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La adicción y su proceso de recompensa por medio de polimorfismos del gen del receptor D2 de dopamina: una revisión

Published online by Cambridge University Press:  12 May 2020

E.P. Noble*
Affiliation:
Departamento de Psiquiatría y Ciencias Bioconductuales, e Instituto de Investigación del Cerebro, Universidad de California, Los Angeles CA, EE.UU.
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Resumen

Desde 1990, los estudios de asociación han acumulado sólidos datos que implican al gen del receptor D2 de dopamina (DRD2) en el alcoholismo. Específicamente, se ha asociado con el alcoholismo el alelo menor A (Al) Taql del gen del DRD2. Se ha encontrado también que el gen del DRD2 está implicado en otros trastornos por uso de sustancias, incluida la dependencia de cocaína, nicotina y opioides, y la obesidad. Además de los estudios de asociación, los estudios farmacológicos han mostrado un número reducido de receptores D2 de dopamina cerebrales en los portadores de alelos Al+ (genotipos A1A1 y A1A2), en comparación con los portadores de alelos Al- (genotipo A2A2). Por medio de varios otros enfoques, se han identificado también fenotipos diferentes en los sujetos con los alelos Al+ y Al-. Estos enfoques incluyen estudios metabólicos, neurofisiológicos, neuropsicoógicos, de personalidad, de estrés y de tratamiento. Se ha formado la hipótesis de que, en un esfuerzo por compensar las deficiencias en el sistema dopaminérgico, las personas que abusan de sustancias pueden tratar de estimular los circuitos mesocorticolímbicos del cerebro, que desde hace mucho tiempo se ha pensado que son importantes en la recompensa y el refuerzo conductuales. En efecto, una forma del gen del DRD2, el alelo Al, hace ineficaz el sistema dopaminérgico y recompensa el abuso de sustancias que aumenta los niveles de dopamina en el cerebro.

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Revisión
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Copyright © European Psychiatric Association 2000

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