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The international prevalence of prenatal alcohol use obtained via meconium biomarkers: A systematic literature review 通过胎粪生物标志物获得产前饮酒的国际流行率:系统性文献综述。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-31 DOI: 10.1111/acer.15410
Orlagh Keating, Ruth H. Brown, Renate Kuenssberg, Sarah Driscoll, Stewart McDougall, Suzanne O'Rourke

Fetal alcohol exposure is a growing public health concern. However, ascertaining its true extent remains challenging as maternal self-reports may lack validity. Increasingly, interest has turned to more objective measures of prenatal alcohol use (PAU) of which one, meconium, is recognized as a valuable tool. This review assesses both the international prevalence of PAU obtained using meconium biomarkers in general maternity populations and, when feasible, the level of agreement between meconium biomarkers and self-reported PAU. A systematic literature search for studies reporting the prevalence of PAU, as determined by meconium biomarker testing, was conducted using multiple electronic databases from 1990 to 2023. Seventeen studies were identified for inclusion and evaluated for methodological quality. Using fatty acid ethyl esters (FAEEs) meconium biomarkers, PAU prevalence varied from 2.4% to 44%. Rates based on EtG (ethyl glucuronide) analysis ranged from 0% to 16.3%, and EtS (ethyl sulfate) analysis from 7.8% to 16.7%. Studies were of moderate quality with high heterogeneity. Prevalence rates based on self-report data ranged from 0% to 46.4%. When reported, none of the reviewed studies identified agreement between meconium-based and self-report-based PAU prevalence rates. Using both self-reports to detect early pregnancy alcohol use, and meconium biomarkers to detect the occurrence of alcohol use later in pregnancy, may provide a more complete picture of PAU prevalence. Furthermore, research is warranted to develop stringent guidance on the ascertainment, storage, analysis, and reporting required in this field.

胎儿酒精暴露是一个日益受到关注的公共健康问题。然而,由于孕产妇的自我报告可能缺乏有效性,因此确定其真实程度仍具有挑战性。越来越多的人开始关注更客观的产前酒精使用(PAU)测量方法,其中胎粪被认为是一种有价值的工具。本综述评估了在普通孕产妇人群中使用胎粪生物标志物获得的 PAU 国际流行率,并在可行的情况下评估了胎粪生物标志物与自我报告的 PAU 之间的一致程度。从 1990 年到 2023 年,我们使用多个电子数据库对通过胎粪生物标记物检测确定的 PAU 患病率的研究进行了系统性文献检索。最终确定了 17 项研究可供纳入,并对研究方法的质量进行了评估。使用脂肪酸乙酯(FAEEs)胎粪生物标记物,PAU 患病率从 2.4% 到 44% 不等。基于EtG(乙基葡萄糖醛酸)分析的发病率从0%到16.3%不等,基于EtS(乙基硫酸酯)分析的发病率从7.8%到16.7%不等。研究质量中等,异质性较高。基于自我报告数据的患病率从 0% 到 46.4% 不等。当报告时,所审查的研究均未发现基于胎粪和基于自我报告的 PAU 患病率之间存在一致性。同时使用自我报告和胎粪生物标志物来检测妊娠早期的饮酒情况和妊娠晚期的饮酒情况,可以更全面地反映 PAU 的患病率。此外,还需要就该领域所需的确定、存储、分析和报告制定严格的指南。
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引用次数: 0
Effects of adolescent intermittent ethanol exposure on cortical perineuronal net and parvalbumin expression in adulthood mediate behavioral inflexibility 青春期间歇性乙醇暴露对大脑皮层神经元周围网和成年期副发光素表达的影响介导了行为的不灵活性。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-28 DOI: 10.1111/acer.15395
Emily D. K. Sullivan, Carol A. Dannenhoffer, Elizabeth B. Sutherland, Elena M. Vidrascu, Alexander Gómez-A, Charlotte A. Boettiger, Donita L. Robinson

Background

Alcohol is commonly consumed by adolescents in a binge-like pattern, which can lead to long-lasting cognitive deficits, including reduced behavioral flexibility. We and others have determined that adolescent intermittent ethanol (AIE) exposure leads to increased number of perineuronal net (PNN) numbers in brain regions that are important for behavioral flexibility. However, whether altered neurochemistry stemming from AIE exposure plays a significant role in reduced behavioral flexibility is unknown.

Methods

We measured the number and size of parvalbumin expressing (PV+) interneurons and associated PNNs within the orbitofrontal cortex (OFC), prelimbic cortex (PrL), infralimbic cortex (IL), and anterior insular cortex (AIC) of female and male rats following AIE or control exposure and subsequent training on an attentional set-shift task (ASST). We then ran analyses to determine whether AIE-induced changes in PV and PNN measures statistically mediated the AIE-induced behavioral deficit in reversal learning.

Results

We demonstrate that AIE exposure impaired behavioral flexibility on reversal two of the ASST (i.e., recalling the initial learned associations), and led to smaller PV+ cells and increased PNN numbers in the AIC. Interestingly, PNN size and number were not altered in the PrL or IL following AIE exposure, in contrast to prior reports. Mediation analyses suggest that AIE alters behavioral flexibility, at least in part through changes in PV and PNN fluorescent measures in the AIC.

Conclusions

This study reveals a significant link between AIE exposure, neural alterations, and diminished behavioral flexibility in rats, and highlights a potential novel mechanism comprising changes in PV and PNN measures within the AIC. Future studies should explore the impact of PNN degradation within the AIC on behavioral flexibility.

背景:青少年通常以酗酒的方式饮酒,这会导致长期的认知缺陷,包括行为灵活性降低。我们和其他人已经确定,青少年间歇性接触乙醇(AIE)会导致对行为灵活性非常重要的脑区神经元周围网(PNN)数量增加。然而,因接触乙醇而导致的神经化学变化是否在降低行为灵活性方面发挥了重要作用,目前尚不清楚:方法:我们测量了雌性和雄性大鼠在暴露于 AIE 或对照组并随后接受注意力集合转移任务(ASST)训练后,其眶额叶皮层(OFC)、前边缘皮层(PrL)、下边缘皮层(IL)和前岛叶皮层(AIC)中表达副白蛋白(PV+)的中间神经元和相关 PNN 的数量和大小。然后,我们进行了分析,以确定AIE诱导的PV和PNN测量变化是否在统计学上介导了AIE诱导的逆转学习行为缺陷:结果:我们证明,暴露于AIE会损害ASST逆转二(即回忆最初学习到的联想)的行为灵活性,并导致AIC中PV+细胞变小和PNN数量增加。有趣的是,与之前的报道相反,暴露于AIE后,PrL或IL中的PNN大小和数量没有改变。中介分析表明,AIE会改变行为的灵活性,至少部分是通过AIC中PV和PNN荧光测量的变化:本研究揭示了大鼠暴露于 AIE、神经改变和行为灵活性降低之间的重要联系,并强调了一种由 AIC 中 PV 和 PNN 测量变化组成的潜在新机制。未来的研究应探讨AIC内PNN退化对行为灵活性的影响。
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引用次数: 0
Impact of text-only versus large text-and-picture alcohol warning formats: A functional magnetic resonance imaging study in French young male drinkers 纯文字与大段文字加图片的酒精警告格式的影响:法国年轻男性饮酒者的功能磁共振成像研究
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-27 DOI: 10.1111/acer.15389
Karine Gallopel-Morvan, Quentin Duche, Jacques François Diouf, Sophie Lacoste-Badie, Olivier Droulers, Romain Moirand, Elise Bannier
<div> <section> <h3> Background</h3> <p>Although the World Health Organization recommends visible and clear warning labels about the risks of alcohol consumption on containers and advertising, many of the currently used labels are too small to be visible. This study investigated the brain activity (using fMRI) and alcohol consumption intentions of French young men exposed to two warning formats displayed on alcoholic beverage advertisements: a small Text-only Alcohol Warning (TAW) currently used in many countries, and a larger text-and-picture alcohol warning (PAW).</p> </section> <section> <h3> Methods</h3> <p>Seventy-four eligible 18–25-year-old male drinkers completed a face-to-face individual visit with a physician expert in addiction medicine. This was followed by the fMRI session during which they viewed 288 stimuli [96 alcohol advertisements with TAWs, the same 96 advertisements with PAWs, and 96 water advertisements (controls)] for 3 s each. If the advertisement made participants want (“yes”)/do not want (“no”) to consume the product, they pressed the corresponding button (self-report responses). The number of “yes” responses was compared between advertisement types with a paired sample <i>t</i>-test. Whole-brain and region-of-interest (ROI) analyses of the fMRI data were performed.</p> </section> <section> <h3> Results</h3> <p>Whole-brain BOLD fMRI highlighted contrasting effects of PAWs and TAWs. Compared with TAWs, PAWs elicited more activation in the precuneus, angular gyrus, occipital, frontal and temporal areas, and less activation in the nucleus accumbens, ventral tegmental areas, and putamen areas (regions of the reward circuit). The ROI analysis confirmed less activation in the reward circuit (left and right ventral tegmental areas, left and right nucleus accumbens) when viewing PAWs than TAWs. Analysis of the self-report responses indicated that the desire to consume the advertised alcohol product was lower when PAWs were viewed (compared with TAWs) (<i>T</i> = 8.18, <i>p</i> < 10<sup>−11</sup>).</p> </section> <section> <h3> Conclusions</h3> <p>This is the first fMRI study to assess the effect of different alcohol warning formats. Our findings show that compared with TAWs, stronger PAWs in advertisements elicited less activity in key regions of the reward system. This suggests that the effects may influence the desire to consume alcohol products (self-report response analysis). These results could help policymakers who are interested in developing more effective labeling measures that target young people.</p> </
尽管世界卫生组织建议在容器和广告上贴上醒目、清晰的酒精消费风险警示标签,但目前使用的许多标签都太小,难以看清。本研究调查了法国年轻男性在接触酒精饮料广告上显示的两种警告形式时的大脑活动(使用 fMRI)和饮酒意向:一种是许多国家目前使用的小尺寸纯文字酒精警告(TAW),另一种是较大的文字加图片酒精警告(PAW)。
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引用次数: 0
Antidepressants and alcohol use disorder: A multicenter study on the mediating role of depression symptom changes 抗抑郁药与酒精使用障碍:一项关于抑郁症状变化的中介作用的多中心研究。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-26 DOI: 10.1111/acer.15386
Joshua Jaeger, Lara Osterburg, Maria Stein, Miranda Germann, Sara A. Lustenberger, Alexander Wopfner, Niklaus Denier, Tobias Bracht, Franz Moggi, Leila M. Soravia

Background

Alcohol use disorder (AUD) and depression are highly prevalent and tied to significant psychological, physiological, social and economic consequences. Their co-occurrence presents a complex clinical challenge, as the impact of antidepressant medication on AUD outcomes remains equivocal. In this multicenter, longitudinal study we investigated the relationship between antidepressant medication and changes in depression symptoms and alcohol use in AUD patients.

Methods

We analyzed data from 153 detoxified AUD patients who attended a 12-week residential treatment program between 2015 and 2019. Within a mediation analysis, adopting a bootstrapping approach and a quasi-Bayesian framework, we estimated the total, direct, and mediated effects of antidepressants on the percentage of days abstinent to assess the role of changes in depression symptoms as a mediating factor.

Results

The mediation analysis revealed a dual impact pathway model with a negative direct effect of antidepressants on abstinence (p = 0.004) and a positive indirect effect, mediated through the reduction of depression symptoms (p = 0.002).

Conclusions

The findings of the mediation analysis show that patients treated with antidepressants and whose depression symptoms do not improve over time show more relapses, while patients treated with antidepressants who achieve a reduction in depression symptoms show fewer relapses over time. Thus, to optimize treatment outcome, depression symptoms should be vigilantly monitored when antidepressants are prescribed during AUD treatment.

背景:酒精使用障碍(AUD)和抑郁症的发病率很高,并对心理、生理、社会和经济造成严重后果。由于抗抑郁药物对 AUD 治疗结果的影响仍不明确,因此这两种疾病的共存给临床带来了复杂的挑战。在这项多中心纵向研究中,我们调查了抗抑郁药物治疗与 AUD 患者抑郁症状和饮酒量变化之间的关系:我们分析了 2015 年至 2019 年期间参加为期 12 周住院治疗项目的 153 名戒毒 AUD 患者的数据。在中介分析中,我们采用引导法和准贝叶斯框架,估算了抗抑郁药物对戒酒天数百分比的总效应、直接效应和中介效应,以评估抑郁症状变化作为中介因素的作用:中介分析显示了一个双重影响路径模型,即抗抑郁药对戒断的直接影响为负数(p = 0.004),而通过抑郁症状的减轻而产生的间接影响为正数(p = 0.002):中介分析结果表明,接受抗抑郁药物治疗的患者,如果抑郁症状长期得不到改善,复发率会更高,而接受抗抑郁药物治疗的患者,如果抑郁症状得到缓解,复发率会更低。因此,为了优化治疗效果,在 AUD 治疗期间使用抗抑郁药时,应密切监测抑郁症状。
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引用次数: 0
Neurosteroid [3α,5α]3-hydroxypregnan-20-one inhibition of chemokine monocyte chemoattractant protein-1 in alcohol-preferring rat brain neurons, microglia, and astroglia 神经类固醇[3α,5α]3-羟基孕甾-20-酮对酒精偏爱型大鼠脑神经元、小胶质细胞和星形胶质细胞中趋化因子单核细胞趋化蛋白-1的抑制作用。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-11 DOI: 10.1111/acer.15404
Samantha Lucenell Chéry, Todd K. O'Buckley, Giorgia Boero, Irina Balan, A. Leslie Morrow

Background

Neuroimmune dysfunction in alcohol use disorder (AUD) is associated with activation of myeloid differentiation primary response 88 (MyD88)-dependent Toll-like receptors (TLR) resulting in overexpression of the chemokine monocyte chemoattractant protein-1 (MCP-1/CCL2). MCP-1 overexpression in the brain is linked to anxiety, higher alcohol intake, neuronal death, and activation of microglia observed in AUD. The neurosteroid [3α,5α][3-hydroxypregnan-20-one (3α,5α-THP) has been reported as an inhibitor of MyD88-dependent TLR activation and MCP-1 overexpression in mouse and human macrophages and the brain of alcohol-preferring (P) rats.

Methods

We investigated how 3α,5α-THP regulates MCP-1 expression at the cellular level in P rat nucleus accumbens (NAc) and central amygdala (CeA). We focused on neurons, microglia, and astrocytes, examining the individual voxel density of MCP-1, neuronal marker NeuN, microglial marker IBA1, astrocytic marker GFAP, and their shared voxel density, defined as intersection. Ethanol-naïve male and female P rats were perfused 1 h after IP injections of 15 mg/kg of 3α,5α-THP, or vehicle. The NAc and CeA were imaged using confocal microscopy following double-immunofluorescence staining for MCP-1 with NeuN, IBA1, and GFAP, respectively.

Results

MCP-1 intersected with NeuN predominantly and IBA1/GFAP negligibly. 3α,5α-THP reduced MCP-1 expression in NeuN-labeled cells by 38.27 ± 28.09% in male and 56.11 ± 21.46% in female NAc, also 37.99 ± 19.53% in male and 54.96 ± 30.58% in female CeA. In females, 3α,5α-THP reduced the MCP-1 within IBA1 and GFAP-labeled voxels in the NAc and CeA. Conversely, in males, 3α,5α-THP did not significantly alter the MCP-1 within IBA1 in NAc or with GFAP in the CeA. Furthermore, 3α,5α-THP decreased levels of IBA1 in both regions and sexes with no impact on GFAP or NeuN levels. Secondary analysis performed on data normalized to % control values indicated that no significant sex differences were present.

Conclusions

These data suggest that 3α,5α-THP inhibits neuronal MCP-1 expression and decreases the proliferation of microglia in P rats. These results increase our understanding of potential mechanisms for 3α,5α-THP modulation of ethanol consumption.

背景:酒精使用障碍(AUD)的神经免疫功能障碍与依赖于Toll样受体(TLR)的髓样分化初级反应88(MyD88)的激活有关,导致趋化因子单核细胞趋化蛋白-1(MCP-1/CCL2)的过度表达。MCP-1 在大脑中的过度表达与焦虑、酒精摄入量增加、神经元死亡以及在 AUD 中观察到的小胶质细胞活化有关。据报道,神经类固醇[3α,5α][3-hydroxypregnan-20-one (3α,5α-THP)是小鼠、人类巨噬细胞和酒精偏好(P)大鼠大脑中 MyD88 依赖性 TLR 激活和 MCP-1 过度表达的抑制剂:方法:我们研究了 3α,5α-THP如何在细胞水平上调节酒精偏爱型大鼠脑核(NAc)和中央杏仁核(CeA)中 MCP-1 的表达。我们重点研究了神经元、小胶质细胞和星形胶质细胞,检测了 MCP-1、神经元标记物 NeuN、小胶质细胞标记物 IBA1 和星形胶质细胞标记物 GFAP 的单个体节密度以及它们的共同体节密度(定义为交叉点)。在 IP 注射 15 mg/kg 3α、5α-THP 或药物 1 小时后,对乙醇免疫的雄性和雌性 P 大鼠进行灌注。在对MCP-1与NeuN、IBA1和GFAP进行双重免疫荧光染色后,使用共聚焦显微镜对NAc和CeA进行成像:结果:MCP-1主要与NeuN相交,而与IBA1/GFAP相交可忽略不计。3α,5α-THP可使NeuN标记细胞中的MCP-1表达量减少,男性为(38.27 ± 28.09%),女性为(56.11 ± 21.46%);男性为(37.99 ± 19.53%),女性为(54.96 ± 30.58%)。在女性中,3α,5α-THP 可减少 NAc 和 CeA 中 IBA1 和 GFAP 标记体素内的 MCP-1。相反,在男性中,3α,5α-THP 并未显著改变 NAc 中 IBA1 内的 MCP-1 或 CeA 中 GFAP 的 MCP-1。此外,3α,5α-THP 降低了两个区域和两种性别的 IBA1 水平,但对 GFAP 或 NeuN 水平没有影响。对与对照组%值归一化的数据进行的二次分析表明,不存在显著的性别差异:这些数据表明,3α,5α-THP 可抑制 P 型大鼠神经元 MCP-1 的表达并减少小胶质细胞的增殖。这些结果增加了我们对 3α,5α-THP调节乙醇消耗的潜在机制的了解。
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引用次数: 0
Articles of Public Interest 公益文章。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-09 DOI: 10.1111/acer.15405
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引用次数: 0
Inflammation, oxidative stress and gut microbiome perturbation: A narrative review of mechanisms and treatment of the alcohol hangover 炎症、氧化应激和肠道微生物群扰乱:酒精宿醉的机制和治疗方法综述。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-04 DOI: 10.1111/acer.15396
Benedict R. H. Turner, Poppy I Jenkinson, Marc Huttman, Benjamin H. Mullish

Alcohol is the most widely abused substance in the world, the leading source of mortality in 15–49-year-olds, and a major risk factor for heart disease, liver disease, diabetes, and cancer. Despite this, alcohol is regularly misused in wider society. Consumers of excess alcohol often note a constellation of negative symptoms, known as the alcohol hangover. However, the alcohol hangover is not considered to have long-term clinical significance by clinicians or consumers. We undertook a critical review of the literature to demonstrate the pathophysiological mechanisms of the alcohol hangover. Hereafter, the alcohol hangover is re-defined as a manifestation of sickness behavior secondary to alcohol-induced inflammation, using the Bradford-Hill criteria to demonstrate causation above correlation. Alcohol causes inflammation through oxidative stress and endotoxemia. Alcohol metabolism is oxidative and increased intake causes relative tissue hypoxia and increased free radical generation. Tissue damage ensues through lipid peroxidation and the formation of DNA/protein adducts. Byproducts of alcohol metabolism such as acetaldehyde and congeners, sleep deprivation, and the activation of nonspecific inducible CYP2E1 in alcohol-exposed tissues exacerbate free radical generation. Tissue damage and cell death lead to inflammation, but in the intestine loss of epithelial cells leads to intestinal permeability, allowing the translocation of pathogenic bacteria to the systemic circulation (endotoxemia). This leads to a well-characterized cascade of systemic inflammation, additionally activating toll-like receptor 4 to induce sickness behavior. Considering the evidence, it is suggested that hangover frequency and severity may be predictors of the development of later alcohol-related diseases, meriting formal confirmation in prospective studies. In light of the mechanisms of alcohol-mediated inflammation, research into gut permeability and the gut microbiome may be an exciting future therapeutic avenue to prevent alcohol hangover and other alcohol-related diseases.

酒精是世界上最广泛滥用的物质,是 15-49 岁人群死亡的主要原因,也是心脏病、肝病、糖尿病和癌症的主要风险因素。尽管如此,酒精在更广泛的社会中仍经常被滥用。饮酒过量的人通常会出现一系列不良症状,即宿醉。然而,临床医生或消费者并不认为酒精宿醉具有长期的临床意义。我们对文献进行了严格审查,以证明酒精宿醉的病理生理机制。此后,我们采用布拉德福德-希尔(Bradford-Hill)标准,将酒精宿醉重新定义为继发于酒精诱发炎症的病态行为表现,以证明因果关系高于相关关系。酒精通过氧化应激和内毒素血症引起炎症。酒精代谢具有氧化性,摄入量增加会导致组织相对缺氧,自由基生成增加。随后,通过脂质过氧化和 DNA/蛋白质加合物的形成造成组织损伤。酒精代谢的副产物(如乙醛和同系物)、睡眠不足以及酒精暴露组织中非特异性诱导型 CYP2E1 的激活都会加剧自由基的生成。组织损伤和细胞死亡会导致炎症,但在肠道中,上皮细胞的丧失会导致肠道通透性,使病原菌转移到全身循环(内毒素血症)。这将导致一连串特征明显的全身性炎症,并激活收费样受体 4,诱发疾病行为。考虑到这些证据,宿醉的频率和严重程度可能是日后酒精相关疾病发展的预测因素,值得在前瞻性研究中正式确认。鉴于酒精介导炎症的机制,对肠道渗透性和肠道微生物组的研究可能是未来预防宿醉和其他酒精相关疾病的一个令人兴奋的治疗途径。
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引用次数: 0
Effect of N-acetylcysteine on neural alcohol cue reactivity and craving in adolescents who drink heavily: A preliminary randomized clinical trial N-乙酰半胱氨酸对酗酒青少年神经酒精线索反应和渴求的影响:初步随机临床试验。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-03 DOI: 10.1111/acer.15402
ReJoyce Green, Anna E. Kirkland, Brittney D. Browning, Pamela L. Ferguson, Kevin M. Gray, Lindsay M. Squeglia

Background

Alcohol craving is related to problematic alcohol use; therefore, pharmacotherapies that modulate alcohol craving are of interest. N-acetylcysteine, an over-the-counter antioxidant, is a candidate pharmacotherapy for adolescent alcohol use with the potential to impact craving. Cue-reactivity paradigms using functional magnetic resonance imaging (fMRI) can identify neural regions implicated in craving and serve as a screening tool for novel pharmacotherapy options.

Methods

This preliminary study examined the effect of N-acetylcysteine on neural reactivity to alcohol cues and subjective craving among 31 non-treatment-seeking adolescents (17.6–19.9 years old, 55% female) who use alcohol heavily. In a randomized cross-over design, participants completed three fMRI sessions: baseline and after a 10-day course of N-acetylcysteine (1200 mg twice daily) and matched placebo. The primary outcome was neural response to alcohol versus non-alcohol beverage cues after N-acetylcysteine versus placebo, with a secondary outcome of self-reported subjective craving.

Results

In the full sample (n = 31), there was no effect of N-acetylcysteine versus placebo on neural alcohol reactivity (ps ≥ 0.49; s = 0.00–0.07) or self-reported acute alcohol craving (p = 0.18,  = 0.06). However, N-acetylcysteine did reduce self-reported generalized alcohol craving (p = 0.03,  = 0.15). In a subsample of youth who met criteria for past-year alcohol use disorder (n = 19), results remained unchanged.

Conclusions

N-acetylcysteine may not alter neural reactivity to alcohol cues or acute craving; however, it may reduce general subjective alcohol craving among adolescents who consume alcohol heavily.

背景:酒精渴求与问题性饮酒有关;因此,能够调节酒精渴求的药物疗法备受关注。N-乙酰半胱氨酸是一种非处方抗氧化剂,是治疗青少年饮酒的一种候选药物疗法,具有影响渴求的潜力。使用功能性磁共振成像(fMRI)的线索反应范式可以确定与渴求有关的神经区域,并作为新型药物治疗方案的筛选工具:这项初步研究考察了 N-乙酰半胱氨酸对 31 名不寻求治疗的酗酒青少年(17.6-19.9 岁,55% 为女性)的酒精线索神经反应和主观渴求的影响。在随机交叉设计中,受试者完成了三次 fMRI 治疗:基线期和服用 N-乙酰半胱氨酸(1200 毫克,每天两次)和匹配安慰剂的 10 天疗程后。主要结果是服用 N-乙酰半胱氨酸和安慰剂后对酒精和非酒精饮料线索的神经反应,次要结果是自我报告的主观渴望:在全样本(n = 31)中,N-乙酰半胱氨酸与安慰剂相比对神经酒精反应性(ps ≥ 0.49; η p 2 $$ {upeta_{mathrm{p}}^2 $ s = 0.00-0.07)或自我报告的急性酒精渴求(p = 0.18, η p 2 $$ {upeta_{mathrm{p}}^2 $$ = 0.06)没有影响。)然而,N-乙酰半胱氨酸确实会降低自我报告的普遍酒精渴求(p = 0.03, η p 2 $$ {upeta_{mathrm{p}}^2 $$ = 0.15)。在符合过去一年酒精使用障碍标准的青少年子样本(n = 19)中,结果保持不变:结论:N-乙酰半胱氨酸可能不会改变神经对酒精线索的反应或急性渴求;但是,它可能会减少大量饮酒的青少年对酒精的主观渴求。
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引用次数: 0
Unique urine and serum metabolomic signature in patients with excessive alcohol use: An exploratory study 过度饮酒患者独特的尿液和血清代谢组特征:一项探索性研究
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-07-01 DOI: 10.1111/acer.15398
Zhihong Yang, Hui Gao, Jing Ma, Nathan A. Liang, Sophia P. Liang, Nazmul Huda, Yanchao Jiang, Themis Thoudam, Wanzhu Tu, Jing Su, Maggie Hesler, Kristina Chandler, Suthat Liangpunsakul

Background

Excessive alcohol consumption has a multifaceted impact on the body's metabolic pathways and organ systems. The objectives of this study were to characterize global metabolomic changes and identify specific pathways that are altered in individuals with excessive alcohol use.

Methods

This exploratory study included 22 healthy controls with no known history of excessive alcohol use and 38 patients identified as using alcohol excessively. A Fibrosis-4 score was used to determine the risk of underlying alcohol-associated liver disease among the excessive drinkers.

Results

We found significantly altered urinary and serum metabolites among excessive drinkers, affecting various metabolic pathways including the metabolism of lipids, amino acids and peptides, cofactors and vitamins, carbohydrates, and nucleotides. Levels of two steroid hormones—5alpha-androstan-3beta,17beta-diol disulfate and androstenediol (3beta,17beta) disulfate—were significantly higher in both the serum and urine samples of excessive drinkers. These elevated levels may be associated with a higher risk of liver fibrosis in individuals with excessive alcohol use.

Conclusion

Alcohol consumption leads to marked alterations in multiple metabolic pathways, highlighting the systemic impact of alcohol on various tissues and organ systems. These findings provide a foundation for future mechanistic studies aimed at elucidating alcohol-induced changes in these metabolic pathways and their implications.

背景:过度饮酒会对人体的代谢途径和器官系统产生多方面的影响。本研究的目的是描述总体代谢组学变化的特征,并确定过度饮酒者体内发生改变的特定途径:这项探索性研究包括 22 名无过度饮酒史的健康对照者和 38 名被确认为过度饮酒的患者。结果:我们发现尿液和血清中的酒精浓度发生了显著变化:我们发现过量饮酒者的尿液和血清代谢物发生了明显变化,影响了各种代谢途径,包括脂质、氨基酸和肽、辅因子和维生素、碳水化合物和核苷酸的代谢。在过量饮酒者的血清和尿液样本中,两种类固醇激素--5-α-雄甾烷-3beta,17beta-二醇二硫酸盐和雄烯二醇(3beta,17beta)二硫酸盐的含量都明显较高。这些水平的升高可能与过量饮酒者发生肝纤维化的风险较高有关:结论:饮酒导致多种代谢途径发生明显改变,凸显了酒精对各种组织和器官系统的系统性影响。这些发现为今后旨在阐明酒精诱导的这些代谢途径的变化及其影响的机理研究奠定了基础。
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引用次数: 0
Infection burden and ALDH2 rs671, East Asian genetic diversity: A reply 感染负担与 ALDH2 rs671、东亚遗传多样性:答复。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-06-27 DOI: 10.1111/acer.15403
Giovanni Deiana, Ruinan Sun, Jie Huang, Valerio Napolioni, Roberto Ciccocioppo
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引用次数: 0
期刊
Alcohol (Hanover, York County, Pa.)
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