Gwendolyn Gerner V.Joanna Burton Lauren L.Jantzie Department of Pediatrics Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMDDepartment of NeurologyKennedy Krieger InstituteBaltimoreMDDepartment of PediatricsUniversity of New Mexico School of MedicineAlbuquerqueNMDepartment of NeurosciencesUniversity of New Mexico School of MedicineAlbuquerqueNMUSA

Substance use,specifically the use of prescription and non-prescription opioids among pregnant women,is a major public health issue and chief contributor to the opioid crisis.The prevalence of Neonatal Opioid Withdrawal Syndrome has risen 5-fold in the past decade,and is a well-recognized consequence of perinatal opioid exposure.By contrast,the long-term damage to the developing brain from opioid medications is just beginning to be recognized as a serious concern.Published data suggest that opioid exposure commencing in utero negatively affects the maturation of the neural-immune system,and trajectory of central nervous system development.Methadone induces peripheral immune hyper-reactivity,lasting structural and microstructural brain injury,and significant deficits in executive function and cognitive control in adult animals following in utero exposure.Thus,to address the cascading public health crisis stemming from the multitude of infants with in utero opioid exposure who will grow up with altered neurodevelopmental trajectories,rigorous preclinical,mechanistic studies are required.Such studies will define the long-term sequelae of prenatal opioid exposure in an effort to develop appropriate and targeted interventions.Specifically,the development of novel fluid,neuroimaging and biobehavioral biomarkers will be the most useful to aid in early identification and treatment of opioid exposed infants with the greatest risk of poor clinical outcomes.These studies will be essential to understand how in utero insults determine brain structure and function in adulthood,and what targeted interventions will be required to improve longterm outcomes in the countless children being born exposed to opioids each year.

关键词： biomarker buprenorphine cognition executive function magnetic resonance imaging methadone neonate

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