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Forensic psychiatry assessment during parental alienation claims: two cases with different outcomes
Brazilian Journal of Psychiatry ( IF 5.5 ) Pub Date : 2020-08-01 , DOI: 10.1590/1516-4446-2020-0758
Roberta Pena 1 , Hélio Lauar 1 , Alcina Barros 2
Affiliation  

being mediated by the circadian gene, Bmal1. The interactions of melatonin and Bmal1 in the regulation of cocaine-driven changes in mitochondrial function will be important to determine. Cocaine also significantly alters immune system responses, generally increasing the activity of most immune cell subsets. Immune cell activation is powerfully regulated by the shift in mitochondrial metabolism from oxidative phosphorylation to glycolysis, with the shift back to an anti-inflammatory phenotype being driven by the autocrine effects of melatonin, as first shown by Regina Markus and colleagues in Brazil. The effects of melatonin – including via Bmal1 – in the mitochondria of immune cells on the regulation of cocaine’s effects is an important avenue for future investigation. Cocaine has significant effects on the gut microbiome, with the locomotor-inducing effects of cocaine being significantly modulated by the gut microbiome. This research suggests that increasing the levels of gut microbiome-derived short-chain fatty acids, especially butyrate, could have clinical utility. Butyrate effects include the induction of melatonin and the optimization of mitochondrial function, which may underpin its dampening effects on immune cell activity. Whether optimizing the gut microbiome with probiotics or with the nutraceutical sodium butyrate would afford additional clinical efficacy to melatonin in the management of cocaine addiction has yet to be clarified. Such lines of research should considerably help to clarify the biological underpinnings to melatonin’s interaction with cocaine, as well as help optimize treatment.

中文翻译:

父母异化索赔期间的法医精神病学评估:两个不同结果的案例

由昼夜节律基因 Bmal1 介导。褪黑激素和 Bmal1 在调节可卡因驱动的线粒体功能变化中的相互作用将很重要。可卡因还显着改变免疫系统反应,通常会增加大多数免疫细胞亚群的活性。免疫细胞激活受到线粒体代谢从氧化磷酸化到糖酵解的转变的有力调节,褪黑激素的自​​分泌作用驱动了向抗炎表型的转变,正如巴西的 Regina Markus 及其同事首次展示的那样。褪黑激素(包括通过 Bmal1)在免疫细胞线粒体中对可卡因作用调节的影响是未来研究的重要途径。可卡因对肠道微生物群有显着影响,可卡因的运动诱导作用受到肠道微生物群的显着调节。这项研究表明,增加肠道微生物组衍生的短链脂肪酸的水平,尤其是丁酸盐,可能具有临床效用。丁酸盐的作用包括诱导褪黑激素和优化线粒体功能,这可能是其对免疫细胞活性的抑制作用的基础。用益生菌或营养保健品丁酸钠优化肠道微生物组是否会比褪黑激素在可卡因成瘾的管理中提供额外的临床疗效尚待澄清。此类研究应大大有助于阐明褪黑激素与可卡因相互作用的生物学基础,并有助于优化治疗。
更新日期:2020-08-01
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