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Clark PJ, Valery PC, Strasser SI, Weltman M, Thompson A, Levy MT, Leggett B, Zekry A, Rong J, Sinclair M, George J, Sievert W, MacQuillan G, Tse E, Nicoll A, Wade A, Cheng W, Roberts SK. Alcohol does not impact chronic hepatitis C treatment outcomes but increases risk for progressive liver disease: Findings from a prospective multicentre Australian study (OPERA-C). Drug Alcohol Rev 2024; 43:1559-1572. [PMID: 39091194 DOI: 10.1111/dar.13914] [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: 02/13/2024] [Revised: 06/19/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Alcohol use is common in patients with chronic hepatitis C virus (HCV) infection. We examined the impact of alcohol use on direct-acting antiviral (DAA) therapy outcome and the clinical course of liver disease and 2-year survival for patients receiving HCV DAA therapy. METHODS Adults (n = 2624) recruited from 26 Australian hospital liver clinics during 2016-2021 were followed up for 2 years. Risky alcohol use was defined by a combination of self-report (≥40 g/day of ethanol), physician-reported history of problematic alcohol use, and anti-craving medication prescription via population-based database linkage. We examined factors associated with advanced liver fibrosis and survival using multivariable logistic and Cox regression. RESULTS Among 1634 patients (62.3%) with risky alcohol use, 24.6% reported consuming ≥40 g/day of alcohol, 98.3% physician-reported problematic alcohol use; only 4.1% were dispensed naltrexone/acamprosate. One hundred and forty-three patients with cirrhosis reported ≥40 g/day of alcohol, 6 (4.3%) were prescribed naltrexone/acamprosate. Risky alcohol use was associated with advanced fibrosis (adjusted-odds ratio 1.69, 95% confidence interval 1.32-2.17) and patients were over-represented for cirrhosis (45.1% vs. 25.6% in no-risky alcohol use [p < 0.001]) and hepatocellular carcinoma (5.7% vs. 2.5% [p < 0.001]). Sustained viral response (p = 0.319) and 2-year survival (adjusted-hazard ratio 1.98, 95% confidence interval 0.84-4.63) after DAA therapy were not associated with risky alcohol use. DISCUSSION AND CONCLUSIONS Risky alcohol use in HCV patients was prevalent, but did not reduce HCV cure. Treatment for alcohol dependence was low. Risky alcohol use may be under-recognised in liver clinics. Better integration of addiction medicine into liver services and increased resourcing and addiction medicine training opportunities for hepatologists may help address this.
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Grants
- Commonwealth Department of Health, the Gastroenterological Society of Australia (GESA)
- Gilead Sciences
- Merck
- Abbvie
- Robert W. Storr Bequest
- Sydney Medical Foundation, University of Sydney
- APP1053206 A National Health and Medical Research Council of Australia (NHMRC) Program
- APP2001692 Project, Ideas, and Investigator
- APP1107178 Project, Ideas, and Investigator
- APP1108422 Project, Ideas, and Investigator
- APP1196492 Project, Ideas, and Investigator
- 2021/ATRG2028 Cancer Institute, NSW
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Affiliation(s)
- Paul J Clark
- Department of Gastroenterology, Alcohol and Drug Assessment Unit, Princess Alexandra and Mater Hospitals, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Patricia C Valery
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Simone I Strasser
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Alex Thompson
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia
| | - Miriam T Levy
- Department of Gastroenterology and Liver, Liverpool Hospital, Sydney, Australia
| | - Barbara Leggett
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Amany Zekry
- Department of Gastroenterology and Hepatology, St George Hospital, Sydney, Australia
| | - Julian Rong
- Gippsland Gastroenterology, Latrobe Regional Hospital, Traralgon, Australia
| | - Marie Sinclair
- Department of Gastroenterology and Hepatology, Austin Hospital, Melbourne, Australia
| | - Jacob George
- Faculty of Medicine, The University of Sydney, Sydney, Australia
- Storr Liver Centre, Westmead Hospital, Sydney, Australia
| | - William Sievert
- Gastrointestinal and Liver Unit, Monash Health and Monash University, Melbourne, Australia
| | - Gerry MacQuillan
- Department of Hepatology and Liver Transplant Unit, Sir Charles Gairdner Hospital, Perth, Australia
| | - Edmund Tse
- Hepatology, Royal Adelaide Hospital, Adelaide, Australia
| | | | - Amanda Wade
- Burnet Institute, Melbourne, Australia
- Barwon Health Liver Clinic University Hospital, Geelong, Australia
| | - Wendy Cheng
- Department of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Australia
| | - Stuart K Roberts
- The Alfred Hospital and Monash University CCS, Melbourne, Australia
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Abadie RB, Brown EM, Campbell JR, Alvarez IA, Allampalli V, Ahmadzadeh S, Varrassi G, Shekoohi S, Kaye AD. Incidence and Risks of HIV Infection, Medication Options, and Adverse Effects in Accidental Needle Stick Injuries: A Narrative Review. Cureus 2024; 16:e51521. [PMID: 38304675 PMCID: PMC10831193 DOI: 10.7759/cureus.51521] [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: 11/29/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024] Open
Abstract
Accidental needle sticks can lead to infections, including HIV. As scientists have learned more about HIV and its replicative physiology, identification of target sites and novel medications have been developed. HIV is spread throughout the population through contact with blood, semen, and rectal or vaginal secretions of infected individuals. Therefore, it is important in general for healthcare workers to be aware of its transmission modes and ways to minimize exposure. In this regard, even with hospitals providing education, training, and safety protocols, there is a continued infection spread with HIV, especially by accidental needle sticks. There is also a wide variety of testing that can be used for HIV utilizing different methodologies, allowing for improved measurement of infection status. Any person with HIV should be tested to clarify infection status and be educated to minimize future virus spread. The current CDC recommendations for HIV infection treatment are antiretroviral therapies, such as an HIV postexposure prophylaxis regimen, which consists of a cocktail of antiretrovirals and postexposure prophylaxis immediately for occupational exposures, such as accidental needlestick exposure from an HIV infected patient. To decrease accidental HIV stick injuries, there are safety precautions in place, that if followed, would help reduce this incidence. HIV accidental needle stick injuries still happen in the hospital workplace, but with proper education and treatment, if exposed, there is hope to minimize the effects.
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Affiliation(s)
- Raegan B Abadie
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Elise M Brown
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - John R Campbell
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Ivan A Alvarez
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Varsha Allampalli
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | | | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
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Trickey A, Ingle SM, Boyd A, Gill MJ, Grabar S, Jarrin I, Obel N, Touloumi G, Zangerle R, Rauch A, Rentsch CT, Satre DD, Silverberg MJ, Bonnet F, Guest J, Burkholder G, Crane H, Teira R, Berenguer J, Wyen C, Abgrall S, Hessamfar M, Reiss P, d’Arminio Monforte A, McGinnis KA, Sterne JAC, Wittkop L. Contribution of alcohol use in HIV/hepatitis C virus co-infection to all-cause and cause-specific mortality: A collaboration of cohort studies. J Viral Hepat 2023; 30:775-786. [PMID: 37338017 PMCID: PMC10526649 DOI: 10.1111/jvh.13863] [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: 03/13/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023]
Abstract
Among persons with HIV (PWH), higher alcohol use and having hepatitis C virus (HCV) are separately associated with increased morbidity and mortality. We investigated whether the association between alcohol use and mortality among PWH is modified by HCV. Data were combined from European and North American cohorts of adult PWH who started antiretroviral therapy (ART). Self-reported alcohol use data, collected in diverse ways between cohorts, were converted to grams/day. Eligible PWH started ART during 2001-2017 and were followed from ART initiation for mortality. Interactions between the associations of baseline alcohol use (0, 0.1-20.0, >20.0 g/day) and HCV status were assessed using multivariable Cox models. Of 58,769 PWH, 29,711 (51%), 23,974 (41%) and 5084 (9%) self-reported alcohol use of 0 g/day, 0.1-20.0 g/day, and > 20.0 g/day, respectively, and 4799 (8%) had HCV at baseline. There were 844 deaths in 37,729 person-years and 2755 deaths in 443,121 person-years among those with and without HCV, respectively. Among PWH without HCV, adjusted hazard ratios (aHRs) for mortality were 1.18 (95% CI: 1.08-1.29) for 0.0 g/day and 1.84 (1.62-2.09) for >20.0 g/day compared with 0.1-20.0 g/day. This J-shaped pattern was absent among those with HCV: aHRs were 1.00 (0.86-1.17) for 0.0 g/day and 1.64 (1.33-2.02) for >20.0 g/day compared with 0.1-20.0 g/day (interaction p < .001). Among PWH without HCV, mortality was higher in both non-drinkers and heavy drinkers compared with moderate alcohol drinkers. Among those with HCV, mortality was higher in heavy drinkers but not non-drinkers, potentially due to differing reasons for not drinking (e.g. illness) between those with and without HCV.
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Affiliation(s)
- Adam Trickey
- Population Health SciencesUniversity of BristolBristolUK
| | | | - Anders Boyd
- Stichting HIV MonitoringAmsterdamThe Netherlands
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamThe Netherlands
- Amsterdam UMCUniversity of Amsterdam, Infectious DiseasesAmsterdamThe Netherlands
| | - M. John Gill
- South Alberta HIV Clinic, Department of MedicineUniversity of CalgaryCalgaryCanada
| | - Sophie Grabar
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP)ParisFrance
- Department of Public HealthAP‐HP, St Antoine HospitalParisFrance
| | - Inma Jarrin
- National Centre of EpidemiologyCarlos III Health InstituteMadridSpain
- CIBER de Enfermedades InfecciosasInstituto de Salud Carlos III
| | - Niels Obel
- Department of Infectious DiseasesCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical SchoolNational and Kapodistrian University of AthensAthensGreece
| | - Robert Zangerle
- Austrian HIV Cohort Study (AHIVCOS)Medizinische Universität InnsbruckInnsbruchAustria
| | - Andri Rauch
- Department of Infectious Diseases, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Christopher T. Rentsch
- Yale School of Medicine and VA Connecticut Healthcare SystemWest HavenConnecticutUSA
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Derek D. Satre
- Department of Psychiatry and Behavioral SciencesWeill Institute for Neurosciences, University of CaliforniaSan FranciscoUSA
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCaliforniaUSA
| | | | - Fabrice Bonnet
- Institut Bergonié, BPH, U1219, CIC‐EC 1401, INSERM, Univ. BordeauxBordeauxFrance
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERMInstitut Bergonié Hôpital St‐André, CIC‐EC 1401BordeauxFrance
| | - Jodie Guest
- Atlanta VA Medical CenterDecaturGeorgiaUSA
- Rollins School of Public Health at Emory UniversityAtlantaGeorgiaUSA
| | | | - Heidi Crane
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Ramon Teira
- Servicio de Medicina InternaHospital Universitario de SierrallanaTorrelavegaSpain
| | - Juan Berenguer
- Hospital General Universitario Gregorio MarañónMadridSpain
| | - Christoph Wyen
- Department I for Internal MedicineUniversity Hospital of CologneCologneGermany
| | - Sophie Abgrall
- APHP, Service de Médecine Interne, Hôpital BéclèreClamartFrance
- CESP, INSERM U1018, Université Paris‐Saclay, UVSQ, Le Kremlin‐BicêtreVillejuifFrance
| | - Mojgan Hessamfar
- Institut Bergonié, BPH, U1219, CIC‐EC 1401, INSERM, Univ. BordeauxBordeauxFrance
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERMInstitut Bergonié Hôpital St‐André, CIC‐EC 1401BordeauxFrance
| | - Peter Reiss
- Stichting HIV MonitoringAmsterdamThe Netherlands
- Department of Global HealthAmsterdam University Medical CentersAmsterdamThe Netherlands
- Amsterdam Institute for Global Health and DevelopmentAmsterdamThe Netherlands
| | - Antonella d’Arminio Monforte
- Clinic of Infectious and Tropical Diseases, Department of Health SciencesASST Santi Paolo e Carlo, University HospitalMilanItaly
| | - Kathleen A. McGinnis
- Yale School of Medicine and VA Connecticut Healthcare SystemWest HavenConnecticutUSA
| | - Jonathan A. C. Sterne
- Population Health SciencesUniversity of BristolBristolUK
- NIHR Bristol Biomedical Research CentreBristolUK
- Health Data Research UK South‐WestBristolUK
| | - Linda Wittkop
- Institut Bergonié, BPH, U1219, CIC‐EC 1401, INSERM, Univ. BordeauxBordeauxFrance
- INRIA SISTM TeamTalenceFrance
- CHU de Bordeaux, Service d'information Médicale, INSERMInstitut Bergonié, CIC‐EC 1401BordeauxFrance
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Appolonia CN, Wolf KM, Zawatsky CN, Cinar R. Chronic and Binge Alcohol Ingestion Increases Truncated Oxidized Phosphatidylcholines in Mice Lungs Due to Increased Oxidative Stress. Front Physiol 2022; 13:860449. [PMID: 35685280 PMCID: PMC9171009 DOI: 10.3389/fphys.2022.860449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Heavy alcohol drinking has negative health effects in multiple organs. It predisposes lungs to inflammatory conditions associated with acute lung injury and increased incidence of pneumonia and sepsis, which may lead to death due to acute respiratory distress syndrome in some individuals with alcohol use disorder (AUD). In general, rodent models of alcohol exposure either do not recapitulate multiple organ injuries as seen in humans or require longer duration to establish tissue injury and inflammation. The recently introduced NIAAA model of alcohol-induced liver injury, characterized by a marked increase in steatosis and liver damage with 10 days of a liquid diet containing 5% ethanol followed by a single ethanol binge (5 g/kg). Therefore, we employed this model to explore the status of surfactant phospholipids, oxidative stress, tissue injury markers and inflammatory cytokines in lungs. In lungs of C57BL/6J mice, the alcohol feeding significantly increased levels of the surfactant phospholipid dipalmitoyl phosphatidylcholine (DPPC) as well as the truncated oxidized phosphatidylcholines palmitoyl oxovaleryl phosphatidyl-choline (POVPC), palmitoyl glutaryl phosphatidyl-choline (PGPC), palmitoyl oxo-nonanoyl phosphatidyl-choline (ALDO-PC), and palmitoyl azelaoyl phosphatidyl-choline (PAzePC) at 9 h post-binge. Additionally, gene expression of the enzymes catalyzing lipid oxidation, such as arachidonate 15-lipoxygenase (Alox15), prostaglandin synthase 2 (Ptgs2), Cytochrome P450 2E1 (Cyp2E1) and NADPH oxidase 1 (Nox1) were significantly increased. Furthermore, ethanol increased levels of the inflammatory cytokine Interleukin-17 in bronchoalveolar lavage fluid. In conclusion, the NIAAA alcohol feeding model might be suitable to study alcohol-induced lung injury and inflammation.
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Affiliation(s)
| | | | | | - Resat Cinar
- Section on Fibrotic Disorders, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, United States
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5
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Ismaeel A, Laudato JA, Fletcher E, Papoutsi E, Tice A, Hwa LS, Miserlis D, Jamurtas AZ, Steiner J, Koutakis P. High-Fat Diet Augments the Effect of Alcohol on Skeletal Muscle Mitochondrial Dysfunction in Mice. Nutrients 2022; 14:1016. [PMID: 35267991 PMCID: PMC8912391 DOI: 10.3390/nu14051016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
Previous studies have shown that chronic heavy alcohol consumption and consumption of a high-fat (HF) diet can independently contribute to skeletal muscle oxidative stress and mitochondrial dysfunction, yet the concurrent effect of these risk factors remains unclear. We aimed to assess the effect of alcohol and different dietary compositions on mitochondrial activity and oxidative stress markers. Male and female mice were randomized to an alcohol (EtOH)-free HF diet, a HF + EtOH diet, or a low-Fat (LF) + EtOH diet for 6 weeks. At the end of the study, electron transport chain complex activity and expression as well as antioxidant activity and expression, were measured in skeletal muscles. Complex I and III activity were diminished in muscles of mice fed a HF + EtOH diet relative to the EtOH-free HF diet. Lipid peroxidation was elevated, and antioxidant activity was diminished, in muscles of mice fed a HF + EtOH diet as well. Consumption of a HF diet may exacerbate the negative effects of alcohol on skeletal muscle mitochondrial health and oxidative stress.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (E.F.); (E.P.)
| | - Joseph A. Laudato
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32304, USA; (J.A.L.); (A.T.); (J.S.)
| | - Emma Fletcher
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (E.F.); (E.P.)
| | - Evlampia Papoutsi
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (E.F.); (E.P.)
| | - Abigail Tice
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32304, USA; (J.A.L.); (A.T.); (J.S.)
| | - Lara S. Hwa
- Department of Psychology and Neuroscience, Baylor University, Waco, TX 76798, USA;
| | - Dimitrios Miserlis
- Department of Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA;
| | - Athanasios Z. Jamurtas
- Department of Physical Education and Sport Sciences, University of Thessaly, 42100 Trikala, Greece;
- Department of Nutrition and Dietetics, University of Thessaly, 42100 Trikala, Greece
| | - Jennifer Steiner
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32304, USA; (J.A.L.); (A.T.); (J.S.)
| | - Panagiotis Koutakis
- Department of Biology, Baylor University, Waco, TX 76798, USA; (A.I.); (E.F.); (E.P.)
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Yunusoğlu O. Rewarding effect of ethanol-induced conditioned place preference in mice: Effect of the monoterpenoid linalool. Alcohol 2022; 98:55-63. [PMID: 34800613 DOI: 10.1016/j.alcohol.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/06/2021] [Accepted: 11/12/2021] [Indexed: 11/01/2022]
Abstract
Alcohol addiction is a chronic relapsing disease that is progressive and has severe detrimental health outcomes. The use of natural products has become popular for the treatment of side effects of drugs and substance abuse. Linalool is a monoterpenoid that exhibits several effects on the central nervous system. Linalool was identified to have beneficial effects on different mechanisms that are relevant in drug addiction or substance use disorder. The primary aim of the present study was to evaluate the therapeutic effect of linalool on the rewarding properties of alcohol in mice. Conditioned place preference (CPP) was established by intraperitoneal (i.p.) injection of ethanol (2 g/kg) during an 8-day conditioning trial. The effects of acamprosate and linalool on the rewarding properties of ethanol were tested in mice who received linalool (12.5, 25, and 50 mg/kg, i.p.) and acamprosate (300 mg/kg, i.p.) 30 min before each ethanol injection. CPP was extinguished by repeated testing, throughout which conditioned mice were administered daily linalool. Mice were lastly examined for reinstatement provoked by i.p. administration of single low-dose ethanol (0.4 g/kg, i.p.). Treatment with linalool reduced the acquisition and reinstatement, and precipitated the extinction of ethanol-induced CPP in mice. Acquisition and reinstatement of alcohol-induced CPP were significantly reduced by acamprosate, which also precipitated extinction. Ethanol alone and the combination with linalool or acamprosate did not alter locomotor activity. The results of this study suggest that linalool may have pharmacological effects for the treatment of alcohol addiction. In addition, further investigation is required to fully explore the benefits and possible adverse effects of linalool on alcohol addiction.
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Simon L, Edwards S, Molina PE. Pathophysiological Consequences of At-Risk Alcohol Use; Implications for Comorbidity Risk in Persons Living With Human Immunodeficiency Virus. Front Physiol 2022; 12:758230. [PMID: 35115952 PMCID: PMC8804300 DOI: 10.3389/fphys.2021.758230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/13/2021] [Indexed: 12/14/2022] Open
Abstract
At-risk alcohol use is a significant risk factor associated with multisystemic pathophysiological effects leading to multiorgan injury and contributing to 5.3% of all deaths worldwide. The alcohol-mediated cellular and molecular alterations are particularly salient in vulnerable populations, such as people living with HIV (PLWH), diminishing their physiological reserve, and accelerating the aging process. This review presents salient alcohol-associated mechanisms involved in exacerbation of cardiometabolic and neuropathological comorbidities and their implications in the context of HIV disease. The review integrates consideration of environmental factors, such as consumption of a Western diet and its interactions with alcohol-induced metabolic and neurocognitive dyshomeostasis. Major alcohol-mediated mechanisms that contribute to cardiometabolic comorbidity include impaired substrate utilization and storage, endothelial dysfunction, dysregulation of the renin-angiotensin-aldosterone system, and hypertension. Neuroinflammation and loss of neurotrophic support in vulnerable brain regions significantly contribute to alcohol-associated development of neurological deficits and alcohol use disorder risk. Collectively, evidence suggests that at-risk alcohol use exacerbates cardiometabolic and neurocognitive pathologies and accelerates biological aging leading to the development of geriatric comorbidities manifested as frailty in PLWH.
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Guo X, Yan T, Chen M, Ma X, Li R, Li B, Yang A, Chen Y, Fang T, Yu H, Tian H, Chen G, Zhuo C. Differential effects of alcohol-drinking patterns on the structure and function of the brain and cognitive performance in young adult drinkers: A pilot study. Brain Behav 2022; 12:e2427. [PMID: 34808037 PMCID: PMC8785638 DOI: 10.1002/brb3.2427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION This study was aimed to determine how different patterns of alcohol consumption drive changes to brain structure and function and their correlation with cognitive impairments in young adult alcohol drinkers. METHODS In this study, we enrolled five groups participants and defined as: long-term abstinence from alcohol (LA), binge drinking (BD), long-term low dosage alcohol consumption but exceeding the safety drinking dosage (LD), long-term alcohol consumption of damaging dosage (LDD), and long-term heavy drinking (HD). All participants underwent magnetic resonance imaging (MRI) and functional MRI (fMRI) to acquire data on brain structure and function, including gray matter volume (GMV), fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), functional connectivity (FC), and brain network properties. The cognitive ability was evaluated with the California Verbal Learning Test (CVLT), intelligence quotient (IQ), and short delay free recall (SDFR). RESULTS Compared to LA, GMV significantly decreased in the brain regions in VN, SMN, and VAN in the alcohol-drinking groups (BD, LD, LDD, and HD). ReHo was significantly enhanced in the brain regions in VN, SMN, and VAN, while fALFF significantly increased in the brain regions in VN and SMN. The number of intra- and inter-modular connections within networks (VN, SMN, sensory control network [SCN], and VAN) and their connections to other modules were abnormally changed. These changes adversely affected cognition (e.g., IQ, CVLT, SDFR). CONCLUSION Despite the small sample size, this study provides new evidence supporting the need for young people to abstain from alcohol to protect their brains. These findings present strong reasoning for updating anti-alcohol slogans and guidelines for young people in the future.
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Affiliation(s)
- Xiaobing Guo
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tongjun Yan
- Department of Psychiatry, 904th Hospital of PLA, Changzhou, Jiangsu, China
| | - Min Chen
- Institute of Mental Health, Jining Medical University, Jining, China
| | - Xiaoyan Ma
- Department of Alcohol Dependence Management, Tianjin Anding Hospital, Tianjin Medical University Clinical Hospital of Mental Health, Tianjin, China.,Tianjin Anding Hospital, Tianjin Mental Health Center, Key Laboratory of Psychiatry Neuroimaging-Genetics and Co-morbidity (PNGC_Lab) of Tianjin Medical University Clinical Hospital of Mental Health, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China
| | - Ranli Li
- Department of Alcohol Dependence Management, Tianjin Anding Hospital, Tianjin Medical University Clinical Hospital of Mental Health, Tianjin, China.,Tianjin Anding Hospital, Tianjin Mental Health Center, Key Laboratory of Psychiatry Neuroimaging-Genetics and Co-morbidity (PNGC_Lab) of Tianjin Medical University Clinical Hospital of Mental Health, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China
| | - Bo Li
- Department of Psychiatry, Tianjin Kangtai Mental Health Hospital, Tianjin, China
| | - Anqu Yang
- Department of Psychiatry, Tianjin Kangtai Mental Health Hospital, Tianjin, China
| | - Yuhui Chen
- Department of Psychiatry, Tianjin Kangtai Mental Health Hospital, Tianjin, China
| | - Tao Fang
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab), Tianjin Fourth Center Hospital, Tianjin Medical Affiliated Tianjin Fourth Central Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Haiping Yu
- Department of Alcohol Dependence Management, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab), Tianjin Fourth Center Hospital, Tianjin Medical Affiliated Tianjin Fourth Central Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Guangdong Chen
- Department of Alcohol Dependence Management, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chuanjun Zhuo
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab), Tianjin Fourth Center Hospital, Tianjin Medical Affiliated Tianjin Fourth Central Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,Department of Alcohol Dependence Management, Wenzhou Seventh Peoples Hospital, Wenzhou, China
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