51
|
Phillips AZ, Wang Y, Allen NB. Patterns of health care interactions of individuals with alcohol use disorder: A latent class analysis. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 159:209251. [PMID: 38072388 PMCID: PMC11005937 DOI: 10.1016/j.josat.2023.209251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/29/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Given the high rates at which individuals with alcohol use disorder (AUD) utilize health care for co-existing conditions, health systems are promising venues for interventions that will facilitate access to AUD treatment. However, how individuals with AUD interact with such systems and, thus, how systems should intervene is unclear. In this study, we seek to identify patterns in how individuals diagnosed with AUD within an academic health system interacted with the system prior to diagnosis. METHODS We use electronic health records from a single academic health system in a major US metropolitan area to create a deidentified retrospective cohort including all individuals age 18+ diagnosed with AUD 2010-2019 (n = 26,899). Latent class analysis (LCA) identified subgroups defined by aspects of previous system interaction and health status, including having an in-system primary care provider, previous utilization of primary and specialty care, diagnosis setting, payer, and presence of other chronic conditions. We then assessed subgroup differences in demographics and associations with in-system AUD treatment receipt in the year following diagnosis, adjusting for demographics. RESULTS The population was on average 38.6 years old (standard deviation = 15.4) and predominantly male (66.1 %), White (64.5 %), and not of Hispanic/Latino ethnicity (87.8 %). Only 4.7 % received in-system treatment following diagnosis. We deemed the four-class model the optimal LCA model. This model identified subgroups that can be described as 1) average utilization (20.7 % of population), 2) low utilization (54.5 %), 3) high health burden and low utilization (14.2 %), and 4) high health burden and high utilization (10.6 %). Predicted membership in the high health burden and high utilization subgroup and low utilization subgroup were associated with higher and lower odds of treatment receipt, respectively, compared with predicted membership in the average utilization subgroup (odds ratio (OR) for high/high subgroup = 1.21, 95 % confidence interval (CI) = 1.01, 1.27; OR for low subgroup = 0.29 95 % CI = 0.24, 0.34). CONCLUSION Individuals diagnosed with AUD within a health system interact with that system in markedly different ways and are unlikely to benefit uniformly from system-based interventions to facilitate treatment. Group-tailored interventions are more likely to have impact and provide returns on investments for systems.
Collapse
Affiliation(s)
- Aryn Z Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; Department of Health Policy and Management, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA.
| | - Yaojie Wang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA.
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA.
| |
Collapse
|
52
|
Rezapour T, Rafei P, Baldacchino A, Conrod PJ, Dom G, Fishbein DH, Kazemi A, Hendriks V, Newton N, Riggs NR, Squeglia LM, Teesson M, Vassileva J, Verdejo-Garcia A, Ekhtiari H. Neuroscience-informed classification of prevention interventions in substance use disorders: An RDoC-based approach. Neurosci Biobehav Rev 2024; 159:105578. [PMID: 38360332 PMCID: PMC11081014 DOI: 10.1016/j.neubiorev.2024.105578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 01/15/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024]
Abstract
Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.
Collapse
Affiliation(s)
- Tara Rezapour
- Department of Cognitive Psychology, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Parnian Rafei
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Alex Baldacchino
- Division of Population and Behavioral Science, University of St Andrews School of Medicine, St Andrews, United Kingdom
| | - Patricia J Conrod
- CHU Sainte-Justine Research Center, Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Belgium
| | - Diana H Fishbein
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, NC, USA; College of Health and Human Development, Pennsylvania State University, PA, USA
| | - Atefeh Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC, Brijder Addiction Treatment), Zoutkeetsingel 40, The Hague 2512 HN, the Netherlands; Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Center, Leiden, Netherlands
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Nathaniel R Riggs
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Lindsay M Squeglia
- Medical University of South Carolina, Psychiatry and Behavioral Sciences, Charleston, SC, USA
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Jasmin Vassileva
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, VIC, Australia
| | - Hamed Ekhtiari
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
| |
Collapse
|
53
|
Gripshover TC, Wahlang B, Head KZ, Luo J, Bolatimi OE, Smith ML, Rouchka EC, Chariker JH, Xu J, Cai L, Cummins TD, Merchant ML, Zheng H, Kong M, Cave MC. Multiomics Analysis of PCB126's Effect on a Mouse Chronic-Binge Alcohol Feeding Model. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:47007. [PMID: 38619879 PMCID: PMC11018247 DOI: 10.1289/ehp14132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Environmental pollutants, including polychlorinated biphenyls (PCBs) have been implicated in the pathogenesis of liver disease. Our group recently demonstrated that PCB126 promoted steatosis, hepatomegaly, and modulated intermediary metabolism in a rodent model of alcohol-associated liver disease (ALD). OBJECTIVE To better understand how PCB126 promoted ALD in our previous model, the current study adopts multiple omics approaches to elucidate potential mechanistic hypotheses. METHODS Briefly, male C57BL/6J mice were exposed to 0.2 mg / kg polychlorinated biphenyl (PCB) 126 or corn oil vehicle prior to ethanol (EtOH) or control diet feeding in the chronic-binge alcohol feeding model. Liver tissues were collected and prepared for mRNA sequencing, phosphoproteomics, and inductively coupled plasma mass spectrometry for metals quantification. RESULTS Principal component analysis showed that PCB126 uniquely modified the transcriptome in EtOH-fed mice. EtOH feeding alone resulted in > 4,000 differentially expressed genes (DEGs), and PCB126 exposure resulted in more DEGs in the EtOH-fed group (907 DEGs) in comparison with the pair-fed group (503 DEGs). Top 20 significant gene ontology (GO) biological processes included "peptidyl tyrosine modifications," whereas top 25 significantly decreasing GO molecular functions included "metal/ion/zinc binding." Quantitative, label-free phosphoproteomics and western blot analysis revealed no major significant PCB126 effects on total phosphorylated tyrosine residues in EtOH-fed mice. Quantified hepatic essential metal levels were primarily significantly lower in EtOH-fed mice. PCB126-exposed mice had significantly lower magnesium, cobalt, and zinc levels in EtOH-fed mice. DISCUSSION Previous work has demonstrated that PCB126 is a modifying factor in metabolic dysfunction-associated steatotic liver disease (MASLD), and our current work suggests that pollutants also modify ALD. PCB126 may, in part, be contributing to the malnutrition aspect of ALD, where metal deficiency is known to contribute and worsen prognosis. https://doi.org/10.1289/EHP14132.
Collapse
Affiliation(s)
- Tyler C. Gripshover
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, School of Medicine, University of Louisville, Louisville, Kentucky, USA
- University of Louisville Superfund Research Program, University of Louisville, Louisville, Kentucky, USA
| | - Banrida Wahlang
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, School of Medicine, University of Louisville, Louisville, Kentucky, USA
- University of Louisville Superfund Research Program, University of Louisville, Louisville, Kentucky, USA
- The Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Kimberly Z. Head
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, School of Medicine, University of Louisville, Louisville, Kentucky, USA
- Hepatobiology & Toxicology COBRE, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Jianzhu Luo
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, School of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Oluwanifemi E. Bolatimi
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Melissa L. Smith
- The Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, Kentucky, USA
- Department of Biochemistry and Molecular Genetics, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Eric C. Rouchka
- Department of Biochemistry and Molecular Genetics, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Kentucky IDeA Network of Biomedical Research Excellence (KY INBRE) Bioinformatics Core, University of Louisville, Louisville, Kentucky, USA
| | - Julia H. Chariker
- Kentucky IDeA Network of Biomedical Research Excellence (KY INBRE) Bioinformatics Core, University of Louisville, Louisville, Kentucky, USA
- Department of Neuroscience Training, University of Louisville, Louisville, Kentucky, USA
| | - Jason Xu
- Department of Pediatrics, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Lu Cai
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- The Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, Kentucky, USA
- Department of Pediatrics, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Timothy D. Cummins
- Division of Nephrology and Hypertension, Department of Medicine and Clinical Proteomics Center, University of Louisville, Louisville, Kentucky, USA
| | - Michael L. Merchant
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- The Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, Kentucky, USA
- Division of Nephrology and Hypertension, Department of Medicine and Clinical Proteomics Center, University of Louisville, Louisville, Kentucky, USA
- University of Louisville Alcohol Research Center, University of Louisville, Louisville, Kentucky, USA
| | - Hao Zheng
- The Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Maiying Kong
- The Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, Kentucky, USA
- Department of Bioinformatics and Biostatistics School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
- University of Louisville Alcohol Research Center, University of Louisville, Louisville, Kentucky, USA
- Brown Cancer Center, University of Louisville, Louisville, Kentucky, USA
| | - Matthew C. Cave
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, School of Medicine, University of Louisville, Louisville, Kentucky, USA
- University of Louisville Superfund Research Program, University of Louisville, Louisville, Kentucky, USA
- The Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, Kentucky, USA
- Hepatobiology & Toxicology COBRE, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Department of Biochemistry and Molecular Genetics, University of Louisville School of Medicine, Louisville, Kentucky, USA
- University of Louisville Alcohol Research Center, University of Louisville, Louisville, Kentucky, USA
- The Robley Rex Veterans Affairs Medical Center, Louisville, Kentucky, USA
- The Liver Transplant Program at UofL Health – Jewish Hospital Trager Transplant Center, Louisville, Kentucky, USA
| |
Collapse
|
54
|
Tap SC. The potential of 5-methoxy-N,N-dimethyltryptamine in the treatment of alcohol use disorder: A first look at therapeutic mechanisms of action. Addict Biol 2024; 29:e13386. [PMID: 38600715 PMCID: PMC11007263 DOI: 10.1111/adb.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/24/2023] [Accepted: 02/13/2024] [Indexed: 04/12/2024]
Abstract
Alcohol use disorder (AUD) remains one of the most prevalent psychiatric disorders worldwide with high economic costs. Current treatment options show modest efficacy and relapse rates are high. Furthermore, there are increases in the treatment gap and few new medications have been approved in the past 20 years. Recently, psychedelic-assisted therapy with psilocybin and lysergic acid diethylamide has garnered significant attention in the treatment of AUD. Yet, they require significant amounts of therapist input due to prolonged subjective effects (~4-12 h) leading to high costs and impeding implementation. Accordingly, there is an increasing interest in the rapid and short-acting psychedelic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT). This paper offers a first look at potential therapeutic mechanisms for AUD by reviewing the current literature on 5-MeO-DMT. Primarily, 5-MeO-DMT is able to induce mystical experiences and ego-dissolution together with increases in psychological flexibility and mindfulness. This could decrease AUD symptoms through the alleviation of psychiatric mood-related comorbidities consistent with the negative reinforcement and self-medication paradigms. In addition, preliminary evidence indicates that 5-MeO-DMT modulates neural oscillations that might subserve ego-dissolution (increases in gamma), psychological flexibility and mindfulness (increases in theta), and the reorganization of executive control networks (increases in coherence across frequencies) that could improve emotion regulation and inhibition. Finally, animal studies show that 5-MeO-DMT is characterized by neuroplasticity, anti-inflammation, 5-HT2A receptor agonism, and downregulation of metabotropic glutamate receptor 5 with clinical implications for AUD and psychiatric mood-related comorbidities. The paper concludes with several recommendations for future research to establish the purported therapeutic mechanisms of action.
Collapse
Affiliation(s)
- Stephan C. Tap
- Department of PsychiatryGroningen University Medical CenterGroningenThe Netherlands
| |
Collapse
|
55
|
Hibbard PF, Sheidow AJ. Cooperation vs. affiliation: an exploratory qualitative study of alcoholics anonymous' position within the recovery ecosystem. J Addict Dis 2024; 42:103-111. [PMID: 36416589 PMCID: PMC10203051 DOI: 10.1080/10550887.2022.2149233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Addressing substance use disorder (SUD) requires intricate solutions, usually involving several organizations within a complex institutional environment. Alcoholics Anonymous (AA) shares the recovery ecosystem with other organizations, is ubiquitous across communities, and is notably inexpensive as an intervention; yet the exact nature of the connections between AA and other organizations in the recovery ecosystem is underexplored. OBJECTIVE Explore relationships AA has with other recovery ecosystem organizations and guide future research. METHODS Data were gathered via ethnographic participant observations, which were triangulated and contextualized via semi-structured interviews with key informants and archival documents. RESULTS Though AA does not formally link itself with other organizations, findings point toward strong relationships at the individual level and of an informal nature. Individual members who also have affiliation with other organizations (e.g., legal institutions, treatment services) create bridges, enabling efficient solving of complex issues. CONCLUSIONS Services wishing to leverage AA (or other mutual-aid) attendance will likely benefit from fostering informal relationships with individual AA members, including lowering barriers to disclosure of recovery status, and contacting local AA service elements capable of making these connections. Similarly, research to advance community-level SUD services and the knowledge-base would benefit from incorporating and partnering with people in recovery.
Collapse
Affiliation(s)
- Patrick F. Hibbard
- Oregon Social Learning Center, 10 Shelton McMurphy Blvd, Eugene, OR 97401
| | - Ashli J. Sheidow
- Oregon Social Learning Center, 10 Shelton McMurphy Blvd, Eugene, OR 97401
| |
Collapse
|
56
|
Kwon JE, Hong W, Jeon H, Kim CS, Kim H, Kang SC. Suppression of P2X4 and P2X7 by Lactobacillus rhamnosus vitaP1: effects on hangover symptoms. AMB Express 2024; 14:30. [PMID: 38491208 PMCID: PMC10942966 DOI: 10.1186/s13568-024-01685-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
This study aimed to identify substances including Lactobacillus rhamnosus vitaP1 (KACC 92054P) that alleviate hangover-induced emotional anxiety and liver damage. The association between emotional anxiety caused by hangover and the genes P2X4, P2X7, SLC6A4 was investigated. In vitro and in vivo analyses were conducted to assess the influence of free-panica on alcohol-induced upregulated gene expression. Additionally, the concentration of AST, ALT, alcohol, and acetaldehyde in blood was measured. Free-panica, consisting of five natural products (Phyllanthus amarus, Phoenix dactylifera, Vitis vinifera, Zingiber officinale, and Lactobacillus rhamnosus), were evaluated for their regulatory effects on genes involved in alcohol-induced emotional anxiety and liver damage. The combination of these natural products in free-panica successfully restored emotional anxiety, and the concentration of AST, ALT, alcohol, and acetaldehyde in blood to those of the normal control group. These findings support the potential development of free-panica as a health functional food or medicinal intervention for relieving hangover symptoms and protecting liver from alcohol consumption.
Collapse
Affiliation(s)
- Jeong Eun Kwon
- Department of Oriental Medicine Biotechnology, Kyung Hee University, Yongin, Gyeonggi, 17104, Republic of Korea
| | - Woojae Hong
- Department of Biomechatronic Engineering, Sungkyunkwan University, Suwon, Gyeonggi, 16419, Republic of Korea
| | - Hyelin Jeon
- Mbiometherapeutics Co., Ltd., Seongnam, Gyeonggi, 13488, Republic of Korea
| | - Cha Soon Kim
- Genencell Co., Ltd. Yongin, Gyeonggi, 16950, Republic of Korea
| | - Hyunggun Kim
- Department of Biomechatronic Engineering, Sungkyunkwan University, Suwon, Gyeonggi, 16419, Republic of Korea.
| | - Se Chan Kang
- Department of Oriental Medicine Biotechnology, Kyung Hee University, Yongin, Gyeonggi, 17104, Republic of Korea.
| |
Collapse
|
57
|
Aubin HJ. Repurposing drugs for treatment of alcohol use disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 175:153-185. [PMID: 38555115 DOI: 10.1016/bs.irn.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Repurposing drugs for the treatment of alcohol dependence involves the use of drugs that were initially developed for other conditions, but have shown promise in reducing alcohol use or preventing relapse. This approach can offer a more cost-effective and time-efficient alternative to developing new drugs from scratch. Currently approved medications for alcohol use disorder (AUD) include acamprosate, disulfiram, naltrexone, nalmefene, baclofen, and sodium oxybate. Acamprosate was developed specifically for AUD, while disulfiram's alcohol-deterrent effects were discovered incidentally. Naltrexone and nalmefene were originally approved for opioids but found secondary applications in AUD. Baclofen and sodium oxybate were repurposed from neurological conditions. Other drugs show promise. Topiramate and zonisamide, anticonvulsants, demonstrate efficacy in reducing alcohol consumption. Another anticonvulsant, gabapentin has been disappointing overall, except in cases involving alcohol withdrawal symptoms. Varenicline, a nicotinic receptor agonist, benefits individuals with less severe AUD or concurrent nicotine use. Ondansetron, a 5-HT3 antagonist, has potential for early-onset AUD, especially when combined with naltrexone. Antipsychotic drugs like aripiprazole and quetiapine have limited efficacy. Further investigation is needed for potential repurposing of α1 adrenergic receptor antagonists prazosin and doxazosin, glucocorticoid receptor antagonist mifepristone, the phosphodiesterase inhibitor Ibudilast, the cysteine prodrug N-acetylcysteine, and the OX1R and OX2R blocker Suvorexant. This review supports repurposing drugs as an effective strategy for expanding treatment options for AUD.
Collapse
Affiliation(s)
- Henri-Jean Aubin
- Université Paris-Saclay, Inserm, CESP, Villejuif, France; AP-HP, Université Paris Saclay, Villejuif, France.
| |
Collapse
|
58
|
Flores-Ramirez FJ, Illenberger JM, Pascasio G, Terenius L, Martin-Fardon R. LY2444296, a κ-opioid receptor antagonist, selectively reduces alcohol drinking in male and female Wistar rats with a history of alcohol dependence. Sci Rep 2024; 14:5804. [PMID: 38461355 PMCID: PMC10925033 DOI: 10.1038/s41598-024-56500-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/07/2024] [Indexed: 03/11/2024] Open
Abstract
Alcohol use disorder (AUD) remains a major public health concern. The dynorphin (DYN)/κ-opioid receptor (KOP) system is involved in actions of alcohol, particularly its withdrawal-associated negative affective states. This study tested the ability of LY2444296, a selective, short-acting, KOP antagonist, to decrease alcohol self-administration in dependent male and female Wistar rats at 8 h abstinence. Animals were trained to orally self-administer 10% alcohol (30 min/day for 21 sessions) and were made dependent via chronic intermittent alcohol vapor exposure for 6 weeks or exposed to air (nondependent). After 6 weeks, the effect of LY2444296 (0, 3, and 10 mg/kg, p.o.) was tested on alcohol self-administration at 8 h of abstinence. A separate cohort of rats was prepared in parallel, and their somatic withdrawal signs and alcohol self-administration were measured after LY2444296 administration at 8 h, 2 weeks, and 4 weeks abstinence. LY2444296 at 3 and 10 mg/kg significantly reduced physical signs of withdrawal in dependent rats at 8 h abstinence, only. Furthermore, 3 and 10 mg/kg selectively decreased alcohol self-administration in dependent rats at only 8 h abstinence. These results highlight the DYN/KOP system in actions of alcohol during acute abstinence, suggesting KOP antagonism could be beneficial for mitigating acute withdrawal signs and, in turn, significantly reduce excessive alcohol consumption associated with AUD.
Collapse
Affiliation(s)
- Francisco J Flores-Ramirez
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, SR-107, La Jolla, CA, 92037, USA.
| | - Jessica M Illenberger
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, SR-107, La Jolla, CA, 92037, USA
| | - Glenn Pascasio
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, SR-107, La Jolla, CA, 92037, USA
| | - Lars Terenius
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Rémi Martin-Fardon
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, SR-107, La Jolla, CA, 92037, USA
| |
Collapse
|
59
|
Skeva R, Jay C, Pettifer S, Gregg L. Alcohol Treatment Preferences and the Acceptability of Virtual Reality Therapy for Treating Alcohol Misuse in Adult Drinkers. Alcohol 2024:S0741-8329(24)00040-5. [PMID: 38461958 DOI: 10.1016/j.alcohol.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Rigina Skeva
- Advanced Interfaces-Visual Computing, Department of Computer Science, Faculty of Science and Engineering, University of Manchester.
| | - Caroline Jay
- Information Management, Department of Computer Science, Faculty of Science and Engineering, University of Manchester
| | - Steve Pettifer
- Advanced Interfaces-Visual Computing, Department of Computer Science, Faculty of Science and Engineering, University of Manchester
| | - Lynsey Gregg
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester
| |
Collapse
|
60
|
Xiao T, Roland A, Chen Y, Guffey S, Kash T, Kimbrough A. A role for circuitry of the cortical amygdala in excessive alcohol drinking, withdrawal, and alcohol use disorder. Alcohol 2024; 121:151-159. [PMID: 38447789 PMCID: PMC11371945 DOI: 10.1016/j.alcohol.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/30/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
Alcohol use disorder (AUD) poses a significant public health challenge. Individuals with AUD engage in chronic and excessive alcohol consumption, leading to cycles of intoxication, withdrawal, and craving behaviors. This review explores the involvement of the cortical amygdala (CoA), a cortical brain region that has primarily been examined in relation to olfactory behavior, in the expression of alcohol dependence and excessive alcohol drinking. While extensive research has identified the involvement of numerous brain regions in AUD, the CoA has emerged as a relatively understudied yet promising candidate for future study. The CoA plays a vital role in rewarding and aversive signaling and olfactory-related behaviors and has recently been shown to be involved in alcohol-dependent drinking in mice. The CoA projects directly to brain regions that are critically important for AUD, such as the central amygdala, bed nucleus of the stria terminalis, and basolateral amygdala. These projections may convey key modulatory signaling that drives excessive alcohol drinking in alcohol-dependent subjects. This review summarizes existing knowledge on the structure and connectivity of the CoA and its potential involvement in AUD. Understanding the contribution of this region to excessive drinking behavior could offer novel insights into the etiology of AUD and potential therapeutic targets.
Collapse
Affiliation(s)
- Tiange Xiao
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Alison Roland
- Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, United States; Department of Pharmacology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Yueyi Chen
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Skylar Guffey
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Thomas Kash
- Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, United States; Department of Pharmacology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Adam Kimbrough
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, United States; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States; Purdue Institute of Inflammation, Immunology, and Infectious Disease, Purdue University, West Lafayette, IN, United States.
| |
Collapse
|
61
|
Raghav JG, Kumar H, Ji L, Vemuri K, Makriyannis A, Suh J, Leonard MZ, Dang V, Ty C, Marandola S, Kane N, Witt AS, Shaqour S, Miczek KA. The neutral CB1 antagonist AM6527 reduces ethanol seeking, binge-like consumption, reinforcing, and withdrawal effects in male and female mice. Psychopharmacology (Berl) 2024; 241:427-443. [PMID: 38001264 DOI: 10.1007/s00213-023-06500-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
RATIONALE Alcohol use disorder (AUD) is a debilitating physiological and psychiatric disorder which affects individuals globally. The current pharmacological interventions to treat AUD are limited, and hence there is an urgent need for a novel pharmacological therapy which can be effective and safe across the population. OBJECTIVE We aimed to investigate a novel neutral cannabinoid receptor-1 (CB1R) antagonist, AM6527, in several preclinical models of ethanol consumption using male and female C57BL6/J mice. METHODS Independent groups of male and female mice were subjected to repeated cycles of drinking in the dark (DID), or intermittent access to alcohol (IAA) procedures. Twenty minutes prior to ethanol access in each procedure, animals were treated with intraperitoneal injections of either 1, 3, and 10 mg/kg of AM6527 or its respective vehicle. Acamprosate (100, 200, 300, and 400 mg/kg) or its respective vehicle was used as a positive control. Separate groups of male mice were subjected to a chain schedule of ethanol reinforcement to gain access to ethanol wherein completion of a fixed interval (FI; 5 min) schedule (link 1: "Seeking") was reinforced with continuous access to ethanol (fixed ratio; FR1) for up to 1.8 g/kg (link 2: "consumption"). All the animals were treated with 1, 3, and 10 mg/kg of AM6527 or its respective vehicle 20 mins prior to the start of the FI chain of the procedure. Separately, AM6527 was also evaluated in male and female mice undergoing acute ethanol withdrawal following 8 weeks of intermittent or continuous access to 20% ethanol drinking. RESULTS In both DID and IAA procedures, AM6527 reduced ethanol consumption in a dose-related manner in both male and female mice. AM6527 produced no tolerance in the DID procedure; mice treated with 3 mg/kg of AM6527 for 3 weeks continuously drank significantly smaller amounts of ethanol as compared to vehicle-treated mice over a period of three DID cycles. Moreover, in the IAA procedure, AM6527 caused an increase in water intake over the 24-h period. Acamprosate transiently reduced ethanol intake in male mice in both the DID and the IAA procedures but failed to produce any significant effect in female mice. AM6527 also produced a decrease in the FI responding ("ethanol seeking") in animals trained to self-administer ethanol. Lastly, AM6527 mitigated neurological withdrawal signs, i.e., handling induced convulsions (HIC) in mice undergoing acute ethanol withdrawal. CONCLUSIONS Current findings support previous studies with CB1R neutral antagonist in reducing voluntary ethanol intake and seeking behavior. Based on results shown in this work, AM6527 can be developed as a first in class CB1R neutral antagonist to treat AUD in both males and females.
Collapse
Affiliation(s)
- Jimit Girish Raghav
- Center for Drug Discovery, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA
| | - Hritik Kumar
- Center for Drug Discovery, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA
| | - Lipin Ji
- Center for Drug Discovery, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA
| | - Kiran Vemuri
- Center for Drug Discovery, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA
| | - Alexandros Makriyannis
- Center for Drug Discovery, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA.
| | - Junghyup Suh
- Division of Depression and Anxiety Disorders, Department of Psychiatry, Harvard Medical School, Mclean Hospital, Belmont, MA, 02478, USA
| | - Michael Z Leonard
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA
| | - Vivi Dang
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA
| | - Chelsea Ty
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA
| | - Stephen Marandola
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA
| | - Natalie Kane
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA
| | - Annika S Witt
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA
| | - Samar Shaqour
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA
| | - Klaus A Miczek
- Center for Drug Discovery, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA.
- Dept. of Psychology, Tufts University, 530 Boston Ave (Bacon Hall), Medford, MA, 02155, USA.
- Dept. of Neuroscience, Tufts University, Boston, MA, 02111, USA.
| |
Collapse
|
62
|
Selim MK, Harel M, De Santis S, Perini I, Sommer WH, Heilig M, Zangen A, Canals S. Repetitive deep TMS in alcohol dependent patients halts progression of white matter changes in early abstinence. Psychiatry Clin Neurosci 2024; 78:176-185. [PMID: 38085120 DOI: 10.1111/pcn.13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/04/2023] [Accepted: 11/15/2023] [Indexed: 03/13/2024]
Abstract
AIM Alcohol use disorder (AUD) is the most prevalent form of addiction, with a great burden on society and limited treatment options. A recent clinical trial reported significant clinical benefits of deep transcranial magnetic stimulations (Deep TMS) targeting midline frontocortical areas. However, the underlying biological substrate remained elusive. Here, we report the effect of Deep TMS on the microstructure of white matter. METHODS A total of 37 (14 females) AUD treatment-seeking patients were randomized to sham or active Deep TMS. Twenty (six females) age-matched healthy controls were included. White matter integrity was evaluated by fractional anisotropy (FA). Secondary measures included brain functional connectivity and self-reports of craving and drinking units in the 3 months of follow-up period. RESULTS White matter integrity was compromised in patients with AUD relative to healthy controls, as reflected by the widespread reduction in FA. This alteration progressed during early abstinence (3 weeks) in the absence of Deep TMS. However, stimulation of midline frontocortical areas arrested the progression of FA changes in association with decreased craving and relapse scores. Reconstruction of axonal tracts from white-matter regions showing preserved FA values identified cortical regions in the posterior cingulate and dorsomedial prefrontal cortices where functional connectivity was persistently modulated. These effects were absent in the sham-stimulated group. CONCLUSIONS By integrating brain structure and function to characterize the alcohol-dependent brain, this study provides mechanistic insights into the TMS effect, pointing to myelin plasticity as a possible mediator.
Collapse
Affiliation(s)
- Mohamed Kotb Selim
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas (CSIC) and Universidad Miguel Hernández (UMH), Sant Joan d'Alacant, Spain
| | - Maayan Harel
- Department of Life Sciences, Ben-Gurion University, Beer Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University, Beer Sheva, Israel
| | - Silvia De Santis
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas (CSIC) and Universidad Miguel Hernández (UMH), Sant Joan d'Alacant, Spain
| | - Irene Perini
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden
| | - Wolfgang H Sommer
- Department of Addiction Medicine, Department of Clinical Psychology, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden
| | - Abraham Zangen
- Department of Life Sciences, Ben-Gurion University, Beer Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University, Beer Sheva, Israel
| | - Santiago Canals
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas (CSIC) and Universidad Miguel Hernández (UMH), Sant Joan d'Alacant, Spain
| |
Collapse
|
63
|
Witkiewitz K, Garcia CC, Muthén BO. Subjective stress and any drinking during alcohol treatment: Disentangling within and between person autoregressive effects. Neurobiol Stress 2024; 29:100602. [PMID: 38221942 PMCID: PMC10784305 DOI: 10.1016/j.ynstr.2023.100602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/26/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024] Open
Abstract
Alcohol use has been shown to increase stress, and there is some evidence that stress predicts subsequent alcohol use during treatment for alcohol use disorder (AUD), particularly among females who are more likely to report coping-motivated drinking. Gaining a better understanding of the processes by which stress and alcohol use are linked during treatment could potentially inform AUD treatment planning. The current study aimed to characterize the association between stress and drinking during the course of AUD treatment and whether there were sex differences in these associations. Secondary data analyses of the COMBINE study (N = 1375; 69% male, 76.3% non-Hispanic and white, average age of 44.4 years) were conducted to examine self-reported perceived stress and alcohol consumption across 16 weeks of treatment for AUD using a Bayesian random-intercept cross-lagged panel model. There was stronger evidence for any alcohol use predicting greater than typical stress in subsequent weeks and less strong evidence for stress increasing the subsequent probability of alcohol use, particularly among males. For females, greater stress predicted subsequent drinking earlier in the treatment period, and a lower probability of subsequent drinking in the last week of treatment. Interventions might specifically focus on targeting reductions in stress following drinking occasions.
Collapse
Affiliation(s)
- Katie Witkiewitz
- Center on Alcohol, Substance Use, And Addictions, University of New Mexico, USA
| | - Christian C. Garcia
- Center on Alcohol, Substance Use, And Addictions, University of New Mexico, USA
| | - Bengt O. Muthén
- University of California, Los Angeles, USA
- University of New Mexico and Mplus, USA
| |
Collapse
|
64
|
Inomata S, Arima H, Fukuda T, Ozawa H, Yamamoto T. Smoking and diabetes cause telomere shortening among alcohol use disorder patients. Sci Rep 2024; 14:4701. [PMID: 38409427 PMCID: PMC10897475 DOI: 10.1038/s41598-024-55195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
The length of telomeres located at the ends of chromosomes has attracted attention as an indicator of cellular and individual aging. Various diseases or stresses cause telomere shortening, and it has been reported that alcohol use disorder patients actually have shorter telomeres than healthy patients. However, the factors that contribute to the reduction in telomere length among alcohol use disorder patients have not been clarified in detail. Therefore, in this study, we explored the factors that reduce telomere length in alcohol use disorder patients. A questionnaire survey and a measurement of leukocyte telomere length were conducted among alcohol use disorder patients. The mean telomere length of leukocyte was measured by ∆∆Ct analysis using a real-time PCR. We compared the telomere length between alcohol use disorder patients and the control group (Japanese special health check-up examinee). Moreover, we searched for factors associated with telomere length from drinking/smoking characteristics and history of comorbidities. A total of 74 subjects had alcohol use disorder, and 68 were in the control group. Compared to the control group, alcohol use disorder patients had significantly shorter telomere lengths (p < 0.001). A multivariate analysis revealed that a longer duration of smoking resulted in a significantly shorter telomere length (p = 0.0129). In addition, a comparison of the telomere length between the groups with and without a history of suffering from each disease revealed that telomere length was significantly shorter in the group with diabetes than in the group without diabetes (p = 0.0371). This study reveals that in individuals with alcohol dependence, particularly, prolonged smoking habits and the presence of diabetes contribute to telomere shortening. Medication and support for abstinence from alcohol has been mainly provided for alcohol use disorder patients. Our findings demonstrate a potential support approach via smoking cessation programs and controlling diabetes, which may be helpful to suppress the shortening of healthy life expectancy among alcohol use disorder patients.
Collapse
Affiliation(s)
- Shinsaku Inomata
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, Japan
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan.
| | | | - Hiroki Ozawa
- Department of Global Mental Health Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, Japan
| | - Taro Yamamoto
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, Japan
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| |
Collapse
|
65
|
Ruan X, Song Z, Yu T, Chen J. A voxel-level resting-state fMRI study on patients with alcohol use disorders based on a power spectrum slope analysis method. Front Neurosci 2024; 18:1323741. [PMID: 38426022 PMCID: PMC10902125 DOI: 10.3389/fnins.2024.1323741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
Background Earlier neuroimaging investigations showed that abnormal brain activity in patients with alcohol use disorder (AUD) was frequency dependent. However, there is lacking of a comprehensive method to capture the amplitude of multi-frequency bands directly. Here, we used a new method, the power spectrum slope (PSS) to explore abnormal spontaneous activity of brain in patients with AUD. Methods Thirty-three AUD patients and 29 healthy controls (HCs) enrolled in this study. The coefficient b and the power-law slope b' were calculated and compared between two groups. We also used the receiver operating characteristic (ROC) curve to examine the ability of the PSS analysis to distinguish between AUD and HCs. We next examined the correlation between PSS difference in the brain areas and the severity of alcohol dependence. Results Thirty AUD patients and 26 HCs were retained after head motion correction. The two metrics of PSS values increased in the left precentral gyrus in AUD patients. The area under the curve values of PSS differences in the specific brain area were respectively 0.836 and 0.844, with sensitivities of 86.7% and 83.3% and specificities of 73.1% and 76.9%. The Michigan Alcoholism Screening Test (MAST) and Alcohol drinking scale (ADS) scores were not significantly correlated with the PSS values in the specific brain area. Conclusion As a novel method, the PSS can well detect abnormal local brain activity in the AUD patients and may offer new insights for future fMRI studies.
Collapse
Affiliation(s)
- Xia Ruan
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zhiyan Song
- Department of Radiology, Wuhan No. 1 Hospital, Wuhan, Hubei, China
| | - Tingting Yu
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| |
Collapse
|
66
|
Hofford RS, Kiraly DD. Clinical and Preclinical Evidence for Gut Microbiome Mechanisms in Substance Use Disorders. Biol Psychiatry 2024; 95:329-338. [PMID: 37573004 PMCID: PMC10884738 DOI: 10.1016/j.biopsych.2023.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/14/2023]
Abstract
Substance use disorders are a set of recalcitrant neuropsychiatric conditions that cause tremendous morbidity and mortality and are among the leading causes of loss of disability-adjusted life years worldwide. While each specific substance use disorder is driven by problematic use of a different substance, they all share a similar pattern of escalating and out-of-control substance use, continued use despite negative consequences, and a remitting/relapsing pattern over time. Despite significant advances in our understanding of the neurobiology of these conditions, current treatment options remain few and are ineffective for too many individuals. In recent years, there has been a rapidly growing body of literature demonstrating that the resident population of microbes in the gastrointestinal tract, collectively called the gut microbiome, plays an important role in modulating brain and behavior in preclinical and clinical studies of psychiatric disease. While these findings have not yet been translated into clinical practice, this remains an important and exciting avenue for translational research. In this review, we highlight the current state of microbiome-brain research within the substance use field with a focus on both clinical and preclinical studies. We also discuss potential neurobiological mechanisms underlying microbiome effects on models of substance use disorder and propose future directions to bring these findings from bench to bedside.
Collapse
Affiliation(s)
- Rebecca S Hofford
- Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina
| | - Drew D Kiraly
- Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina; Department of Psychiatry, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina.
| |
Collapse
|
67
|
McCabe EM, Luk JW, Stangl BL, Schwandt ML, Ziausyte U, Kim H, Vergeer RR, Gunawan T, Fede SJ, Momenan R, Joseph PV, Goldman D, Diazgranados N, Ramchandani VA. Exercising healthy behaviors: A latent class analysis of positive coping during the COVID-19 pandemic and associations with alcohol-related and mental health outcomes. PLoS One 2024; 19:e0297060. [PMID: 38354113 PMCID: PMC10866465 DOI: 10.1371/journal.pone.0297060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/27/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE To identify latent classes of positive coping behaviors during the COVID-19 pandemic and examine associations with alcohol-related and mental health outcomes across participants with and without a history of alcohol use disorder (AUD). METHODS Baseline data from 463 participants who were enrolled in the NIAAA COVID-19 Pandemic Impact on Alcohol (C19-PIA) Study were analyzed. Latent class analysis (LCA) was applied to five positive coping behaviors during COVID-19: taking media breaks, taking care of their body, engaging in healthy behaviors, making time to relax, and connecting with others. Latent class differences and the moderating role of history of AUD on six alcohol-related and mental health outcomes were examined using multiple regression models. RESULTS LCA revealed two latent classes: 83.4% High Positive Coping and 16.6% Low Positive Coping. Low Positive Coping was associated with higher levels of perceived stress, anxiety symptoms, and loneliness. A history of AUD was consistently associated with higher levels of alcohol-related and mental health outcomes. Significant interactions between Coping Latent Classes and history of AUD indicated that the associations of Low Positive Coping with problematic alcohol use, depressive symptoms, and drinking to cope motives were either stronger or only significant among individuals with a history of AUD. CONCLUSIONS Individuals with a history of AUD may be particularly vulnerable to depressive symptoms and alcohol-related outcomes, especially when they do not utilize positive coping strategies. The promotion of positive coping strategies is a promising avenue to address alcohol-related and mental health problems during a public health crisis and warrants future research.
Collapse
Affiliation(s)
- Emma M. McCabe
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Jeremy W. Luk
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Bethany L. Stangl
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Melanie L. Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Ugne Ziausyte
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Hannah Kim
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Rhianna R. Vergeer
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Tommy Gunawan
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Samantha J. Fede
- Clinical NeuroImaging Research Core, Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Paule V. Joseph
- Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, United States of America
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Vijay A. Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| |
Collapse
|
68
|
Wright J, Chalmers KJ, Rossetto A, Reavley NJ, Kelly CM, Jorm AF. Redevelopment of mental health first aid guidelines for substance use problems: a Delphi study. BMC Psychol 2024; 12:70. [PMID: 38351023 PMCID: PMC10865545 DOI: 10.1186/s40359-024-01561-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Substance use problems have a major impact on the physical and mental health of individuals, families and communities. Early intervention may have a positive effect on recovery and treatment outcomes for those with substance use problems, reducing related risk and harm. Separate mental health first aid guidelines on how a member of the public could assist someone experiencing or developing alcohol use and drug use problems in high income Western countries were developed using Delphi expert consensus in 2009 and 2011, respectively. This study aimed to synthesise and update these two original guidelines to reflect current evidence and best practice. METHODS The Delphi expert consensus method was used to determine the inclusion of statements in the redeveloped guidelines. A questionnaire was developed using previously endorsed helping statements from the original guidelines on alcohol and drug use problems, as well as relevant content identified in systematic searches of academic and grey literature. Three panels of experts (people with lived experience, support people and professionals) rated statements over three consecutive online survey rounds to determine the importance of their inclusion in the guidelines. Statements endorsed by at least 80% of each panel were included. RESULTS 103 panellists completed all three survey rounds. They rated 469 statements and endorsed 300 of these for inclusion in the redeveloped guidelines. CONCLUSIONS This study has developed a broader and more comprehensive set of guidelines for how to support a person experiencing or developing a substance use problem. The redeveloped guidelines provide more detail on knowledge about and recognition of substance use problems, approaching and assisting people who want to change or are not ready to change, harm reduction, community-based supports and professional help, but have less on physical first aid actions. Mental Health First Aid International will use these guidelines in future updates of their training courses.
Collapse
Affiliation(s)
- Judith Wright
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia.
| | - Kathryn J Chalmers
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, 3000, Melbourne, VIC, Australia
| | - Alyssia Rossetto
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
| | - Nicola J Reavley
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, 3000, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
| |
Collapse
|
69
|
Johansson M, Romero D, Jakobson M, Heinemans N, Lindner P. Digital interventions targeting excessive substance use and substance use disorders: a comprehensive and systematic scoping review and bibliometric analysis. Front Psychiatry 2024; 15:1233888. [PMID: 38374977 PMCID: PMC10875034 DOI: 10.3389/fpsyt.2024.1233888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024] Open
Abstract
Addictive substances are prevalent world-wide, and their use presents a substantial and persistent public health problem. A wide range of digital interventions to decrease use and negative consequences thereof have been explored, differing in approach, theoretical grounding, use of specific technologies, and more. The current study was designed to comprehensively map the recent (2015-2022) extant literature in a systematic manner, and to identify neglected and emerging knowledge gaps. Four major databases (Medline, Web of Science Core Collection, and PsychInfo) were searched using database-specific search strategies, combining terms related to clinical presentation (alcohol, tobacco or other drug use), technology and aim. After deduplication, the remaining n=13,917 unique studies published were manually screened in two stages, leaving a final n=3,056 studies, the abstracts of which were subjected to a tailored coding scheme. Findings revealed an accelerating rate of publications in this field, with randomized trials being the most common study type. Several meta-analyses on the topic have now been published, revealing promising and robust effects. Digital interventions are being offered on numerous levels, from targeted prevention to specialized clinics. Detailed coding was at times made difficult by inconsistent use of specific terms, which has important implications for future meta-analyses. Moreover, we identify several gaps in the extant literature - few health economic assessments, unclear descriptions of interventions, weak meta-analytic support for some type of interventions, and limited research on many target groups, settings and new interventions like video calls, chatbots and artificial intelligence - that we argue are important to address in future research.
Collapse
Affiliation(s)
- Magnus Johansson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Danilo Romero
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Miriam Jakobson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Nelleke Heinemans
- Center for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Philip Lindner
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| |
Collapse
|
70
|
Naqvi NH, Srivastava AB, Sanchez-Peña J, Lee JK, Drysdale AT, Mariani JJ, Ochsner KN, Morgenstern J, Patel GH, Levin FR. Neural correlates of drinking reduction during a clinical trial of cognitive behavioral therapy for alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:260-272. [PMID: 38225187 PMCID: PMC11015435 DOI: 10.1111/acer.15259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Cognitive behavioral therapy (CBT) is an effective treatment for alcohol use disorder (AUD). We hypothesized that the dorsolateral prefrontal cortex (DLPFC), a region implicated in cognitive control and goal-directed behavior, plays a role in behavior change during CBT by facilitating the regulation of craving (ROC). METHODS Treatment-seeking participants with AUD (N = 22) underwent functional magnetic resonance imaging (fMRI) scanning both before and after a 12-week, single-arm trial of CBT, using an ROC task that was previously shown to engage the DLPFC. RESULTS We found that both the percentage of heavy drinking days (PHDD) and the overall self-reported alcohol craving measured during the ROC task were significantly reduced from pre- to post-CBT. However, we did not find significant changes over time in either the ability to regulate craving or regulation-related activity in any brain region. We found a significant 3-way interaction between the effects of cue-induced craving, cue-induced brain activity and timepoint of assessment (pre- or post-CBT) on PHDD in the left DLPFC. Follow-up analysis showed that cue-induced craving was associated with cue-induced activity in the left DLPFC among participants who ceased heavy drinking during CBT, both at pre-CBT and post-CBT timepoints. No such associations were present at either timepoint among participants who continued to drink heavily. CONCLUSIONS These results suggest that patients in whom DLPFC functioning is more strongly related to cue-induced craving may preferentially respond to CBT.
Collapse
Affiliation(s)
- Nasir H Naqvi
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| | - A Benjamin Srivastava
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| | - Juan Sanchez-Peña
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| | - Jessica K Lee
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| | - Andrew T Drysdale
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| | - John J Mariani
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| | - Kevin N Ochsner
- Department of Psychology, Columbia University, New York, New York, USA
| | - Jon Morgenstern
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, Hempstead, New York, USA
| | - Gaurav H Patel
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| | - Frances R Levin
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA
| |
Collapse
|
71
|
Monnig MA, Negash S. Immune biomarkers in non-treatment-seeking heavy drinkers who used a probiotic supplement for 30 days: An open-label pilot study. Alcohol 2024; 114:43-50. [PMID: 37604322 PMCID: PMC10875145 DOI: 10.1016/j.alcohol.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/09/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023]
Abstract
Alcohol use disorder (AUD) is associated with significant psychological and economic burdens, as well as physical comorbidities that can lead to death. Previous research has found that probiotics may reduce inflammatory biomarkers in persons with AUD and comorbid conditions such as cirrhosis of the liver. This relationship has not been explored in heavy drinkers without comorbid conditions. In a proof-of-concept study, individuals who were heavy drinkers without known comorbidities received a 30-day course of a daily probiotic supplement in an open-label pilot trial. Eligible participants (N = 16) met NIAAA guidelines for heavy alcohol use and did not report any preexisting medical problems. Blood samples were taken at four timepoints: prior to the probiotic course, at the midpoint, at the end, and after a washout period of at least one month. Immunoassays were conducted on plasma samples to quantify the following inflammatory biomarkers: IL-6, IL-8, IL-10, LBP, MCP-1, sCD14, sCD163, and TNF-α. Linear mixed models were used to test within-subjects changes in biomarker concentrations over the study period, with alcohol use included as a time-varying covariate. Biomarker concentrations did not change significantly. A higher number of heavy drinking days was statistically associated with higher concentrations of IL-6 (F(1,8) = 6.66, p = 0.0326) and IL-8 (F(1,17) = 6.38, p = 0.0218). Greater days since last drink was associated with a lower concentration of MCP-1 (F(1,17) = 5.77, p = 0.028). In summary, biomarker trajectories were associated with alcohol consumption variables, but not probiotic use, in this open-label pilot study. Randomized controlled trials are needed to evaluate fully the potential benefits of probiotics in heavy drinkers without known comorbidities and under conditions of non-abstinence.
Collapse
Affiliation(s)
- Mollie A Monnig
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02903, United States.
| | - Seraphina Negash
- School of Public Health, Brown University, Providence, RI 02903, United States
| |
Collapse
|
72
|
Tuchman FR, Hallgren KA, Richards DK, Aldridge A, Anton RK, Aubin HJ, Kranzler HR, Mann K, O’Malley SS, Witkiewitz K. Reductions in WHO risk drinking levels correlate with alcohol craving among individuals with alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:420-429. [PMID: 38149364 PMCID: PMC10922776 DOI: 10.1111/acer.15257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/26/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Abstinence has historically been considered the preferred goal of alcohol use disorder (AUD) treatment. However, most individuals with AUD do not want to abstain and many are able to reduce their drinking successfully. Craving is often a target of pharmacological and behavioral interventions for AUD, and reductions in craving may signal recovery. Whether reductions in drinking during AUD treatment are associated with reductions in craving has not been well examined. METHODS We conducted secondary analyses of data from three AUD clinical trials (N's= 1327, 346, and 200). Drinking reductions from baseline to the end of treatment were measured as changes in World Health Organization (WHO) risk drinking levels; alcohol craving was measured using validated self-report measures. Regression analyses tested whether drinking reductions were associated with end-of-treatment craving reductions; moderation analyses tested whether associations between drinking reduction and end-of-treatment craving differed across AUD severity. RESULTS Reductions of at least 1 or at least 2 WHO risk drinking levels were associated with lower craving (all p's < 0.05). Results were substantively similar after removing abstainers at the end-of-treatment. Associations between drinking reductions and craving were generally not moderated by AUD severity. CONCLUSIONS Individuals with WHO risk drinking level reductions reported significantly lower craving, as compared to those who did not achieve meaningful reductions in drinking. The results demonstrate the utility of WHO risk drinking levels as AUD clinical trial endpoints and provide evidence that drinking reductions mitigate craving.
Collapse
Affiliation(s)
- Felicia R. Tuchman
- Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM, USA
| | - Kevin A. Hallgren
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Dylan K. Richards
- Center on Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, MSC11-6280, Albuquerque, NM, USA
| | - Arnie Aldridge
- Behavioral Health Financing, Economics and Evaluation Department, Research Triangle Institute (RTI) International, Durham, NC, USA
| | - Raymond K. Anton
- Psychiatry and Behavioral Sciences Department, Medical University of South Carolina, Charleston, SC, USA
| | - Henri-Jean Aubin
- AP-HP. Université Paris Saclay, French Institute of Health and Medical Research (INSERM), Paris, Île-de-France, FRANCE
| | - Henry R. Kranzler
- Center for Studies of Addiction, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Karl Mann
- Central Institute for Mental Health Mannheim, Heidelberg University, Heidelberg, DE
| | - Stephanie S. O’Malley
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM, USA
- Center on Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, MSC11-6280, Albuquerque, NM, USA
| |
Collapse
|
73
|
Meisel SN, Boness CL, Miranda R, Witkiewitz K. Beyond mediators: A critical review and methodological path forward for studying mechanisms in alcohol use treatment research. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:215-229. [PMID: 38099412 PMCID: PMC10922633 DOI: 10.1111/acer.15242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/14/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
Understanding how treatments for alcohol use disorder (AUD) facilitate behavior change has long been recognized as an important area of research for advancing clinical care. However, despite decades of research, the specific mechanisms of change for most AUD treatments remain largely unknown because most prior work in the field has focused only on statistical mediation. Statistical mediation is a necessary but not sufficient condition to establish evidence for a mechanism of change. Mediators are intermediate variables that account statistically for the relationship between independent and dependent variables, whereas mechanisms provide more detailed explanations of how an intervention leads to a desired outcome. Thus, mediators and mechanisms are not equivalent. To advance mechanisms of behavior change research, in this critical review we provide an overview of methodological shortfalls of existing AUD treatment mechanism research and introduce an etiologically informed precision medicine approach that facilitates the testing of mechanisms of behavior change rather than treatment mediators. We propose a framework for studying mechanisms in alcohol treatment research that promises to facilitate our understanding of behavior change and precision medicine (i.e., for whom a given mechanism of behavior change operates and under what conditions). The framework presented in this review has several overarching goals, one of which is to provide a methodological roadmap for testing AUD recovery mechanisms. We provide two examples of our framework, one pharmacological and one behavioral, to facilitate future efforts to implement this methodological approach to mechanism research. The framework proposed in this critical review facilitates the alignment of AUD treatment mechanism research with current theories of etiologic mechanisms, precision medicine efforts, and cross-disciplinary approaches to testing mechanisms. Although no framework can address all the challenges related to mechanisms research, our goal is to help facilitate a shift toward more rigorous and falsifiable behavior change research.
Collapse
Affiliation(s)
| | | | - Robert Miranda
- E. P. Bradley Hospital, Riverside, RI USA
- Department of Psychiatry & Human Behavior, Brown University, Providence, RI USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance use, And Addictions, University of New Mexico
| |
Collapse
|
74
|
Singal AK, Leggio L, DiMartini A. Alcohol use disorder in alcohol-associated liver disease: Two sides of the same coin. Liver Transpl 2024; 30:200-212. [PMID: 37934047 DOI: 10.1097/lvt.0000000000000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
Alcohol-associated liver disease (ALD) has emerged as the leading indication for liver transplantation (LT) worldwide, with 40% of LTs in the United States performed for ALD in 2019. The ALD-related health care burden accelerated during the COVID-19 pandemic, especially in young individuals. Alcohol use disorder (AUD), which focuses on the negative effects of alcohol on psychosocial, physical, and mental health, is present in the majority of patients with ALD, with moderate to severe AUD in 75%-80%. During the last decade, early liver transplantation (eLT) has emerged as a lifesaving treatment for selected patients with alcohol-associated hepatitis; these patients may have a higher risk of using alcohol after LT. The risk of alcohol use recurrence may be reduced during the pretransplant or post-transplant period with AUD treatment using behavioral and/or pharmacological therapies and with regular monitoring for alcohol use (self-reported and complemented with biomarkers like phosphatidylethanol). However, AUD treatment in patients with ALD is challenging due to patient, clinician, and system barriers. An integrated model to provide AUD and ALD care by hepatologists and addiction experts in a colocated clinic starting from LT evaluation and selection to monitoring listed candidates and then to following up on recipients of LT should be promoted. However, the integration of addiction and hepatology teams in an LT program in the real world is often present only during evaluation and candidate selection for LT. Data are emerging to show that a multidisciplinary integrated AUD treatment within an LT program reduces recurrent alcohol use after LT. If we want to continue using early liver transplantation for patients with severe alcohol-associated hepatitis, LT programs should focus on building integrated multidisciplinary care teams for the integrated treatment of both AUD and ALD.
Collapse
Affiliation(s)
- Ashwani K Singal
- Department of Medicine, University of South Dakota, Vermillion, South Dakota, USA
- Department of Gastroenterology and Hepatology, Avera McKennan University Hospital, Sioux Falls, South Dakota, USA
- Department of Transplant Hepatology, Avera Transplant Institute, Sioux Falls, South Dakota, USA
- Department of Medicine, VA Medical Center, Sioux Falls, South Dakota, USA
| | - Lorenzo Leggio
- Department of Neuropsychopharmacology Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, Division of Intramural Clinical and Biological Research, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
- Department of Medicine, Division of Addiction Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Andrea DiMartini
- Departments of Psychiatry and Transplant Surgery, and the Clinical and Translational Science Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
75
|
Dhanda A, Andrade J, Allende H, Allgar V, Bailey M, Callaghan L, Cocking L, Goodwin E, Hawton A, Hayward C, Hudson B, Ingram W, Jeffery A, King A, Lavers V, Lomax J, McCune CA, Musicha C, Parker R, Rollinson C, Wilks J, Creanor ES. Mental Imagery to Reduce Alcohol-related harm in patients with alcohol use disorder and alcohol-related liver damaGE: the MIRAGE randomised pilot trial results. BMJ Open Gastroenterol 2024; 11:e001267. [PMID: 38286518 PMCID: PMC10870787 DOI: 10.1136/bmjgast-2023-001267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/04/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE The healthcare burden of alcohol-related liver disease (ARLD) is increasing. ARLD and alcohol use disorder (AUD) is best managed by reduction or cessation of alcohol use, but effective treatments are lacking. We tested whether people with ARLD and AUD admitted to hospital could be recruited to and retained in a trial of Functional Imagery Training (FIT), a psychological therapy that uses mental imagery to reduce alcohol craving. We conducted a multicentre randomised pilot trial of treatment as usual (TAU) versus FIT+TAU in people admitted to hospital with ARLD and AUD. DESIGN Participants were randomised to TAU (a single session of brief intervention) or FIT+TAU (TAU with one hospital-based FIT session then eight telephone sessions over 6 months). Pilot outcomes included recruitment rate and retention at day 180. Secondary outcomes included fidelity of FIT delivery, alcohol use, and severity of alcohol dependence. RESULTS Fifty-four participants (mean age 49; 63% male) were recruited and randomised, 28 to TAU and 26 to FIT+TAU. The retention rate at day 180 was 43%. FIT was delivered adequately by most alcohol nurses. 50% of intervention participants completed FIT sessions 1 and 2. There were no differences in alcohol use or severity of alcohol dependence between treatment groups at day 180. CONCLUSION Participants with ARLD and AUD could be recruited to a trial of FIT versus FIT+TAU. However, retention at day 180 was suboptimal. Before conducting a definitive trial of FIT in this patient group, modifications in the intervention and recruitment/retention strategy must be tested. TRIAL REGISTRATION NUMBER ISRCTN41353774.
Collapse
Affiliation(s)
- Ashwin Dhanda
- Faculty of Health, University of Plymouth, Plymouth, UK
- South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | - Hannah Allende
- Research, Development and Innovation, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | | | | | - Laura Cocking
- Faculty of Health, University of Plymouth, Plymouth, UK
| | | | - Annie Hawton
- Medical School, University of Exeter, Exeter, UK
| | | | - Ben Hudson
- Royal Devon University Hospital Foundation NHS Trust, Exeter, UK
| | - Wendy Ingram
- Faculty of Health, University of Plymouth, Plymouth, UK
| | | | - Angela King
- Faculty of Health, University of Plymouth, Plymouth, UK
| | | | - Joe Lomax
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - C Anne McCune
- Department of Liver Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Richard Parker
- Leeds Liver Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Christopher Rollinson
- Research, Development and Innovation, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Jonny Wilks
- Faculty of Health, University of Plymouth, Plymouth, UK
| | | |
Collapse
|
76
|
Koob GF. Alcohol Use Disorder Treatment: Problems and Solutions. Annu Rev Pharmacol Toxicol 2024; 64:255-275. [PMID: 38261428 DOI: 10.1146/annurev-pharmtox-031323-115847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Alcohol use disorder (AUD) afflicts over 29 million individuals and causes more than 140,000 deaths annually in the United States. A heuristic framework for AUD includes a three-stage cycle-binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation-that provides a starting point for exploring the heterogeneity of AUD with regard to treatment. Effective behavioral health treatments and US Food and Drug Administration-approved medications are available but greatly underutilized, creating a major treatment gap. This review outlines challenges that face the alcohol field in closing this treatment gap and offers solutions, including broadening end points for the approval of medications for the treatment of AUD; increasing the uptake of screening, brief intervention, and referral to treatment; addressing stigma; implementing a heuristic definition of recovery; engaging early treatment; and educating health-care professionals and the public about challenges that are associated with alcohol misuse. Additionally, this review focuses on broadening potential targets for the development of medications for AUD by utilizing the three-stage heuristic model of addiction that outlines domains of dysfunction in AUD and the mediating neurobiology of AUD.
Collapse
Affiliation(s)
- George F Koob
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA;
| |
Collapse
|
77
|
Chapp AD, Shan Z, Chen QH. Acetic Acid: An Underestimated Metabolite in Ethanol-Induced Changes in Regulating Cardiovascular Function. Antioxidants (Basel) 2024; 13:139. [PMID: 38397737 PMCID: PMC10886048 DOI: 10.3390/antiox13020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/13/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
Acetic acid is a bioactive short-chain fatty acid produced in large quantities from ethanol metabolism. In this review, we describe how acetic acid/acetate generates oxidative stress, alters the function of pre-sympathetic neurons, and can potentially influence cardiovascular function in both humans and rodents after ethanol consumption. Our recent findings from in vivo and in vitro studies support the notion that administration of acetic acid/acetate generates oxidative stress and increases sympathetic outflow, leading to alterations in arterial blood pressure. Real-time investigation of how ethanol and acetic acid/acetate modulate neural control of cardiovascular function can be conducted by microinjecting compounds into autonomic control centers of the brain and measuring changes in peripheral sympathetic nerve activity and blood pressure in response to these compounds.
Collapse
Affiliation(s)
- Andrew D. Chapp
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zhiying Shan
- Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI 49931, USA;
| | - Qing-Hui Chen
- Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI 49931, USA;
| |
Collapse
|
78
|
Hellum R, Bilberg R, Mejldal A, Nielsen AS. Potential factors affecting the impact of community reinforcement and family training. Secondary analysis of an RCT. BMC Public Health 2024; 24:213. [PMID: 38233850 PMCID: PMC10795348 DOI: 10.1186/s12889-024-17656-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND In addition to increasing the quality of life among concerned significant others (CSOs), Community Reinforcement and Family training (CRAFT) aim at helping CSOs motivate treatment-refusing identified patients (IPs) into treatment through a positive reinforcement process. The aim of the present study was to investigate if the following factors, measured at baseline, have an influence on IP future treatment engagement (1) Type of relation between CSO and the IP (2) The amount of time the CSO spend with the IP (3) if the IP knows that the CSOs seeks help, and (4) The CSO's own alcohol use. METHODS A secondary analysis from the Danish CRAFT study. CSOs completed a self-administered questionnaire at baseline, after three months, and six months. To investigate the relationship between the four variables and treatment engagement, logistic regression was used. RESULTS CSO's relation to the IP, the frequency of contact between the CSO and the IP, and the CSO's AUDIT score at the time of the baseline interview were not associated with the IP's treatment engagement. If CSO at baseline had informed the IP that the CSO participated in CRAFT, odds for IP treatment engagement were significantly higher (adjusted OR [(CI)] = 2.29 [1.13; 4.63] (p < 0.05), relative to if IP not being informed. CONCLUSIONS CRAFT has a higher impact on the likelihood for treatment seeking, if the CSOs inform the IP about his or her own help seeking in order to change the situation. The underlying mechanism behind this is needs further investigations.
Collapse
Affiliation(s)
- Rikke Hellum
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
- Department of Mental Health Odense, Region of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
| | - Randi Bilberg
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
- Department for Data, Innovation and Research, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Anna Mejldal
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, J.B. Winsløws vej 9A, Odense C, 5000, Denmark
| | - Anette Søgaard Nielsen
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark.
- Department of Mental Health Odense, Region of Southern Denmark, J.B. Winsløws vej 18, Odense C, 5000, Denmark.
| |
Collapse
|
79
|
Lehner T, Gao B, Mackowiak B. Alcohol metabolism in alcohol use disorder: a potential therapeutic target. Alcohol Alcohol 2024; 59:agad077. [PMID: 37950904 PMCID: PMC10783952 DOI: 10.1093/alcalc/agad077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023] Open
Abstract
Ethanol metabolism plays an essential role in how the body perceives and experiences alcohol consumption, and evidence suggests that modulation of ethanol metabolism can alter the risk for alcohol use disorder (AUD). In this review, we explore how ethanol metabolism, mainly via alcohol dehydrogenase and aldehyde dehydrogenase 2 (ALDH2), contributes to drinking behaviors by integrating preclinical and clinical findings. We discuss how alcohol dehydrogenase and ALDH2 polymorphisms change the risk for AUD, and whether we can harness that knowledge to design interventions for AUD that alter ethanol metabolism. We detail the use of disulfiram, RNAi strategies, and kudzu/isoflavones to inhibit ALDH2 and increase acetaldehyde, ideally leading to decreases in drinking behavior. In addition, we cover recent preclinical evidence suggesting that strategies other than increasing acetaldehyde-mediated aversion can decrease ethanol consumption, providing other potential metabolism-centric therapeutic targets. However, modulating ethanol metabolism has inherent risks, and we point out some of the key areas in which more data are needed to mitigate these potential adverse effects. Finally, we present our opinions on the future of treating AUD by the modulation of ethanol metabolism.
Collapse
Affiliation(s)
- Taylor Lehner
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5625 Fishers Lane, Bethesda, MD 20892, United States
| | - Bin Gao
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5625 Fishers Lane, Bethesda, MD 20892, United States
| | - Bryan Mackowiak
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5625 Fishers Lane, Bethesda, MD 20892, United States
| |
Collapse
|
80
|
Zheng L, Aimaiti Z, Long L, Xia C, Wang W, Zhou ZZ. Discovery of 4-Ethoxy-6-chloro-5-azaindazoles as Novel PDE4 Inhibitors for the Treatment of Alcohol Use Disorder and Alcoholic Liver Diseases. J Med Chem 2024; 67:728-753. [PMID: 38156615 DOI: 10.1021/acs.jmedchem.3c02087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Alcohol use disorder (AUD) results in numerous disabilities and approximately 3 million deaths annually, caused mainly by alcoholic liver disease (ALD). Phosphodiesterase IV (PDE4) has emerged as an attractive molecular target for a new treatment for AUD and ALD. In this study, we describe the identification of 5-azaindazole analogues as PDE4 inhibitors against AUD and ALD. System optimization studies led to the discovery of ZL40 (IC50 = 37.4 nM) with a remarkable oral bioavailability (F = 94%), satisfactory safety, and a lower emetogenic potency than the approved PDE4 inhibitors roflumilast and apremilast. Encouragingly, ZL40 exhibited AUD therapeutic effects by decreasing alcohol intake and improving acute alcohol-induced sedation and motor impairment. Meanwhile, ZL40 displayed the potential to alleviate alcoholic liver injury and attenuate inflammation in the NIAAA mice model. These results showed that ZL40 is a promising compound for future drug development to treat alcohol-related diseases.
Collapse
Affiliation(s)
- Lei Zheng
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Zulihuma Aimaiti
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lu Long
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Chuang Xia
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Wenya Wang
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Zhong-Zhen Zhou
- Innovation Program of Drug Research on Neurological and Metabolic Diseases, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| |
Collapse
|
81
|
Khikhmetova K, Semenova Y, Bjørklund G. The Roles of Endogenous D2R Dopamine and μ-opioid Receptors of the Brain in Alcohol use Disorder. Curr Med Chem 2024; 31:6393-6406. [PMID: 37921171 DOI: 10.2174/0109298673248999231013043249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/02/2023] [Accepted: 09/15/2023] [Indexed: 11/04/2023]
Abstract
Alcohol use disorder (AUD) affects millions of people worldwide. It is characterized by a strong physiological and psychological craving to consume large amounts of alcohol despite adverse consequences. Alcohol use disorder carries a large health and economic burden on society. Despite its prevalence, AUD is still severely undertreated. The precise molecular mechanisms of how alcohol addiction forms are yet unknown. However, previous studies on animal models show that along with the μ-opioid receptors, the D2R dopamine receptors may also be involved in alcohol craving and reward pathways. Currently, there is a limited number of treatment strategies for alcohol use disorder, which include several medications and therapy. By understanding the limitations of current treatment options and exploring new potential targets, it could be possible to find more effective ways of treating AUD in the future.
Collapse
Affiliation(s)
| | - Yuliya Semenova
- School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| |
Collapse
|
82
|
Bremmer MP, Hendershot CS. Social Media as Pharmacovigilance: The Potential for Patient Reports to Inform Clinical Research on Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists for Substance Use Disorders. J Stud Alcohol Drugs 2024; 85:5-11. [PMID: 37917019 PMCID: PMC10846600 DOI: 10.15288/jsad.23-00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023] Open
Abstract
The surge in popularity of semaglutide (Ozempic, Wegovy, Rybelsus) and other glucagon-like-peptide 1 (GLP-1) receptor agonists has been accompanied by widespread reports of unintended reductions in alcohol use (and other addictive behaviors) during treatment. With clinical trials of GLP-1 receptor agonists for substance use only recently under way, anecdotal reports (including via social media) are now a primary reason for interest in potential effects of GLP-1 receptor agonists on alcohol use in patient populations. The nature and volume of these reports raises the prospect that social media data can potentially be leveraged to inform the study of novel addiction treatments and the prioritization of behavioral or neurobiological targets for mechanistic research. This approach, which aligns with recent efforts to apply social media data to pharmacovigilance, may be particularly relevant for drug repurposing efforts. This possibility is illustrated by a thematic analysis of anonymous online reports concerning changes in alcohol use or alcohol-related effects during treatment with GLP-1 receptor agonists. These reports not only support the rationale for clinical trials but also point to potential neurobehavioral mechanisms (e.g., satiety, craving/preoccupation, aversion, altered subjective response) that might inform hypotheses for human laboratory and neuroscience studies. Refined methods for capturing patient reports of incidental medication effects on addictive behaviors at large scale could potentially lead to novel, pharmacovigilance-based approaches to identify candidate therapies for drug repurposing efforts.
Collapse
Affiliation(s)
- Michael P. Bremmer
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Christian S. Hendershot
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
83
|
Hnatiuk MS, Nesteruk SO, Fedoniuk LY, Yakymchuk OA, Smachylo II, Tverdochlib VV. Quantitative morphological analysis of age structural changes in prostate of experimental animals with ethanol poisoning. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:268-272. [PMID: 38592988 DOI: 10.36740/wlek202402112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Aim: To find out the age remodeling of the structural components of the prostate gland at alcohol poisoning using quantitative morphological analysis. PATIENTS AND METHODS Materials and Methods: The structure of the prostate gland of 4 white male rats groups were morphologically investigated. The 1 group included 30 control intact animals aged 8 months, the 2-nd group - 30 rats aged 24 months, the 3-rd group - 30 8-month-old animals with ethanol intoxication, and the 4-th group included 30 24-month-old rats with the specified simulated pathology. Ethanol intoxication was modeled by intragastric administration of 30% ethyl alcohol solution at a dose of 20 ml/kg once daily for 28 days. Rats were euthanized by bloodletting under general thiopental anesthesia 28 days after the beginning of the experiment. The area of glands, the height of glandular epithelial cells, the area of their nuclei and cytoplasm, the nuclear-cytoplasmic ratio in these cells and the stromal-parenchymal ratio in the organ were studied using light microscopy and were determined morphometrically. Morphometric parameters were processed statistically. RESULTS Results: It was established that with age in the intact prostate of laboratory sexually mature white male rats, the area of glands, the height of glandular epitheliocytes, the area of their nuclei and cytoplasm, with the stability of nuclear-cytoplasmic ratios in the epithelial cells of the glands, significantly decreases, and the stromal-parenchymal ratio in the organ under study increases. Long-term ethanol poisoning leads to pronounced structural changes in the prostate, which is characterized by pronounced atrophy of the glandular epithelium, a decrease in the area of the glands, a decrease in the height of epithelial cells, a violation of nuclear-cytoplasmic relations in them, an increase in stromal-parenchymal ratio, and a prominent growth of the muscle-elastic stroma. The revealed structural changes of the studied components of the prostate dominated in 24-month-old experimental animals. CONCLUSION Conclusions: Morphological analysis of the prostate gland established that morphometric and morphological changed significantly according to the age and were depend on the ethanol poisoning.
Collapse
Affiliation(s)
| | - Serhiy O Nesteruk
- I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | | | - Olena A Yakymchuk
- I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | - Ivan I Smachylo
- I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | | |
Collapse
|
84
|
Östh J, Danielsson AK, Lundin A, Wennberg P, Andréasson S, Jirwe M. Keeping Track of My Drinking - Patient Perceptions of Using Smartphone Applications as a Treatment Complement for Alcohol Dependence. Subst Use Misuse 2023; 59:291-299. [PMID: 37876238 DOI: 10.1080/10826084.2023.2269578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
BACKGROUND Alcohol dependence is common, yet highly undertreated. Smartphone applications (apps) have potential to enhance treatment accessibility and effectiveness, however evidence is limited, especially studies focussing on user experiences. The aim was to describe patient perceptions on the usability and acceptability of self-monitoring apps provided as treatment complement for alcohol dependence. METHODS Individual semi-structured interviews were conducted through video or phone calls with 21 participants, recruited from a randomized controlled trial at a dependency clinic in Stockholm. The participants had used two specific apps for self-monitoring consumption ("Glasklart" and "iBAC") during 12 wk prior to the interviews. Data was analyzed using Qualitative Content Analysis. RESULTS Two domains were identified: 1) Smartphone applications as facilitators to treatment, and 2) Barriers to smartphone application use. Using apps within the treatment context was believed to increase the accuracy of the reported consumption. Participants became more aware of their alcohol problem and described the apps as reinforcers that could increase both the motivation to change and the focus on the problem and commitment to treatment. The apps were further described as helpful to control alcohol consumption. However, app usage was constrained by technical problems, unfit app-specific features and procedures, and alcohol-related shame and stigma. DISCUSSION AND CONCLUSIONS Self-monitoring alcohol apps have several beneficial features that can help assess, track, and control alcohol consumption, and improve communication with clinicians. The results indicate they can be useful complements to treatment for patients with alcohol dependence, but their use can be limited by different, foremost technical, issues.
Collapse
Affiliation(s)
- J Östh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - A K Danielsson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - A Lundin
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - P Wennberg
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - S Andréasson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - M Jirwe
- Department of Health Sciences, Swedish Red Cross University, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
85
|
Yao J, Han K, Cui H, Chen N, Xiu M, Wu F. Grouping motivational interviewing is only effective for younger patients with alcohol dependence in the rehabilitation stage. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01736-1. [PMID: 38123714 DOI: 10.1007/s00406-023-01736-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
Alcohol dependence (AD) is a risk factor for death and disability. Relapse prevention for AD has been exclusively dominated by psychotherapy intervention for many years. Our study aimed to investigate the efficacy of group motivational interviewing (MI) on the psychological craving for alcohol and depressive symptoms in AD patients in the rehabilitation phase, as well as the impact of age. The participants included 108 individuals with AD in the rehabilitation phase. All participants were assigned to the MI intervention group or the control group and were treated for 6 weeks. The severity of psychological craving for alcohol was assessed by the Penn Alcohol Craving Scale (PACS), and psychological status was evaluated by the Hamilton Depression Rating Scale (HAMD). We found that group MI significantly reduced the psychological craving for alcohol in patients with AD in the rehabilitation phase (p < 0.05). In addition, when patients were divided into two groups according to their ages, we found that group MI interventions tended to be effective only in younger patients with AD, but not in older patients. Our findings provide further evidence that the efficacy of group MI interventions was influenced by the age of patients with AD in the rehabilitation stage.
Collapse
Affiliation(s)
- Jing Yao
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Kun Han
- Qingdao Mental Health Center, Qingdao, China
| | - Hongmei Cui
- Qingdao Mental Health Center, Qingdao, China
| | - Nan Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Meihong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China.
- Department of Biomedical Engineering, Guangzhou Medical University, Liwan District, Guangzhou, 510370, China.
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Liwan District, Guangzhou, 510370, China.
| |
Collapse
|
86
|
Russell AM, Montemayor BN, Ndulue EB, Barry AE, Massey PM. Alcohol Use Disorder Narratives in U.S. Digital News Coverage and Engagement on Social Media. HEALTH COMMUNICATION 2023; 38:2986-2992. [PMID: 36178062 PMCID: PMC10060439 DOI: 10.1080/10410236.2022.2129314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Social media regularly serves as a source of news and health-related information subsequently shaping public opinion and behavior. We examined mainstream digital news narratives about alcohol use disorder (AUD), including coverage of solutions to AUD, and associations between narratives and engagement on social media. AUD-related articles (N = 339) published in top U.S. newspapers and digital native news sources in 2019 were analyzed by trained coders with a structured codebook (κ = 0.75), examining characteristics of stories highlighting specific individuals affected by AUD and solution-framing of AUD. Facebook shares were used as a proxy measure for an article's potential "reach" on social media. Of articles focused on individuals (72.0%), most (62.7%) depicted individuals affected by AUD as criminals, as opposed to engaging with alcohol treatment or being in recovery (31.1%). These criminal depictions received over eight times as many FB shares, compared to alcohol use treatment or recovery depictions. Law enforcement solutions (63.9%) were depicted most often, followed by AUD-treatment oriented solutions (40.1%), and prevention-oriented solutions (15.8%). Law enforcement solutions received more than five times as much social media engagement than AUD-treatment oriented solutions and over twenty-nine times more engagement than prevention-oriented solutions. There is a need to increase news coverage featuring depictions of individuals who have successfully engaged with alcohol treatment and recovery, reflecting the millions of Americans who have resolved a significant past alcohol problem. News coverage of AUD should also incorporate more depictions of evidence-based prevention-oriented and treatment-oriented solutions to AUD.
Collapse
Affiliation(s)
- Alex M. Russell
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Ben N. Montemayor
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | | | - Adam E. Barry
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Philip M. Massey
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| |
Collapse
|
87
|
Gully BJ, Eaton E, Capone C, Haass-Koffler CL. Treating posttraumatic stress disorder and alcohol use disorder comorbidity: Current pharmacological therapies and the future of MDMA-integrated psychotherapy. J Psychopharmacol 2023; 37:1182-1189. [PMID: 38009477 DOI: 10.1177/02698811231200880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur in patients who have experienced trauma. This comorbidity leads to a vicious cycle where PTSD symptoms beget heavy drinking and vice versa. There are no FDA-approved medications to treat PTSD-AUD; therefore, individuals suffering from this comorbidity are treated with medication approved to treat the disorders separately or with off-label pharmacological interventions. However, these medications are limited in their efficacy for treating PTSD-AUD comorbidity. Emerging research on the nonclassical psychedelic drug 3,4-methylenedioxymethamphetamine (MDMA) suggests that it may be an effective drug used in conjunction with psychotherapy. The following reviews the current research for clinical pharmacotherapies, as well as MDMA-integrative psychotherapy as they pertain to PTSD and AUD in isolation and co-occurrence. Future directions for the role of psychedelic-integrative therapy for the treatment of this comorbidity are discussed.
Collapse
Affiliation(s)
- Brian J Gully
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Erica Eaton
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Christy Capone
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Carolina L Haass-Koffler
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Carney Institute for Brain Science, Brown University, Providence, RI, USA
| |
Collapse
|
88
|
DesLauriers N, Sambai B, Mbogo L, Ludwig-Barron N, Kingston H, Chohan B, Gitau E, Sinkele W, Masyuko S, Herbeck J, Bukusi D, Guthrie BL, Farquhar C, Monroe-Wise A. Alcohol use among people who inject drugs living with HIV in Kenya is associated with needle sharing, more new sex partners, and lower engagement in HIV care. AIDS Behav 2023; 27:3970-3980. [PMID: 37318665 DOI: 10.1007/s10461-023-04113-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
We assessed the prevalence and correlates of alcohol use among 870 people who inject drugs living with HIV in Kenya, with attention toward (1) sexual and injecting risk behaviors for HIV transmission and (2) HIV care engagement. We defined heavy alcohol use as > 14 drinks/week for men and > 7 drinks/week for women, moderate alcohol use as any lesser but non-zero amount, and any alcohol use as either moderate or heavy use. Approximately 39% of participants reported any alcohol use and 15% heavy use. In multivariate analysis, any alcohol use compared to no use was associated with needle sharing, > 3 new sex partners in the past 3 months, being unaware of HIV status, never enrolling in HIV care, and not being on ART (all p < 0.05). Heavy alcohol use as compared to no use was associated with needle sharing (aOR = 2.72; 95% CI 1.43, 5.13), injection equipment sharing (aOR = 1.80; 95% CI 1.00, 3.16), > 3 new sex partners in the past 3 months (aOR = 1.99; 95% CI 1.12, 3.49), and being unaware of HIV status (aOR = 2.77; 95% CI 1.46, 5.19). There was no association between any measure of alcohol use and unsuppressed viral load. Alcohol use among people who inject drugs living with HIV may carry elevated risk of HIV transmission mediated by sexual and injecting practices and is associated with lower engagement in multiple stages of the HIV care cascade.
Collapse
Affiliation(s)
- N DesLauriers
- Department of Medicine, University of Washington, Seattle, USA.
| | - B Sambai
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - L Mbogo
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - N Ludwig-Barron
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - H Kingston
- Institute for Public Health Genetics, University of Washington, Seattle, USA
| | - B Chohan
- Department of Global Health, University of Washington, Seattle, USA
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - E Gitau
- Support for Addiction Prevention and Treatment in Africa, Nairobi, Kenya
| | - W Sinkele
- Support for Addiction Prevention and Treatment in Africa, Nairobi, Kenya
| | - S Masyuko
- Department of Global Health, University of Washington, Seattle, USA
- National AIDS and STI Control Programme (NASCOP), Kenya Ministry of Health, Nairobi, Kenya
| | - J Herbeck
- Department of Global Health, University of Washington, Seattle, USA
| | - D Bukusi
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - B L Guthrie
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - C Farquhar
- Department of Medicine, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - A Monroe-Wise
- Department of Global Health, University of Washington, Seattle, USA
| |
Collapse
|
89
|
Leggio L, Hendershot CS, Farokhnia M, Fink-Jensen A, Klausen MK, Schacht JP, Simmons WK. GLP-1 receptor agonists are promising but unproven treatments for alcohol and substance use disorders. Nat Med 2023; 29:2993-2995. [PMID: 38001271 DOI: 10.1038/s41591-023-02634-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Affiliation(s)
- Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA.
| | - Christian S Hendershot
- Bowles Center for Alcohol Studies and Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen, Mental Health Services in the Capitol Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Kruse Klausen
- Psychiatric Centre Copenhagen, Mental Health Services in the Capitol Region of Denmark, Copenhagen, Denmark
| | - Joseph P Schacht
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - W Kyle Simmons
- Department of Pharmacology & Physiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- OSU Biomedical Imaging Center, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| |
Collapse
|
90
|
Bale R, Doshi G. Cross talk about the role of Neuropeptide Y in CNS disorders and diseases. Neuropeptides 2023; 102:102388. [PMID: 37918268 DOI: 10.1016/j.npep.2023.102388] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
A peptide composed of a 36 amino acid called Neuropeptide Y (NPY) is employed in a variety of physiological processes to manage and treat conditions affecting the endocrine, circulatory, respiratory, digestive, and neurological systems. NPY naturally binds to G-protein coupled receptors, activating the Y-receptors (Y1-Y5 and y6). The findings on numerous therapeutic applications of NPY for CNS disease are presented in this review by the authors. New targets for treating diseases will be revealed by medication combinations that target NPY and its receptors. This review is mainly focused on disorders such as anxiety, Alzheimer's disease, Parkinson's disease, Huntington's disease, Machado Joseph disease, multiple sclerosis, schizophrenia, depression, migraine, alcohol use disorder, and substance use disorder. The findings from the preclinical studies and clinical studies covered in this article may help create efficient therapeutic plans to treat neurological conditions on the one hand and psychiatric disorders on the other. They may also open the door to the creation of novel NPY receptor ligands as medications to treat these conditions.
Collapse
Affiliation(s)
- Rajeshwari Bale
- Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, V L M Road, Vile Parle (w), Mumbai 400056, India
| | - Gaurav Doshi
- Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, V L M Road, Vile Parle (w), Mumbai 400056, India.
| |
Collapse
|
91
|
Ruan X, Song Z, Zhang J, Yu T, Chen J, Zhou T. Alterations of brain activity in patients with alcohol use disorder: a resting-state fMRI study. BMC Psychiatry 2023; 23:894. [PMID: 38037006 PMCID: PMC10688004 DOI: 10.1186/s12888-023-05361-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) has a negative impact on one's health and wastes a lot of societal resources since it damages one's brain tissue. Yet the knowledge of the neural mechanisms underlying alcohol addiction still remains limited. This study aims to investigate the neural mechanisms underlying alcohol addiction by using voxel-wise binarized degree centrality (DC), weighted DC and functional connectivity (FC) methods to analyze brain network activity in individuals with AUD. METHODS Thirty-three AUD patients and 29 healthy controls (HC) participated in this study. Binarized and weighted DC approach coupled with a second seed-based FC algorithm was used to assess the abnormal intrinsic hub features in AUD. We also examined the correlation between changes in functional network nodes and the severity of alcohol dependence. RESULTS Thirty AUD patients and 26 HC were retained after head motion correction. The spatial distribution maps of the binarized DC and weighted DC for the AUD and HC groups were roughly similar. In comparison to HC, the AUD group had decreased binarized DC and decreased weighted DC in the left precentral gyrus (PreCG) and the left inferior parietal lobule (IPL). Significantly different brain regions in the DC analysis were defined as seed points in the FC analysis. Compared with HC, changes in FC within the right inferior temporal gyrus (ITG), right middle temporal gyrus (MTG), left dorsolateral superior frontal gyrus (SFGdor), bilateral IPL, left precuneus (PCUN), left lingual gyrus (LING), right cerebellum_crus1/ITG/inferior occipital gyrus (IOG) and right superior parietal gyrus (SPG) were observed. The correlation analysis revealed that FC of right MTG-right PreCG was negatively correlated with MAST scores, and FC of right IPL-left IPL was positively correlated with ADS scores. CONCLUSIONS Alcohol use disorder is associated with aberrant regional activities in multiple brain areas. Binarized DC, weighted DC and FC analyses may be useful biological indicators for the detection of regional brain activities in patients with AUD. Intergroup differences in FC have also been observed in AUD patients, and these variations were connected to the severity of the symptoms. The AUD patients with lower FC value of the right IPL - left IPL has a lighter dependence on alcohol. This difference in symptom severity may be a compensation for cognitive impairment, indicating a difference in pathological pathways. Future AUD research will now have a fresh path thanks to these discoveries.
Collapse
Affiliation(s)
- Xia Ruan
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, 430060, People's Republic of China
| | - Zhiyan Song
- Department of Radiology, Wuhan No.1 Hospital, Wuhan, Hubei Province, 430030, People's Republic of China
| | - Jie Zhang
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430079, People's Republic of China
| | - Tingting Yu
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, 430060, People's Republic of China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, 430060, People's Republic of China.
| | - Tiantian Zhou
- Department of Medical Imaging, Wuhan Pulmonary Hospital, Wuhan, Hubei Province, 430030, People's Republic of China.
| |
Collapse
|
92
|
Probst L, Monnerat S, Vogt DR, Lengsfeld S, Burkard T, Meienberg A, Bathelt C, Christ-Crain M, Winzeler B. Effects of dulaglutide on alcohol consumption during smoking cessation. JCI Insight 2023; 8:e170419. [PMID: 37991022 PMCID: PMC10721313 DOI: 10.1172/jci.insight.170419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/04/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUNDAlcohol use disorder has a detrimental impact on global health and new treatment targets are needed. Preclinical studies show attenuating effects of glucagon-like peptide-1 (GLP-1) agonists on addiction-related behaviors in rodents and nonhuman primates. Some trials have shown an effect of GLP-1 agonism on reward processes in humans; however, results from clinical studies remain inconclusive.METHODSThis is a predefined secondary analysis of a double-blind, randomized, placebo-controlled trial evaluating the GLP-1 agonist dulaglutide as a therapy for smoking cessation. The main objective was to assess differences in alcohol consumption after 12 weeks of treatment with dulaglutide compared to placebo. The effect of dulaglutide on alcohol consumption was analyzed using a multivariable generalized linear model.RESULTSIn the primary analysis, participants out of the cohort (n = 255) who reported drinking alcohol at baseline and who completed 12 weeks of treatment (n = 151; placebo n = 75, dulaglutide n = 76) were included. The median age was 42 (IQR 33-53) with 61% (n = 92) females. At week 12, participants receiving dulaglutide drank 29% less (relative effect = 0.71, 95% CI 0.52-0.97, P = 0.04) than participants receiving placebo. Changes in alcohol consumption were not correlated with smoking status at week 12.CONCLUSIONThese results provide evidence that dulaglutide reduces alcohol intake in humans and contribute to the growing body of literature promoting the use of GLP-1 agonists in treatment of substance use disorders.TRIAL REGISTRATIONClinicalTrials.gov NCT03204396.FUNDINGSwiss National Foundation, Gottfried Julia Bangerter-Rhyner Foundation, Goldschmidt-Jacobson Foundation, Hemmi Foundation, University of Basel, University Hospital Basel, Swiss Academy of Medical Science.
Collapse
Affiliation(s)
- Leila Probst
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Sophie Monnerat
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Deborah R. Vogt
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Sophia Lengsfeld
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Thilo Burkard
- Department of Cardiology, and
- Medical Outpatient Department, University Hospital Basel, Basel, Switzerland
| | - Andrea Meienberg
- Department of Cardiology, and
- Medical Outpatient Department, University Hospital Basel, Basel, Switzerland
| | - Cemile Bathelt
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Mirjam Christ-Crain
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Bettina Winzeler
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| |
Collapse
|
93
|
Russell AM, Montemayor BN, Chiang SC, Milaham PJ, Barry AE, Lin HC, Bergman BG, Massey PM. Characterizing Twitter chatter about temporary alcohol abstinence during "Dry January". Alcohol Alcohol 2023; 58:589-598. [PMID: 37652745 PMCID: PMC10642608 DOI: 10.1093/alcalc/agad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/02/2023] Open
Abstract
With roots as a public health campaign in the United Kingdom, "Dry January" is a temporary alcohol abstinence initiative encouraging participants to abstain from alcohol use during the month of January. Dry January has become a cultural phenomenon, gaining increasing news media attention and social media engagement. Given the utility of capturing naturalistic discussions around health topics on social media, we examined Twitter chatter about Dry January and associated temporary abstinence experiences. Public tweets were collected containing the search terms "dry january" or "dryjanuary" posted between 15 December and 15 February across 3 years (2020-2). A random subsample stratified by year (n = 3145) was pulled for manual content analysis by trained coders. Final codebook accounted for user sentiment toward Dry January, user account type, and themes related to Dry January participation. Engagement metadata (e.g. likes) were also collected. Though user sentiment was mixed, most tweets expressed positive or neutral sentiment toward Dry January (74.7%). Common themes included encouragement and support for Dry January participation (14.1%), experimentation with and promotion of nonalcoholic drinks (14.0%), and benefits derived from Dry January participation (10.4%). While there is promise in the movement to promote positive alcohol-related behavior change, increased efforts to deliver the campaign within a public health context are needed. Health communication campaigns designed to inform participants about evidence-based treatment and recovery support services proven to help people quit or cut down on their drinking are likely to maximize benefits.
Collapse
Affiliation(s)
- Alex M Russell
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac St., Floor 4, Boston, MA 02114, United States
| | - Ben N Montemayor
- Department of Health Behavior, Texas A&M University, College Station, TX 77843, United States
| | - Shawn C Chiang
- Department of Health Behavior, Texas A&M University, College Station, TX 77843, United States
| | - Plangkat J Milaham
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, United States
| | - Adam E Barry
- Department of Health Behavior, Texas A&M University, College Station, TX 77843, United States
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN 47405, United States
| | - Brandon G Bergman
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac St., Floor 4, Boston, MA 02114, United States
| | - Philip M Massey
- Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, CA 90095, United States
| |
Collapse
|
94
|
Havlik JL, Rhee TG, Rosenheck RA. Characterization of quality of life among individuals with current treated, untreated, and past alcohol use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:787-798. [PMID: 37788415 DOI: 10.1080/00952990.2023.2245125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/28/2023] [Indexed: 10/05/2023]
Abstract
Background: Understanding health-related quality of life (HRQOL) among those who seek treatment for their alcohol use disorder (AUD) and those not seeking AUD treatment is critical to decreasing morbidity and mortality, yet HRQOL in these groups has been little characterized.Objectives: Characterize HRQOL among those who meet diagnostic criteria for AUD, both receiving and not receiving treatment.Methods: This analysis used the NESARC-III database (n = 36,309; female = 56.3%), a nationally representative survey of US adults, to compare four groups: those treated for current AUD; those untreated for current AUD; those with past AUD only; and those who never met criteria for AUD. Multiple regression analysis was used to account for differences in sociodemographic and other behavioral factors across these groups. HRQOL was operationalized using annual quality-adjusted life years (QALYs).Results: Patients treated for past-year AUD had a deficit of 0.07 QALYs/year compared to those who never met criteria for AUD (P < .001). They retained a still clinically meaningful 0.03 QALYs/year deficit after controlling for concomitant psychiatric disorders and other behavioral health factors (P < .001). Those with past-year untreated AUD or past AUD had a near-zero difference in QALYs compared with those who never met criteria for AUD.Conclusion: These findings suggest that previously-reported differences in HRQOL associated with AUD may be due to the problems of the relatively small sub-group who seek treatment. Clinicians seeking to treat those with currently untreated AUD may do better to focus on the latent potential health effects of AUD instead of current HRQOL concerns.
Collapse
Affiliation(s)
- John L Havlik
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
- Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Robert A Rosenheck
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| |
Collapse
|
95
|
Pince CL, Whiting KE, Wang T, Lékó AH, Farinelli LA, Cooper D, Farokhnia M, Vendruscolo LF, Leggio L. Role of aldosterone and mineralocorticoid receptor (MR) in addiction: A scoping review. Neurosci Biobehav Rev 2023; 154:105427. [PMID: 37858908 PMCID: PMC10865927 DOI: 10.1016/j.neubiorev.2023.105427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/24/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
Preclinical and human studies suggest a role of aldosterone and mineralocorticoid receptor (MR) in addiction. This scoping review aimed to summarize (1) the relationship between alcohol and other substance use disorders (ASUDs) and dysfunctions of the aldosterone and MR, and (2) how pharmacological manipulations of MR may affect ASUD-related outcomes. Our search in four databases (MEDLINE, Embase, Web of Science, and Cochrane Library) indicated that most studies focused on the relationship between aldosterone, MR, and alcohol (n = 30), with the rest focused on opioids (n = 5), nicotine (n = 9), and other addictive substances (n = 9). Despite some inconsistencies, the overall results suggest peripheral and central dysregulations of aldosterone and MR in several species and that these dysregulations depended on the pattern of drug exposure and genetic factors. We conclude that MR antagonism may be a promising target in ASUD, yet future studies are warranted.
Collapse
Affiliation(s)
- Claire L Pince
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA; Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA; Stress & Addiction Neuroscience Unit, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA
| | - Kimberly E Whiting
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA; Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA
| | - Tammy Wang
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA
| | - András H Lékó
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA; Center on Compulsive Behaviors, Intramural Research Program, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lisa A Farinelli
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA
| | - Diane Cooper
- Office of Research Services, Division of Library Services, National Institutes of Health, Building 10, Bethesda, MD 20892, USA
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA
| | - Leandro F Vendruscolo
- Stress & Addiction Neuroscience Unit, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA.
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA.
| |
Collapse
|
96
|
Richardson RS, Sulima A, Rice KC, Kucharczk JA, Janda KD, Nisbett KE, Koob GF, Vendruscolo LF, Leggio L. Pharmacological GHSR (ghrelin receptor) blockade reduces alcohol binge-like drinking in male and female mice. Neuropharmacology 2023; 238:109643. [PMID: 37369277 PMCID: PMC10513123 DOI: 10.1016/j.neuropharm.2023.109643] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023]
Abstract
Ghrelin is a peptide that is produced by endocrine cells that are primarily localized in the stomach. Ghrelin receptors (GHSR) are expressed in the brain and periphery. Preclinical and clinical studies support a role for ghrelin in alcohol drinking and seeking. The GHSR has been suggested to be a potential pharmacotherapeutic target for alcohol use disorder (AUD). However, the role of the ghrelin system and its potential modulation by biological sex on binge-like drinking has not been comprehensively investigated. The present study tested six GHSR antagonists in an alcohol binge-like drinking procedure in male and female mice. Systemic administration of the GHSR antagonists JMV2959, PF-5190457, PF-6870961, and HM-04 reduced alcohol intake in both male and female mice. YIL-781 decreased intake in males, and LEAP2 (likely peripherally restricted) did not reduce intake in mice of either sex. We also administered LEAP2 and JMV2959 intracerebroventricularly to investigate whether the effects of GHSR blockade on alcohol intake are mediated by central receptors. The central administration of LEAP2 and JMV2959 decreased alcohol intake, particularly in high-drinking animals. Finally, in a preliminary experiment, an anti-ghrelin vaccine was examined for its potential effect on binge-like drinking and had no effect. In all experiments, there was a lack of meaningful sex differences. These findings suggest that central GHSR mediates binge-like alcohol intake. These data reveal novel pharmacological compounds with translational potential in the treatment of AUD and provide further evidence of the GHSR as a potential treatment target for AUD.
Collapse
Affiliation(s)
- Rani S Richardson
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Stress & Addiction Neuroscience Unit, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; University of North Carolina School of Medicine MD/PhD Program, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
| | - Agnieszka Sulima
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Kenner C Rice
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Jed A Kucharczk
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Kim D Janda
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Khalin E Nisbett
- Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Stress & Addiction Neuroscience Unit, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Graduate Program in Neuroscience, Graduate College, University of Illinois Chicago, Chicago, IL, USA
| | - George F Koob
- Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Leandro F Vendruscolo
- Stress & Addiction Neuroscience Unit, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA.
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA; Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA.
| |
Collapse
|
97
|
Witkiewitz K, Kirouac M, Baurley JW, McMahan CS. Patterns of drinking behavior around a treatment episode for alcohol use disorder: Predictions from pre-treatment measures. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2138-2148. [PMID: 38226755 PMCID: PMC11164067 DOI: 10.1111/acer.15183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Alcohol use disorder (AUD) has been described as a chronic disease given the high rates that affected individuals have in returning to drinking after a change attempt. Many studies have characterized predictors of aggregated alcohol use (e.g., percent heavy drinking days) following treatment for AUD. However, to inform future research on predicting drinking as an AUD outcome measure, a better understanding is needed of the patterns of drinking that surround a treatment episode and which clinical measures predict patterns of drinking. METHODS We analyzed data from the Project MATCH and COMBINE studies (MATCH: n = 1726; 24.3% female, 20.0% non-White; COMBINE: n = 1383; 30.9% female, 23.2% non-White). Daily drinking was measured in the 90 days prior to treatment, 90 days (MATCH) and 120 days (COMBINE) during treatment, and 365 days following treatment. Gradient boosting machine learning methods were used to explore baseline predictors of drinking patterns. RESULTS Drinking patterns during a prior time period were the most consistent predictors of future drinking patterns. Social network drinking, AUD severity, mental health symptoms, and constructs based on the addiction cycle (incentive salience, negative emotionality, and executive function) were associated with patterns of drinking prior to treatment. Addiction cycle constructs, AUD severity, purpose in life, social network, legal history, craving, and motivation were associated with drinking during the treatment period and following treatment. CONCLUSIONS There is heterogeneity in drinking patterns around an AUD treatment episode. This study provides novel information about variables that may be important to measure to improve the prediction of drinking patterns during and following treatment. Future research should consider which patterns of drinking they aim to predict and which period of drinking is most important to predict. The current findings could guide the selection of predictor variables and generate hypotheses for those predictors.
Collapse
Affiliation(s)
- Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA
| | - Megan Kirouac
- Center on Alcohol, Substance Use, and Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA
| | | | - Christopher S McMahan
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, South Carolina, USA
| |
Collapse
|
98
|
Diaz LA, Winder GS, Leggio L, Bajaj JS, Bataller R, Arab JP. New insights into the molecular basis of alcohol abstinence and relapse in alcohol-associated liver disease. Hepatology 2023:01515467-990000000-00605. [PMID: 37862466 DOI: 10.1097/hep.0000000000000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023]
Abstract
Alcohol use disorder remains a significant public health concern, affecting around 5% of adults worldwide. Novel pathways of damage have been described during the last years, providing insight into the mechanism of injury due to alcohol misuse beyond the direct effect of ethanol byproducts on the liver parenchyma and neurobehavioral mechanisms. Thus, the gut-liver-brain axis and immune system involvement could be therapeutic targets for alcohol use disorder. In particular, changes in gut microbiota composition and function, and bile acid homeostasis, have been shown with alcohol consumption and cessation. Alcohol can also directly disrupt intestinal and blood-brain barriers. Activation of the immune system can be triggered by intestinal barrier dysfunction and translocation of bacteria, pathogen-associated molecular patterns (such as lipopolysaccharide), cytokines, and damage-associated molecular patterns. These factors, in turn, promote liver and brain inflammation and the progression of liver fibrosis. Other involved mechanisms include oxidative stress, apoptosis, autophagy, and the release of extracellular vesicles and miRNA from hepatocytes. Potential therapeutic targets include gut microbiota (probiotics and fecal microbiota transplantation), neuroinflammatory pathways, as well as neuroendocrine pathways, for example, the ghrelin system (ghrelin receptor blockade), incretin mimetics (glucagon-like peptide-1 analogs), and the mineralocorticoid receptor system (spironolactone). In addition, support with psychological and behavioral treatments is essential to address the multiple dimensions of alcohol use disorder. In the future, a personalized approach considering these novel targets can contribute to significantly decreasing the alcohol-associated burden of disease.
Collapse
Affiliation(s)
- Luis Antonio Diaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institutes of Health, NIDA and NIAAA, Baltimore, Maryland, USA
| | - Jasmohan S Bajaj
- Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University and Central Virginia Veterans Health Care System, Richmond, Virginia, USA
| | - Ramon Bataller
- Liver Unit, Hospital Clinic, Institut d'Investigacions August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Medicine, Division of Gastroenterology, Schulich School of Medicine, Western University, London, Ontario, Canada
| |
Collapse
|
99
|
Teng PN, Barakat W, Tran SM, Tran ZM, Bateman NW, Conrads KA, Wilson KN, Oliver J, Gist G, Hood BL, Zhou M, Maxwell GL, Leggio L, Conrads TP, Lee MR. Brain proteomic atlas of alcohol use disorder in adult males. Transl Psychiatry 2023; 13:318. [PMID: 37833300 PMCID: PMC10575941 DOI: 10.1038/s41398-023-02605-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Alcohol use disorder (AUD) affects transcriptomic, epigenetic and proteomic expression in several organs, including the brain. There has not been a comprehensive analysis of altered protein abundance focusing on the multiple brain regions that undergo neuroadaptations occurring in AUD. We performed a quantitative proteomic analysis using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis of human postmortem tissue from brain regions that play key roles in the development and maintenance of AUD, the amygdala (AMG), hippocampus (HIPP), hypothalamus (HYP), nucleus accumbens (NAc), prefrontal cortex (PFC) and ventral tegmental area (VTA). Brain tissues were from adult males with AUD (n = 11) and matched controls (n = 16). Across the two groups, there were >6000 proteins quantified with differential protein abundance in AUD compared to controls in each of the six brain regions. The region with the greatest number of differentially expressed proteins was the AMG, followed by the HYP. Pathways associated with differentially expressed proteins between groups (fold change > 1.5 and LIMMA p < 0.01) were analyzed by Ingenuity Pathway Analysis (IPA). In the AMG, adrenergic, opioid, oxytocin, GABA receptor and cytokine pathways were among the most enriched. In the HYP, dopaminergic signaling pathways were the most enriched. Proteins with differential abundance in AUD highlight potential therapeutic targets such as oxytocin, CSNK1D (PF-670462), GABAB receptor and opioid receptors and may lead to the identification of other potential targets. These results improve our understanding of the molecular alterations of AUD across brain regions that are associated with the development and maintenance of AUD. Proteomic data from this study is publicly available at www.lmdomics.org/AUDBrainProteomeAtlas/ .
Collapse
Affiliation(s)
- Pang-Ning Teng
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Waleed Barakat
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Sophie M Tran
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Zoe M Tran
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Nicholas W Bateman
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Kelly A Conrads
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Katlin N Wilson
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Julie Oliver
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Glenn Gist
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Brian L Hood
- Women's Health Integrated Research Center, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Ming Zhou
- Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - G Larry Maxwell
- Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Baltimore, Bethesda, Maryland, USA
- Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, Maryland, USA
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
- Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA
| | - Thomas P Conrads
- Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA.
| | - Mary R Lee
- Veterans Affairs Medical Center, Washington, DC, USA.
| |
Collapse
|
100
|
Yukhnenko D, Blackwood N, Lichtenstein P, Fazel S. Association of substance use and other psychiatric disorders with all-cause and external-cause mortality in individuals given community sentences in Sweden: a national cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 33:100703. [PMID: 37954004 PMCID: PMC10636268 DOI: 10.1016/j.lanepe.2023.100703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 11/14/2023]
Abstract
Background Consistently high rates of premature mortality have been reported in individuals who receive community sentences. However, few studies have explored potential modifiable risk factors for these rates, particularly mental health. We examined the association of substance use and other psychiatric disorders with all-cause and external-cause mortality in individuals convicted of a criminal offence and given a community sentence. Methods We did a longitudinal cohort study of 109,751 individuals given community sentences in Sweden using population-based registers. We calculated mortality rates for all-cause and external-cause mortality, hazard ratios for the association between psychiatric disorders and mortality, and population attributable fractions to quantify the contribution of psychiatric disorders to mortality risk. Findings During the follow-up, 5749 (5.2%) individuals died, including 2709 (2.5%) from external causes. Individuals with pre-existing substance use and other psychiatric disorders had an increased mortality risk from any cause (aHR = 2.28 [95% CI 2.15-2.42]) and from external causes (3.11 [2.85-3.40]) compared to individuals without known psychiatric or substance use disorders. Suicide was the most common cause of death in younger persons. Interpretation In individuals given community sentences, substance use and other psychiatric disorders were associated with an increased risk of premature death with suicide being the leading cause of death. Community supervision represents an opportunity to provide sentenced individuals with access to evidence-based treatment targeting substance misuse and psychiatric disorders to prevent potentially preventable deaths. Funding Wellcome Trust.
Collapse
Affiliation(s)
| | - Nigel Blackwood
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| |
Collapse
|