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Developmental neurotoxicity of MDMA. A systematic literature review summarized in a putative adverse outcome pathway

机译:MDMA的发育神经毒性。 在推定的不利结果途径中综述了系统的文献综述

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摘要

The increasing use of illegal drugs by pregnant women causes a public health concern because it is associated with health risks for mothers and their developing children. One of such drugs is MDMA (3,4-methylenedioxymethamphetamine) or ecstasy due to its high consumption in relevant age and sex groups and its adverse effects on human and rodent developing brains. To thoroughly review the current knowledge on the developmentally neurotoxic potential of MDMA we systematically collected and summarized articles investigating developmental neurotoxicity (DNT) of MDMA in humans and animals in vivo and in vitro. In addition, we summarized the findings in a putative adverse outcome pathway (AOP). From an initial 299 articles retrieved from the bibliographic databases Web of Science, PubMed and DART, we selected 39 articles according to inclusion/exclusion criteria for data collection after title/abstract and full text screening. Of these 3 where epidemiological studies, 34 where in vivo studies in mice and rats and 2 were in vitro studies. The three epidemiological studies reported from the same longitudinal study and suggested that MDMA exposure during pregnancy impairs neuromotor function in infants. In rat, postnatal exposure towards MDMA also caused locomotor deficits as well as impaired spatial learning that might be associated with decreased serotonin levels in the hippocampus. In vitro MDMA caused cytotoxicity at high concentrations and effects on the serotonergic and neuritogenic alterations at lower concentrations which are in line with some of the in vivo alterations observed. Considering the adverse outcomes of developmental MDMA described in humans and in rodents we summarized the first putative AOP on developmental compound exposure leading to impaired neuromotor function in children. For generation of this AOP, MDMA exposure was taken as a model compound. In addition, we hypothesized a second AOP involving developmental disturbance of the dopaminergic system. However, further in vitro mechanistic studies are needed to understand the molecular initiating event(s) (MIE) triggering the downstream cascades and obtain consistent evidences causally linking the adverse outcome to effects at the cellular, organ and organism level.
机译:由于孕妇越来越多地利用非法药物导致公共卫生关注,因为它与母亲和发展中国家的健康风险有关。其中一种药物是MDMA(3,4-亚甲基二氧基戊酰胺)或由于其在相关年龄和性群体的高消耗以及对人和啮齿动物发育大脑的不利影响而产生的。彻底审查目前关于MDMA的发育神经毒性潜力的目前的知识,我们系统地收集和概括了在体内和体外体内的人和动物中的MDMA发育神经毒性(DNT)的文章。此外,我们在推定的不利结果途径(AOP)中总结了该研究结果。从初始的299文章从“书目数据库网络”,PubMed和Dart检索,我们根据包含/排除标准选择39篇文章,用于标题/摘要和全文筛选后的数据收集。其中3个流行病学研究,34在小鼠和大鼠中的体内研究和2中的体外研究。从相同的纵向研究报告了三种流行病学研究,并提出了在妊娠期间的MDMA暴露在婴儿中损害神经电动机功能。在大鼠中,对MDMA的后期暴露还导致运动缺陷以及可能与海马中的血清素水平降低有关的空间学习。体外MDMA在高浓度下引起细胞毒性,并对较低浓度的血清奈良菌和神经根出改变的影响,这些浓度与观察到的一些体内改变。考虑到人类和啮齿动物中描述的发育MDMA的不良结果,我们总结了第一个推定的AOP对发育复合的暴露导致儿童神经大通功能受损。对于该AOP的产生,MDMA暴露作为模型化合物。此外,我们假设涉及多巴胺能系统的发育扰动的第二个AOP。然而,需要进一步的体外机械研究来理解触发下游级联的分子发起事件(mie),并获得一致的证据,这些证据随着在细胞,器官和生物水平对效应的不利结果。

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