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Previous issue date: 2014-01-16 / BACKGROUND: Both childhood maltreatment (CM) and substance abuse, especially cocaine, have robust effects on the inflammatory system. Considering that CM have been described as an important risk factor for addiction, this study aimed to investigate peripheral levels of inflammatory mediators during early abstinence from female crack cocaine dependents with and without history of CM. METHOD: This dissertation consists of two empirical studies. The first is a follow-up study that investigated three adipocytokines in 104 dependent on crack cocaine and 18 healthy controls. Plasma levels of adiponectin, resistin and leptin were evaluated every seven days for three weeks by ELISA. The second is a cross-sectional study that investigated the TNF-alpha and four members of the TNF superfamily, by ELISA and flow cytometry in 44 dependent on crack cocaine and 25 healthy controls. Both studies used the Childhood Trauma Questionnaire (CTQ) to retrospectively assess history of CM of participants. RESULTS: The first study revealed that users of crack increased plasma leptin levels during early abstinence, although concentrations have remained lower compared with the control group. In relation to the levels of adiponectin, the group of women who had suffered CM reduced compared with users without CM levels. Moreover, only the group of users without CM had increased plasma levels of adiponectin during detoxification. The second study showed that users with CM had higher levels of TNF-alpha and lower levels of TWEAK compared with users without CM and the control group. sTNFRII was high, but only in comparison with the group using crack and controls. TRAIL levels were slightly elevated in the group with CM, and it was not found differences between the groups in the levels of sTNFRI. In addition, the plasma level of TNF-alpha was positively predicted by craving and CM gravity. CONCLUSION: The present work corroborates the knowledge about the association between early life stress and peripheral pro-inflammatory mediators. The results showed inflammatory abnormalities in crack addiction and explores the cumulative effects in relation to CM as a relevant factor for this deregulation. / JUSTIFICATIVA: Estudos recentes t?m demonstrado que tanto o estresse precoce, quanto o abuso de drogas, especialmente a coca?na, tem fortes efeitos sobre o sistema inflamat?rio. Considerando que maus-tratos na inf?ncia (MI) t?m sido descrito como um importante fator de risco para a depend?ncia, este estudo teve como objetivo investigar n?veis perif?ricos de mediadores inflamat?rios durante a abstin?ncia inicial de coca?na tipo crack em usu?rias do sexo feminino, com e sem hist?ria de MI. M?TODO: A presente disserta??o ? composta por dois estudos emp?ricos. O primeiro ? um estudo de follow-up que investigou tr?s adipocitocinas em 104 dependentes de coca?na tipo crack e 18 controles saud?veis. Os n?veis plasm?ticos de adiponectina, resistina e leptina foram avaliados a cada sete dias, durante tr?s semanas, atrav?s de ELISA. O segundo ? um estudo transversal que investigou o TNF-alfa e quatro membros da superfam?lia do TNF, atrav?s de ELISA e citometria de fluxo em 44 dependentes de coca?na tipo crack e 25 controles saud?veis. Ambos os estudos utilizaram o Childhood Trauma Questionnaire (CTQ) para avaliar retrospectivamente hist?ria de maus tratos na inf?ncia das participantes. RESULTADOS: O primeiro estudo destacou que as usu?rias de crack aumentaram os n?veis plasm?ticos de leptina durante a abstin?ncia inicial, apesar de as concentra??es terem se mantido mais baixas em compara??o com o grupo controle. J? em rela??o aos n?veis de adiponectina, o grupo de usu?rias que sofreu MI apresentou n?veis reduzidos em rela??o ?s usu?rias sem MI. Al?m disso, somente o grupo de usu?rias sem MI tiveram aumento dos n?veis plasm?ticos de adiponectina durante a desintoxica??o. J? o segundo estudo evidencia que as usu?rias com MI tinham n?veis mais elevados de TNF-alfa e menor de TWEAK em compara??o com as usu?rias sem MI e o grupo controle. sTNFRII estava elevado, mas apenas em compara??o com os grupos de usu?rias de crack e controles. Os n?veis de TRAIL estavam levemente elevados no grupo com MI, enquanto n?o foram encontradas diferen?as entre os grupos nos n?veis de sTNFRI. Al?m disso, o n?vel plasm?tico de TNF-alfa foi predito positivamente pela gravidade de craving e de MI. CONCLUS?O: A presente disserta??o corrobora com o conhecimento sobre a associa??o entre o estresse precoce e os n?veis pr?-inflamat?rios perif?ricos atrav?s de resultados in?ditos na literatura para a popula??o estudada. Os resultados mostram anomalias inflamat?rias na depend?ncia de crack e explora os efeitos cumulativos em rela??o aos maus-tratos na inf?ncia como fator relevante para esta desregula??o.
Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/869 |
Date | 16 January 2014 |
Creators | Levandowski, Mateus Luz |
Contributors | Grassi-oliveira, Rodrigo |
Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, BR, Faculdade de Psicologia |
Source Sets | IBICT Brazilian ETDs |
Language | Portuguese |
Detected Language | English |
Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
Format | application/pdf |
Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
Rights | info:eu-repo/semantics/openAccess |
Relation | 2588426296948062698, 500, 600, 2599381623216554467 |
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