{"title":"Articles of Public Interest","authors":"","doi":"10.1111/acer.15442","DOIUrl":"https://doi.org/10.1111/acer.15442","url":null,"abstract":"","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 9","pages":"1624"},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142169938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly Torosian, Bita Shahrvini, Willie Mohammed Johnson Jr, Irine Vodkin, Monica Tincopa, Nicholas Lim, Allison Kwong, Veeral Ajmera
Background
Alcohol use after liver transplant (LT) is associated with higher rates of graft loss and increased mortality; however, there are limited data evaluating predictors of return to alcohol use using biochemical markers like phosphatidylethanol (PEth).
Methods
This multicenter retrospective cohort study evaluated psychosocial predictors of return to alcohol use using PEth testing in patients transplanted for alcohol-associated liver disease (ALD). The study included 223 patients at three centers who had received a LT for ALD and had at least one PEth measurement post-LT.
Results
The rate of return to alcohol use was 6.9 cases per 100 person-years (26 patients total) over a median 555 days of follow-up after transplant. Younger age (HR 0.96; 95% CI 0.92–0.99, p = 0.02), mental health comorbidities (HR 2.83; 95% CI 1.25–6.39, p = 0.01), and non-Hispanic White race (HR 3.79; 95% CI 1.42–10.15, p = 0.01) were associated with return to alcohol use post-LT. There was no difference between post-LT return to alcohol use rates or short-term survival among patients with less than 6 months of sobriety prior to listing compared with those with more than 6 months. Patients with sustained alcohol use post-LT had increased odds of history of illicit substance use (OR 5.20; 95% CI 1.01–26.83, p = 0.04) but no significant difference in time from the last drink to listing (OR 1.03; 95% CI 0.18–5.80, p = 0.97).
Conclusions
These findings emphasize the importance of mental health comorbidities rather than period of sobriety in predicting post-LT return to alcohol use. Furthermore, the higher risk of return to alcohol use in non-Hispanic White patients suggests a potential disparity with referral and selection of higher risk White patients.
{"title":"Psychosocial predictors of return to alcohol use after liver transplant: A multicenter cohort study","authors":"Kelly Torosian, Bita Shahrvini, Willie Mohammed Johnson Jr, Irine Vodkin, Monica Tincopa, Nicholas Lim, Allison Kwong, Veeral Ajmera","doi":"10.1111/acer.15438","DOIUrl":"10.1111/acer.15438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alcohol use after liver transplant (LT) is associated with higher rates of graft loss and increased mortality; however, there are limited data evaluating predictors of return to alcohol use using biochemical markers like phosphatidylethanol (PEth).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective cohort study evaluated psychosocial predictors of return to alcohol use using PEth testing in patients transplanted for alcohol-associated liver disease (ALD). The study included 223 patients at three centers who had received a LT for ALD and had at least one PEth measurement post-LT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rate of return to alcohol use was 6.9 cases per 100 person-years (26 patients total) over a median 555 days of follow-up after transplant. Younger age (HR 0.96; 95% CI 0.92–0.99, <i>p</i> = 0.02), mental health comorbidities (HR 2.83; 95% CI 1.25–6.39, <i>p</i> = 0.01), and non-Hispanic White race (HR 3.79; 95% CI 1.42–10.15, <i>p</i> = 0.01) were associated with return to alcohol use post-LT. There was no difference between post-LT return to alcohol use rates or short-term survival among patients with less than 6 months of sobriety prior to listing compared with those with more than 6 months. Patients with sustained alcohol use post-LT had increased odds of history of illicit substance use (OR 5.20; 95% CI 1.01–26.83, <i>p</i> = 0.04) but no significant difference in time from the last drink to listing (OR 1.03; 95% CI 0.18–5.80, <i>p</i> = 0.97).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings emphasize the importance of mental health comorbidities rather than period of sobriety in predicting post-LT return to alcohol use. Furthermore, the higher risk of return to alcohol use in non-Hispanic White patients suggests a potential disparity with referral and selection of higher risk White patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2137-2144"},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pancreatitis is a severe inflammatory pathology that occurs from pancreatic duct and exocrine acinar injury, leading to improper secretion of digestive enzymes, auto-digestion of the pancreas, and subsequent inflammation. Clinical reports show that 60%–90% of pancreatitis patients have a history of chronic alcohol use. More recent studies reveal that exocrine pancreas disorders like acute pancreatitis can precede diabetes type II onset, though mechanisms are not yet fully known. This study identified molecules and key signaling pathways underlying alcohol-induced acute pancreatitis and their effects on diabetes type II onset.
Methods
Data on human peripheral blood samples with or without acute pancreatitis were retrieved from the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (accession number GSE194331). Acute pancreatitis-mediated differentially expressed genes (DEGs) were generated from GSE194331 using CLC Genomics Workbench 12. Molecules associated with ethanol (EtOH), acute pancreatitis, and diabetes type II were collected from QIAGEN Knowledge Base (QKB). The relationship between the molecules and signaling pathways associated with EtOH, acute pancreatitis, or diabetes type II was examined using various Ingenuity Pathway Analysis (IPA) tools.
Results
Our investigation showed that acute pancreatitis-mediated DEGs were closely associated with EtOH by revealing that EtOH-induced acute pancreatitis appears to lead to the onset of diabetes type II. We found that diabetes type II onset was mediated by pro-inflammatory and metabolic mechanisms underlying EtOH-induced acute pancreatitis, involving increased expression of cytokines including macrophage migration inhibitory factor (MIF), and decreased expression of hormones such as insulin.
Conclusions
Exposure to alcohol may promote diabetes type II by affecting the activity of key inflammatory and metabolic mediators involved in acute pancreatitis. These findings call for further investigation into the role of pro-inflammatory and metabolic mediators like resistin, IL-6, and insulin in EtOH-induced diabetes type II associated with acute pancreatitis pathologies.
胰腺炎是一种严重的炎症性病变，由胰腺导管和外分泌尖状体损伤引起，导致消化酶分泌失调、胰腺自身消化，继而引发炎症。临床报告显示，60%-90% 的胰腺炎患者有长期饮酒史。最近的研究表明，急性胰腺炎等胰腺外分泌疾病可先于 II 型糖尿病发病，但其发病机制尚未完全明了。这项研究确定了酒精诱发急性胰腺炎的分子和关键信号通路及其对 II 型糖尿病发病的影响。
{"title":"Network meta-analysis on the mechanisms underlying alcohol augmentation of acute pancreatitis and diabetes type II","authors":"Ryan J. Kim, Muhammed Bishir, Sulie L. Chang","doi":"10.1111/acer.15428","DOIUrl":"10.1111/acer.15428","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pancreatitis is a severe inflammatory pathology that occurs from pancreatic duct and exocrine acinar injury, leading to improper secretion of digestive enzymes, auto-digestion of the pancreas, and subsequent inflammation. Clinical reports show that 60%–90% of pancreatitis patients have a history of chronic alcohol use. More recent studies reveal that exocrine pancreas disorders like acute pancreatitis can precede diabetes type II onset, though mechanisms are not yet fully known. This study identified molecules and key signaling pathways underlying alcohol-induced acute pancreatitis and their effects on diabetes type II onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on human peripheral blood samples with or without acute pancreatitis were retrieved from the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (accession number GSE194331). Acute pancreatitis-mediated differentially expressed genes (DEGs) were generated from GSE194331 using CLC Genomics Workbench 12. Molecules associated with ethanol (EtOH), acute pancreatitis, and diabetes type II were collected from QIAGEN Knowledge Base (QKB). The relationship between the molecules and signaling pathways associated with EtOH, acute pancreatitis, or diabetes type II was examined using various Ingenuity Pathway Analysis (IPA) tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our investigation showed that acute pancreatitis-mediated DEGs were closely associated with EtOH by revealing that EtOH-induced acute pancreatitis appears to lead to the onset of diabetes type II. We found that diabetes type II onset was mediated by pro-inflammatory and metabolic mechanisms underlying EtOH-induced acute pancreatitis, involving increased expression of cytokines including macrophage migration inhibitory factor (MIF), and decreased expression of hormones such as insulin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Exposure to alcohol may promote diabetes type II by affecting the activity of key inflammatory and metabolic mediators involved in acute pancreatitis. These findings call for further investigation into the role of pro-inflammatory and metabolic mediators like resistin, IL-6, and insulin in EtOH-induced diabetes type II associated with acute pancreatitis pathologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1837-1852"},"PeriodicalIF":3.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristoffer Høiland, Espen Kristian Ajo Arnevik, Lien My Diep, Tove Mathisen, Katie Witkiewitz, Jens Egeland
Background
Cognitive impairments are common in alcohol use disorder (AUD), but only a few studies have investigated the accuracy of the Montreal Cognitive Assessment (MoCA) in this population. We examined the accuracy and precision of the MoCA in detecting cognitive impairment in a sample of patients with AUD. In addition, we investigated whether the MoCA predicts premature discontinuation from treatment.
Method
A sample of 126 persons with AUD undergoing treatment in specialist health services were administered the MoCA and a battery of 12 neuropsychological tests. Five cognitive domains were derived from the reference tests. A composite total score from these tests was used as a reference criterion for determining correct and incorrect classifications for the MoCA. We analyzed the optimal cut-off score for the MoCA and the accuracy and agreement of classification between the MoCA and the reference tests.
Results
Receiver operating characteristic (ROC) curve analyzes yielded an area under the curve (AUC) of 0.77 (95% CI [0.67, 0.87]). Applying 25 as the cut-off, MoCA sensitivity was 0.77 and specificity 0.62. The PPV was 0.53. The NPV was 0.84. Using a cut-off score of 24 yielded a lower sensitivity 0.60, but specificity was significantly better i.e., 0.79. PPV was 0.68. The NPV was 0.82. Kappa agreement between MoCA and the reference tests was fair to moderate, 0.38 for the cut-off of 25, and 0.44 for the cut-off of 24. MoCA did not predict discontinuation from treatment.
Conclusions
Our findings indicate limitations in the classification accuracy of the MoCA in predicting cognitive impairment in AUD. Achieving the right balance between accurately identifying impaired cases without including too many false positives can be challenging. Further, MoCA does not predict discontinuation from treatment. Overall, the results do not support MoCA as a time-efficient screening instrument.
{"title":"Impaired or not impaired: The accuracy of the Montreal Cognitive Assessment in detecting cognitive impairment among patients with alcohol use disorder","authors":"Kristoffer Høiland, Espen Kristian Ajo Arnevik, Lien My Diep, Tove Mathisen, Katie Witkiewitz, Jens Egeland","doi":"10.1111/acer.15437","DOIUrl":"10.1111/acer.15437","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cognitive impairments are common in alcohol use disorder (AUD), but only a few studies have investigated the accuracy of the Montreal Cognitive Assessment (MoCA) in this population. We examined the accuracy and precision of the MoCA in detecting cognitive impairment in a sample of patients with AUD. In addition, we investigated whether the MoCA predicts premature discontinuation from treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A sample of 126 persons with AUD undergoing treatment in specialist health services were administered the MoCA and a battery of 12 neuropsychological tests. Five cognitive domains were derived from the reference tests. A composite total score from these tests was used as a reference criterion for determining correct and incorrect classifications for the MoCA. We analyzed the optimal cut-off score for the MoCA and the accuracy and agreement of classification between the MoCA and the reference tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Receiver operating characteristic (ROC) curve analyzes yielded an area under the curve (AUC) of 0.77 (95% CI [0.67, 0.87]). Applying 25 as the cut-off, MoCA sensitivity was 0.77 and specificity 0.62. The PPV was 0.53. The NPV was 0.84. Using a cut-off score of 24 yielded a lower sensitivity 0.60, but specificity was significantly better i.e., 0.79. PPV was 0.68. The NPV was 0.82. Kappa agreement between MoCA and the reference tests was fair to moderate, 0.38 for the cut-off of 25, and 0.44 for the cut-off of 24. MoCA did not predict discontinuation from treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings indicate limitations in the classification accuracy of the MoCA in predicting cognitive impairment in AUD. Achieving the right balance between accurately identifying impaired cases without including too many false positives can be challenging. Further, MoCA does not predict discontinuation from treatment. Overall, the results do not support MoCA as a time-efficient screening instrument.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"2070-2078"},"PeriodicalIF":3.0,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15437","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prior research has shown that using lifetime abstainers as the reference group to examine the association between alcohol use and health-related consequences has several disadvantages. The aim of the present study was to examine the consistency of self-reported lifetime abstention and never-binge drinking, respectively, using national, longitudinal data collected in 2019 and 2020. Additionally, the prevalence of alcohol-related morbidity among lifetime abstainers was examined by linking survey data to alcohol-related morbidity data in a national patient register.
Methods
Data come from the Danish Health and Wellbeing Survey in 2019 and from a follow-up survey of the same individuals in 2020. A random sample of 14,000 individuals aged 15 years or older was drawn in mid-August 2019. Data were collected between September and December 2019. All those who were invited to the survey in 2019 and who were still alive and living in Denmark were invited to participate in a follow-up survey in 2020. Data in both waves were collected by self-administered questionnaires. Both questionnaires included the standard questions on alcohol consumption from the European Health Interview Survey model questionnaire. Information on alcohol-related morbidity was obtained from the Danish National Patient Register.
Results
In all, 5000 individuals completed the questionnaire in both waves. Approximately half (44.4%) of the individuals who declared that they were lifetime abstainers in 2020 (n = 252) had reported in 2019 to have drunk at some point in their life. Moreover, 39.7% contradicted earlier reported binge drinking. Furthermore, 2.4% of the respondents who defined themselves as lifetime abstainers in 2020 had earlier been diagnosed with an alcohol-related health condition.
Conclusion
The present research reaffirms previous studies which have found self-reported lifetime abstainers to be unreliable as a consistent reference group. Additionally, the results indicated that a non-negligible proportion of lifetime abstainers had been diagnosed with an alcohol-related health condition.
{"title":"Alcohol habits and alcohol-related health conditions of self-defined lifetime abstainers and never binge drinkers","authors":"Ola Ekholm, Kim Bloomfield, Lau Caspar Thygesen","doi":"10.1111/acer.15433","DOIUrl":"10.1111/acer.15433","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prior research has shown that using lifetime abstainers as the reference group to examine the association between alcohol use and health-related consequences has several disadvantages. The aim of the present study was to examine the consistency of self-reported lifetime abstention and never-binge drinking, respectively, using national, longitudinal data collected in 2019 and 2020. Additionally, the prevalence of alcohol-related morbidity among lifetime abstainers was examined by linking survey data to alcohol-related morbidity data in a national patient register.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data come from the Danish Health and Wellbeing Survey in 2019 and from a follow-up survey of the same individuals in 2020. A random sample of 14,000 individuals aged 15 years or older was drawn in mid-August 2019. Data were collected between September and December 2019. All those who were invited to the survey in 2019 and who were still alive and living in Denmark were invited to participate in a follow-up survey in 2020. Data in both waves were collected by self-administered questionnaires. Both questionnaires included the standard questions on alcohol consumption from the European Health Interview Survey model questionnaire. Information on alcohol-related morbidity was obtained from the Danish National Patient Register.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all, 5000 individuals completed the questionnaire in both waves. Approximately half (44.4%) of the individuals who declared that they were lifetime abstainers in 2020 (<i>n</i> = 252) had reported in 2019 to have drunk at some point in their life. Moreover, 39.7% contradicted earlier reported binge drinking. Furthermore, 2.4% of the respondents who defined themselves as lifetime abstainers in 2020 had earlier been diagnosed with an alcohol-related health condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present research reaffirms previous studies which have found self-reported lifetime abstainers to be unreliable as a consistent reference group. Additionally, the results indicated that a non-negligible proportion of lifetime abstainers had been diagnosed with an alcohol-related health condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1905-1914"},"PeriodicalIF":3.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The alcohol hangover is defined as the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero (Verster, Scholey, et al., <span>2020a</span>). December 2021, the Classification and Statistics Advisory Committee (CSAC) of the International Classification of Diseases – 11th revision (ICD-11) adopted this definition and reclassified the alcohol hangover as a separate child entity to alcohol intoxication. Over the past 15 years, research on the pathology and treatment of alcohol hangover has attracted increased attention. There are, however, still major gaps in knowledge regarding its etiology and pathology. Both require further research to enable the development of effective and safe treatments to prevent or reduce the alcohol hangover.</p><p>Contrary to popular belief, the alcohol hangover is not caused by dehydration, and the consumption of water is not effective in reducing or preventing a hangover (Mackus et al., <span>2024</span>). Instead, Turner et al. (<span>2024</span>) concluded that inflammation and associated oxidative stress together represent the main causes of the alcohol hangover. In their review, Turner et al. (<span>2024</span>) synthesized existing data and confirmed previous publications that reported a critical role of inflammation and alcohol metabolism in the pathology of the alcohol hangover (Mackus et al., <span>2020a</span>; Van de Loo et al., <span>2020</span>). Turner et al. (<span>2024</span>) applied the Brandford-Hill criteria to demonstrate the connection between inflammation, oxidative stress, and the alcohol hangover. This is a major strength of their review. In addition, the authors discussed the role of alcohol congeners and alcohol-associated perturbations in the microbiome, electrolytes, and sleep architecture in the development of inflammation. Turner et al. (<span>2024</span>) concluded that, “hangover frequency and severity may be predictors of the development of later alcohol-related diseases.” They further suggested that treatments that prevent or reduce the inflammatory response to alcohol, such as nonsteroid anti-inflammatory drugs (NSAIDs) and probiotics, may prevent hangovers or reduce their severity.</p><p>Indeed, moderate to high alcohol consumption leads to an inflammatory response which may result in hangovers. As discussed by Turner et al. (<span>2024</span>), several studies have demonstrated elevated blood, saliva, and urine levels of inflammatory biomarkers (e.g., Interleukin (IL)-6, C-reactive protein (CRP), and tumor necrosis factor (TNF-α) during the hangover state; e.g., Kim et al., <span>2003</span>; Merlo et al., <span>2023</span>; Van de Loo et al., <span>2021</span>). These findings correspond with reduced self-reported immune fitness during hangover (Merlo et al., <span>2023</span>). Although not fully elucidated, the role of oxidative stress in the pat
{"title":"Alcohol hangovers as a predictor of the development of immune-related chronic diseases","authors":"Emina Išerić, Andrew Scholey, Joris C. Verster","doi":"10.1111/acer.15434","DOIUrl":"10.1111/acer.15434","url":null,"abstract":"<p>The alcohol hangover is defined as the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero (Verster, Scholey, et al., <span>2020a</span>). December 2021, the Classification and Statistics Advisory Committee (CSAC) of the International Classification of Diseases – 11th revision (ICD-11) adopted this definition and reclassified the alcohol hangover as a separate child entity to alcohol intoxication. Over the past 15 years, research on the pathology and treatment of alcohol hangover has attracted increased attention. There are, however, still major gaps in knowledge regarding its etiology and pathology. Both require further research to enable the development of effective and safe treatments to prevent or reduce the alcohol hangover.</p><p>Contrary to popular belief, the alcohol hangover is not caused by dehydration, and the consumption of water is not effective in reducing or preventing a hangover (Mackus et al., <span>2024</span>). Instead, Turner et al. (<span>2024</span>) concluded that inflammation and associated oxidative stress together represent the main causes of the alcohol hangover. In their review, Turner et al. (<span>2024</span>) synthesized existing data and confirmed previous publications that reported a critical role of inflammation and alcohol metabolism in the pathology of the alcohol hangover (Mackus et al., <span>2020a</span>; Van de Loo et al., <span>2020</span>). Turner et al. (<span>2024</span>) applied the Brandford-Hill criteria to demonstrate the connection between inflammation, oxidative stress, and the alcohol hangover. This is a major strength of their review. In addition, the authors discussed the role of alcohol congeners and alcohol-associated perturbations in the microbiome, electrolytes, and sleep architecture in the development of inflammation. Turner et al. (<span>2024</span>) concluded that, “hangover frequency and severity may be predictors of the development of later alcohol-related diseases.” They further suggested that treatments that prevent or reduce the inflammatory response to alcohol, such as nonsteroid anti-inflammatory drugs (NSAIDs) and probiotics, may prevent hangovers or reduce their severity.</p><p>Indeed, moderate to high alcohol consumption leads to an inflammatory response which may result in hangovers. As discussed by Turner et al. (<span>2024</span>), several studies have demonstrated elevated blood, saliva, and urine levels of inflammatory biomarkers (e.g., Interleukin (IL)-6, C-reactive protein (CRP), and tumor necrosis factor (TNF-α) during the hangover state; e.g., Kim et al., <span>2003</span>; Merlo et al., <span>2023</span>; Van de Loo et al., <span>2021</span>). These findings correspond with reduced self-reported immune fitness during hangover (Merlo et al., <span>2023</span>). Although not fully elucidated, the role of oxidative stress in the pat","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 11","pages":"1995-1999"},"PeriodicalIF":3.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142128161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeanne E. Savage, Christiaan A. de Leeuw, Josefin Werme, Spit for Science Working Group, Danielle M. Dick, Danielle Posthuma, Sophie van der Sluis
Background
Gene–environment interaction (G × E) is likely an important influence shaping individual differences in alcohol misuse (AM), yet it has not been extensively studied in molecular genetic research. In this study, we use a series of genome-wide gene–environment interaction (GWEIS) and in silico annotation methods with the aim of improving gene identification and biological understanding of AM.
Methods
We carried out GWEIS for four AM phenotypes in the large UK Biobank sample (N = 360,314), with trauma exposure and socioeconomic status (SES) as moderators of the genetic effects. Exploratory analyses compared stratified genome-wide association (GWAS) and GWEIS modeling approaches. We applied functional annotation, gene- and gene-set enrichment, and polygenic score analyses to interpret the GWEIS results.
Results
GWEIS models showed few genetic variants with significant interaction effects across gene–environment pairs. Enrichment analyses identified moderation by SES of the genes NOXA1, DLGAP1, and UBE2L3 on drinking quantity and the gene IFIT1B on drinking frequency. Except for DLGAP1, these genes have not previously been linked to AM. The most robust results (GWEIS interaction p = 4.59e-09) were seen for SES moderating the effects of variants linked to immune-related genes on a pattern of drinking with versus without meals.
Conclusions
Our results highlight several genes and a potential mechanism of immune system functioning behind the moderating effect of SES on the genetic influences on AM. Although GWEIS seems to be a preferred approach over stratified GWAS, modeling G × E effects at the molecular level remains a challenge even in large samples. Understanding these effects will require substantial effort and more in-depth phenotypic measurement.
背景：基因-环境相互作用（G×E）可能是形成酒精滥用（AM）个体差异的重要影响因素，但分子遗传学研究尚未对其进行广泛研究。在本研究中，我们采用了一系列全基因组范围的基因-环境相互作用（GWEIS）和硅标注方法，旨在提高对酒精滥用的基因鉴定和生物学理解：我们在英国生物库（UK Biobank）大样本（N = 360,314）中对四种急性髓系白血病表型进行了全基因组-环境相互作用（GWEIS）研究，将创伤暴露和社会经济地位（SES）作为遗传效应的调节因子。探索性分析比较了分层全基因组关联（GWAS）和 GWEIS 建模方法。我们应用功能注释、基因和基因组富集以及多基因评分分析来解释 GWEIS 的结果：结果：GWEIS 模型显示，在基因-环境配对中具有显著交互效应的基因变异很少。富集分析发现，NOXA1、DLGAP1 和 UBE2L3 基因以及 IFIT1B 基因对饮酒量和饮酒频率的影响受 SES 的调节。除 DLGAP1 外，这些基因以前从未与 AM 联系在一起。最稳健的结果（GWEIS交互作用 p = 4.59e-09）是，社会经济地位调节了与免疫相关基因有关的变异对有餐饮酒与无餐饮酒模式的影响：我们的研究结果凸显了 SES 对 AM 遗传影响的调节作用背后的几个基因和免疫系统功能的潜在机制。尽管 GWEIS 似乎是比分层 GWAS 更受青睐的方法，但即使在大样本中，在分子水平上建立 G × E 效应模型仍然是一项挑战。要了解这些影响，需要大量的努力和更深入的表型测量。
{"title":"Refining the scope of genetic influences on alcohol misuse through environmental stratification and gene–environment interaction","authors":"Jeanne E. Savage, Christiaan A. de Leeuw, Josefin Werme, Spit for Science Working Group, Danielle M. Dick, Danielle Posthuma, Sophie van der Sluis","doi":"10.1111/acer.15425","DOIUrl":"10.1111/acer.15425","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gene–environment interaction (G × E) is likely an important influence shaping individual differences in alcohol misuse (AM), yet it has not been extensively studied in molecular genetic research. In this study, we use a series of genome-wide gene–environment interaction (GWEIS) and in silico annotation methods with the aim of improving gene identification and biological understanding of AM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We carried out GWEIS for four AM phenotypes in the large UK Biobank sample (<i>N</i> = 360,314), with trauma exposure and socioeconomic status (SES) as moderators of the genetic effects. Exploratory analyses compared stratified genome-wide association (GWAS) and GWEIS modeling approaches. We applied functional annotation, gene- and gene-set enrichment, and polygenic score analyses to interpret the GWEIS results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GWEIS models showed few genetic variants with significant interaction effects across gene–environment pairs. Enrichment analyses identified moderation by SES of the genes <i>NOXA1</i>, <i>DLGAP1</i>, and <i>UBE2L3</i> on drinking quantity and the gene <i>IFIT1B</i> on drinking frequency. Except for <i>DLGAP1</i>, these genes have not previously been linked to AM. The most robust results (GWEIS interaction <i>p</i> = 4.59e-09) were seen for SES moderating the effects of variants linked to immune-related genes on a pattern of drinking with versus without meals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results highlight several genes and a potential mechanism of immune system functioning behind the moderating effect of SES on the genetic influences on AM. Although GWEIS seems to be a preferred approach over stratified GWAS, modeling G × E effects at the molecular level remains a challenge even in large samples. Understanding these effects will require substantial effort and more in-depth phenotypic measurement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1853-1865"},"PeriodicalIF":3.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaiya Brand, William Mellick, Bryan Tolliver, James J. Prisciandaro
Background
Bipolar disorder (BD) and alcohol use disorder (AUD) often co-occur, with BD + AUD characterized by higher levels of impulsivity relative to either disorder alone. Emotional facets of impulsivity (e.g., “urgency,” measured by the UPPS-P), however, remain underexplored in this population and could have distinct associations with clinical correlates.
Methods
This cross-sectional study used a two-by-two (BDxAD) factorial design, including groups with BD + AD (n = 28), BD (n = 29), AD (n = 28), and healthy controls (HC) (n = 27), to identify between-group differences among the five subscales of the UPPS-P. Associations of UPPS-P subscales with Barratt Impulsiveness Scale (BIS) total scores and clinical variables of interest were also examined.
Results
BD + AD had the highest scores for every UPPS-P subscale but Sensation Seeking, with the Positive and Negative Urgency subscales having the largest main effects for both BD and AD. BIS-11 total scores were most correlated with the urgency subscales of the UPPS-P. Negative Urgency was found to be uniquely relevant to clinical measures in the BD + AD group. Rapid cycling was associated with both urgency subscales and BIS-11 scores, and the Alcohol Dependence Scale was most correlated with the Premeditation subscale.
Limitations
Cross sectional design and predominantly white sample.
Conclusions
Unlike the BIS-11, UPPS-P is able to distinguish emotional from nonemotional facets of impulsivity, something especially relevant to people with co-occurring BD + AD, where fluid emotionality is a key part of symptom presentation. For this reason, the UPPS-P should be utilized in future studies and clinical settings measuring trait impulsivity in this population.
{"title":"A sense of urgency: Trait impulsivity in co-occurring bipolar and alcohol use disorder","authors":"Kaiya Brand, William Mellick, Bryan Tolliver, James J. Prisciandaro","doi":"10.1111/acer.15430","DOIUrl":"10.1111/acer.15430","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bipolar disorder (BD) and alcohol use disorder (AUD) often co-occur, with BD + AUD characterized by higher levels of impulsivity relative to either disorder alone. Emotional facets of impulsivity (e.g., “urgency,” measured by the UPPS-P), however, remain underexplored in this population and could have distinct associations with clinical correlates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used a two-by-two (BDxAD) factorial design, including groups with BD + AD (<i>n</i> = 28), BD (<i>n</i> = 29), AD (<i>n</i> = 28), and healthy controls (HC) (<i>n</i> = 27), to identify between-group differences among the five subscales of the UPPS-P. Associations of UPPS-P subscales with Barratt Impulsiveness Scale (BIS) total scores and clinical variables of interest were also examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>BD + AD had the highest scores for every UPPS-P subscale but Sensation Seeking, with the Positive and Negative Urgency subscales having the largest main effects for both BD and AD. BIS-11 total scores were most correlated with the urgency subscales of the UPPS-P. Negative Urgency was found to be uniquely relevant to clinical measures in the BD + AD group. Rapid cycling was associated with both urgency subscales and BIS-11 scores, and the Alcohol Dependence Scale was most correlated with the Premeditation subscale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>Cross sectional design and predominantly white sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unlike the BIS-11, UPPS-P is able to distinguish emotional from nonemotional facets of impulsivity, something especially relevant to people with co-occurring BD + AD, where fluid emotionality is a key part of symptom presentation. For this reason, the UPPS-P should be utilized in future studies and clinical settings measuring trait impulsivity in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1929-1940"},"PeriodicalIF":3.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sofia Hemrage, Stephen Parkin, Nicola Kalk, Naina Shah, Paolo Deluca, Colin Drummond
Background
Effective interventions to improve patient outcomes in comorbid alcohol use disorder (AUD) and alcohol-related liver disease (ARLD) remain a clinical unmet need. While the choice of abstinence is the cornerstone for the prevention of disease progression and mortality, evidence suggests a suboptimal engagement with treatment supporting recovery. This qualitative investigation aims to understand barriers and facilitators to treatment as experienced by this clinical population by applying a multidimensional adherence model proposed by the World Health Organization.
Methods
Twenty-four participants with comorbid AUD and ARLD were recruited from an inpatient clinical setting. Data for this study were collected through semistructured, in-depth interviews. Deductive analysis was organized by the Framework method, and theory-driven themes were identified according to the multidimensional adherence model. This included factors across the social and economic, patient, condition, treatment, and healthcare system levels.
Results
The findings in this study indicate systematic challenges in maintaining continuity between primary, secondary, and community care. Aspects related to social and economic context, treatment, and healthcare systems were found to hinder engagement. Identified facilitators to engagement included the participatory role of family, shared lived experience of addiction/recovery, and therapeutic alliance with healthcare providers.
Conclusion
The understanding of these barriers and facilitators from a service user's perspective can bridge the treatment gap for this clinical population. This can provide an opportunity for the implementation of effective interventions and inform the development of policies promoting accessible care. Government and public health bodies have fundamental roles in shifting treatment paradigms in comorbid AUD and ARLD.
{"title":"Treatment engagement in comorbid alcohol use disorder and alcohol-related liver disease: A qualitative exploration of barriers and facilitators with service users","authors":"Sofia Hemrage, Stephen Parkin, Nicola Kalk, Naina Shah, Paolo Deluca, Colin Drummond","doi":"10.1111/acer.15427","DOIUrl":"10.1111/acer.15427","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective interventions to improve patient outcomes in comorbid alcohol use disorder (AUD) and alcohol-related liver disease (ARLD) remain a clinical unmet need. While the choice of abstinence is the cornerstone for the prevention of disease progression and mortality, evidence suggests a suboptimal engagement with treatment supporting recovery. This qualitative investigation aims to understand barriers and facilitators to treatment as experienced by this clinical population by applying a multidimensional adherence model proposed by the World Health Organization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-four participants with comorbid AUD and ARLD were recruited from an inpatient clinical setting. Data for this study were collected through semistructured, in-depth interviews. Deductive analysis was organized by the Framework method, and theory-driven themes were identified according to the multidimensional adherence model. This included factors across the social and economic, patient, condition, treatment, and healthcare system levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings in this study indicate systematic challenges in maintaining continuity between primary, secondary, and community care. Aspects related to social and economic context, treatment, and healthcare systems were found to hinder engagement. Identified facilitators to engagement included the participatory role of family, shared lived experience of addiction/recovery, and therapeutic alliance with healthcare providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The understanding of these barriers and facilitators from a service user's perspective can bridge the treatment gap for this clinical population. This can provide an opportunity for the implementation of effective interventions and inform the development of policies promoting accessible care. Government and public health bodies have fundamental roles in shifting treatment paradigms in comorbid AUD and ARLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1965-1978"},"PeriodicalIF":3.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15427","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edwin J. Schenkel, Robert Schöneck, Eni S. Becker, Reinout W. Wiers, Johannes Lindenmeyer, Mike Rinck
Background
Patients with alcohol use disorder (AUD) tend to selectively approach alcohol cues in the environment, demonstrating an alcohol-approach bias. Alcohol-approach-bias modification (Alcohol-ApBM) effectively increases abstinence rates in patients with AUD when added to abstinence-focused treatment, but the evidence for its proposed working mechanism (reduction of the alcohol-approach bias) is limited. Moreover, not all patients benefit from Alcohol-ApBM, and previous research did not identify reliable pretreatment predictors of Alcohol-ApBM effectiveness. Therefore, the current study focused on learning processes during the Alcohol-ApBM training itself. Specifically, we examined whether changes in approach-avoidance tendencies over the course of Alcohol-ApBM would predict abstinence after inpatient treatment.
Methods
The training data of 543 AUD patients in Germany (70% male, M = 47.96, SD = 9.08), receiving Alcohol-ApBM training during inpatient treatment, were used to examine whether various aspects of learning during training predicted abstinence 1 year after treatment discharge, both separately and in interaction with potential sociodemographic and clinical moderators of Alcohol-ApBM effectiveness.
Results
Overall, successful learning across six Alcohol-ApBM training sessions was observed; that is, the approach tendency toward alcoholic stimuli was reduced over time. However, none of the examined learning parameters were predictive of abstinence, neither separately nor in combination with clinical or sociodemographic variables.
Conclusions
Previous studies have shown that Alcohol-ApBM is an effective add-on to abstinence-focused treatment for AUD, and this study showed that learning took place during Alcohol-ApBM training. However, specific learning parameters during training did not predict abstinence 1 year after treatment discharge. Therefore, we cannot specify which patients are most likely to benefit from ApBM with regard to abstinence after 1 year.
{"title":"Long-term effects of alcohol-avoidance training: Do changes in approach bias predict who will remain abstinent?","authors":"Edwin J. Schenkel, Robert Schöneck, Eni S. Becker, Reinout W. Wiers, Johannes Lindenmeyer, Mike Rinck","doi":"10.1111/acer.15431","DOIUrl":"10.1111/acer.15431","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with alcohol use disorder (AUD) tend to selectively approach alcohol cues in the environment, demonstrating an alcohol-approach bias. Alcohol-approach-bias modification (Alcohol-ApBM) effectively increases abstinence rates in patients with AUD when added to abstinence-focused treatment, but the evidence for its proposed working mechanism (reduction of the alcohol-approach bias) is limited. Moreover, not all patients benefit from Alcohol-ApBM, and previous research did not identify reliable pretreatment predictors of Alcohol-ApBM effectiveness. Therefore, the current study focused on learning processes during the Alcohol-ApBM training itself. Specifically, we examined whether changes in approach-avoidance tendencies over the course of Alcohol-ApBM would predict abstinence after inpatient treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The training data of 543 AUD patients in Germany (70% male, <i>M</i> = 47.96, SD = 9.08), receiving Alcohol-ApBM training during inpatient treatment, were used to examine whether various aspects of learning during training predicted abstinence 1 year after treatment discharge, both separately and in interaction with potential sociodemographic and clinical moderators of Alcohol-ApBM effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, successful learning across six Alcohol-ApBM training sessions was observed; that is, the approach tendency toward alcoholic stimuli was reduced over time. However, none of the examined learning parameters were predictive of abstinence, neither separately nor in combination with clinical or sociodemographic variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Previous studies have shown that Alcohol-ApBM is an effective add-on to abstinence-focused treatment for AUD, and this study showed that learning took place during Alcohol-ApBM training. However, specific learning parameters during training did not predict abstinence 1 year after treatment discharge. Therefore, we cannot specify which patients are most likely to benefit from ApBM with regard to abstinence after 1 year.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 10","pages":"1979-1990"},"PeriodicalIF":3.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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