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Carlini LE, Fernandez AC, Mellinger JL. Sex and gender in alcohol use disorder and alcohol-associated liver disease in the United States: A narrative review. Hepatology 2024:01515467-990000000-00864. [PMID: 38683562 DOI: 10.1097/hep.0000000000000905] [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: 11/24/2023] [Accepted: 04/05/2024] [Indexed: 05/01/2024]
Abstract
Over the last 20 years, there has been an alarming increase in alcohol use and AUD prevalence among women, narrowing the historical gender gap. Concurrently, there has also been a significant rise in alcohol-associated liver disease (ALD) prevalence, severity, and mortality among women. Despite this, there are no recent reviews that have sought to evaluate both sex and gender differences at the intersection of AUD and ALD. In this narrative review, we address the escalating rates of ALD and AUD in the United States, with a specific focus on the disproportionate impact on women. Sex and gender play an important and well-known role in the pathogenesis and epidemiology of ALD. However, sex and gender are also implicated in the development and prevalence of AUD, as well as in the treatment of AUD, all of which have important consequences on the approach to the treatment of patients with ALD and AUD. A better understanding of sex and gender differences in AUD, ALD, and the intersection of the 2 is essential to enhance prevention, diagnosis, and management strategies. These data underscore the urgent need for awareness and preventive efforts to mitigate the potential long-term health consequences.
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Affiliation(s)
- Lauren E Carlini
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Anne C Fernandez
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jessica L Mellinger
- Department of Internal Medicine and Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
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De Oliveira Sergio T, Frasier RM, Hopf FW. Animal models of compulsion alcohol drinking: Why we love quinine-resistant intake and what we learned from it. Front Psychiatry 2023; 14:1116901. [PMID: 37032937 PMCID: PMC10080007 DOI: 10.3389/fpsyt.2023.1116901] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/17/2023] [Indexed: 04/11/2023] Open
Abstract
Alcohol Use Disorder (AUD) ranks among the most prevalent mental disorders, extracting ~$250 billion/year in the US alone and producing myriad medical and social harms. Also, the number of deaths related to problem drinking has been increasing dramatically. Compulsive alcohol drinking, characterized by intake that persists despite negative consequences, can be particularly important and a major obstacle to treatment. With the number of people suffering from AUD increasing during the past years, there is a critical need to understand the neurobiology related to compulsive drives for alcohol, as well as the development of novel AUD pharmacological therapies. Here we discuss rodent compulsion-like alcohol drinking (CLAD) models, focusing on the two most widely used adverse stimuli to model rodent compulsion-like responding, quinine adulteration of alcohol and footshook-resistant alcohol intake. For both cases, the goal is to uncover behavior patterns and brain circuits that underlie drive for alcohol even in the face of negative consequences. We discuss caveats, benefits, and potential brain mechanisms, of models for consequence-resistant responding for alcohol more generally, and especially highlight some advantages of quinine-resistance over footshook-resistance. Further, since this review contributes to a Special issue focused on Molecular Aspects of Compulsive Drug Use, we discuss our new findings showing how the noradrenergic system is related to CLAD responding. In particular, we comment on the importance of α1 and β adrenergic receptors (ARs) as potential targets for treating AUD.
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Hackleman A, Ibrahim M, Shim K, Sangha S. Interaction of stress and alcohol on discriminating fear from safety and reward in male and female rats. Psychopharmacology (Berl) 2023; 240:609-621. [PMID: 35960326 PMCID: PMC9922333 DOI: 10.1007/s00213-022-06206-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/28/2022] [Indexed: 10/16/2022]
Abstract
RATIONALE Stressful events can have lasting and impactful effects on behavior, especially in terms of appropriate fear regulation and reward seeking. Our prior work in rats has shown baseline sex differences in fear expression and sucrose seeking in a discriminative reward-fear-safety conditioning task. OBJECTIVES The objectives of the current study were to determine how prior stress may affect alcohol consumption across a reward-fear-safety learning task, and how prior alcohol history may interact with stress to impact learning in this task. METHODS Male and female Long Evans rats were given home cage intermittent 24 h access to both water and alcohol for 5 weeks. A subset of rats then received exposure to stress (15 unsignaled footshocks), while remaining unstressed rats received context exposure without shock. One week later, all rats were trained on the same reward-fear-safety cue task while having continuous home cage access to both water and alcohol. RESULTS All rats increased consumption (g/kg/24 h) across the 5 weeks of intermittent access, with females showing higher consumption levels. Stress exposure did not alter alcohol consumption in the week following stress, but did increase home cage alcohol consumption during later reward-fear-safety cue learning. Stress in both sexes also elevated freezing levels to the reward cue resulting in decreased sucrose seeking and was positively correlated with home cage alcohol consumption. CONCLUSIONS While stress increased drinking in both males and females, the effects of stress were particularly pronounced in females, indicating our results could be capturing a higher propensity for females to display stress-induced drinking.
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Affiliation(s)
- Abigail Hackleman
- Department of Psychological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Muhja Ibrahim
- Department of Psychological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Kevin Shim
- Department of Psychological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Susan Sangha
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, 47907, USA. .,Department of Psychiatry, Indiana University School of Medicine, 320 W. 15th Street, Indianapolis, IN, NB 300A46202, USA.
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Valyear MD, LeCocq MR, Brown A, Villaruel FR, Segal D, Chaudhri N. Learning processes in relapse to alcohol use: lessons from animal models. Psychopharmacology (Berl) 2023; 240:393-416. [PMID: 36264342 DOI: 10.1007/s00213-022-06254-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
RATIONALE Alcohol use is reliably preceded by discrete and contextual stimuli which, through diverse learning processes, acquire the capacity to promote alcohol use and relapse to alcohol use. OBJECTIVE We review contemporary extinction, renewal, reinstatement, occasion setting, and sex differences research within a conditioning framework of relapse to alcohol use to inform the development of behavioural and pharmacological therapies. KEY FINDINGS Diverse learning processes and corresponding neurobiological substrates contribute to relapse to alcohol use. Results from animal models indicate that cortical, thalamic, accumbal, hypothalamic, mesolimbic, glutamatergic, opioidergic, and dopaminergic circuitries contribute to alcohol relapse through separable learning processes. Behavioural therapies could be improved by increasing the endurance and generalizability of extinction learning and should incorporate whether discrete cues and contexts influence behaviour through direct excitatory conditioning or occasion setting mechanisms. The types of learning processes that most effectively influence responding for alcohol differ in female and male rats. CONCLUSION Sophisticated conditioning experiments suggest that diverse learning processes are mediated by distinct neural circuits and contribute to relapse to alcohol use. These experiments also suggest that gender-specific behavioural and pharmacological interventions are a way towards efficacious therapies to prevent relapse to alcohol use.
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Affiliation(s)
- Milan D Valyear
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada. .,Department of Psychology, McGill University, 1205 Ave. Dr. Penfield, Room N8/5, Montréal, QC, H3A 1B1, Canada.
| | - Mandy R LeCocq
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Alexa Brown
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Franz R Villaruel
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Diana Segal
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Nadia Chaudhri
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
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Armstrong A, Rosenthal H, Stout N, Richard JM. Reinstatement of Pavlovian responses to alcohol cues by stress. Psychopharmacology (Berl) 2023; 240:531-545. [PMID: 36227353 PMCID: PMC9931652 DOI: 10.1007/s00213-022-06255-w] [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: 05/06/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
RATIONALE Stress may contribute to relapse to alcohol use in part by enhancing reactivity to cues previously paired with alcohol. Yet, standard models of stress-induced reinstatement generally use contingent presentations of alcohol-paired cues to reinforce instrumental behaviors, making it difficult to isolate the ability of cues to invigorate alcohol-seeking. OBJECTIVE Here we sought to test the impact of stress on behavioral responses to alcohol-paired cues, using a model of stress-induced reinstatement of Pavlovian conditioned approach, inspired by Nadia Chaudhri's work on context-induced reinstatement. METHODS Long Evans rats were trained to associate one auditory cue with delivery of alcohol or sucrose and an alternative auditory cue with no reward. Following extinction training, rats were exposed to a stressor prior to being re-exposed to the cues under extinction conditions. We assessed the effects of yohimbine, intermittent footshock and olfactory cues paired with social defeat on responses to alcohol-paired cues and the effects of yohimbine on responses to sucrose-paired cues. RESULTS The pharmacological stressor, yohimbine, enhanced alcohol seeking in a Pavlovian setting, but not in a cue-selective manner. Intermittent footshock and social defeat cues did not enhance alcohol seeking in this paradigm. CONCLUSIONS While yohimbine elicited reinstatement of reward-seeking in a Pavlovian setting, these effects may be unrelated to activation of stress systems or to interactions with specific cues.
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Affiliation(s)
- Anne Armstrong
- Department of Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Hailey Rosenthal
- Department of Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Nakura Stout
- Department of Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Jocelyn M Richard
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, 55415, USA.
- Medical Discovery Team On Addiction, University of Minnesota, Minneapolis, MN, 55415, USA.
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Segal D, Valyear MD, Chaudhri N. Supplementary dataset of context-dependent conditioned responding to an alcohol-predictive cue in female and male rats. Data Brief 2022; 42:108058. [PMID: 35330738 PMCID: PMC8938858 DOI: 10.1016/j.dib.2022.108058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 11/03/2022] Open
Abstract
This supplementary dataset is supportive of the research article entitled ‘The role of context on responding to an alcohol-predictive cue in female and male rats’ [1]. This article describes the raw data pertaining to the behaviour of male and female rats during intermittent to ethanol and Pavlovian conditioning training and testing procedures. Specifically, the dataset describes the alcohol consumption and ingested-dose of ethanol during home-cage ethanol exposure, as well as the conditioned responding during Pavlovian discrimination training, a test assessing the effect of context on responding to an alcohol-predict cue in the absence of alcohol, and a reinstatement test assessing the effect of context on conditioned responding to an extinguished alcohol-predictive cue.
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Affiliation(s)
- Diana Segal
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Milan D Valyear
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada
| | - Nadia Chaudhri
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montreal, QC, Canada
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