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Alcohol Research : Current Reviews Oct 2019Alcohol use disorder (AUD) and depressive disorders are among the most prevalent psychiatric disorders and co-occur more often than expected by chance. The aim of this... (Review)
Review
Alcohol use disorder (AUD) and depressive disorders are among the most prevalent psychiatric disorders and co-occur more often than expected by chance. The aim of this review is to characterize the prevalence, course, and treatment of co-occurring AUD and depressive disorders. Studies have indicated that the co-occurrence of AUD and depressive disorders is associated with greater severity and worse prognosis for both disorders. Both pharmacologic and behavioral treatments have demonstrated efficacy for this population. However, treatment response is somewhat modest, particularly for drinking outcomes, highlighting the importance of further research on the etiology and treatment of co-occurring AUD and depressive disorders. Key future directions include studies to understand the heterogeneity of both AUD and depressive disorders, research on novel treatment approaches to enhance outcomes, and better understanding of sex and gender differences.
Topics: Alcoholism; Comorbidity; Depressive Disorder; Humans; Prevalence; Prognosis
PubMed: 31649834
DOI: 10.35946/arcr.v40.1.01 -
Trends in Neurosciences Dec 2021Alcohol use produces wide-ranging and diverse effects on the central nervous system. It influences intracellular signaling mechanisms, leading to changes in gene... (Review)
Review
Alcohol use produces wide-ranging and diverse effects on the central nervous system. It influences intracellular signaling mechanisms, leading to changes in gene expression, chromatin remodeling, and translation. As a result of these molecular alterations, alcohol affects the activity of neuronal circuits. Together, these mechanisms produce long-lasting cellular adaptations in the brain that in turn can drive the development and maintenance of alcohol use disorder (AUD). We provide an update on alcohol research, focusing on multiple levels of alcohol-induced adaptations, from intracellular changes to changes in neural circuits. A better understanding of how alcohol affects these diverse and interlinked mechanisms may lead to the identification of novel therapeutic targets and to the development of much-needed novel and efficacious treatment options.
Topics: Alcoholism; Brain; Chromatin Assembly and Disassembly; Ethanol; Humans; Neurons
PubMed: 34702580
DOI: 10.1016/j.tins.2021.09.006 -
Science Advances Sep 2019Alcohol is a major contributor to global disease and a leading cause of preventable death, causing approximately 88,000 deaths annually in the United States alone.... (Review)
Review
Alcohol is a major contributor to global disease and a leading cause of preventable death, causing approximately 88,000 deaths annually in the United States alone. Alcohol use disorder is one of the most common psychiatric disorders, with nearly one-third of U.S. adults experiencing alcohol use disorder at some point during their lives. Alcohol use disorder also has economic consequences, costing the United States at least $249 billion annually. Current pharmaceutical and behavioral treatments may assist patients in reducing alcohol use or facilitating alcohol abstinence. Although recent research has expanded understanding of alcohol use disorder, more research is needed to identify the neurobiological, genetic and epigenetic, psychological, social, and environmental factors most critical in the etiology and treatment of this disease. Implementation of this knowledge in clinical practice and training of health care providers is also needed to ensure appropriate diagnosis and treatment of individuals suffering from alcohol use disorder.
Topics: Alcoholism; Biomarkers; Clinical Trials as Topic; Combined Modality Therapy; Diagnosis, Differential; Disease Management; Disease Susceptibility; Humans; Reinforcement, Psychology; Research; Treatment Outcome
PubMed: 31579824
DOI: 10.1126/sciadv.aax4043 -
The American Journal of Gastroenterology Feb 2018Alcoholic liver disease (ALD) comprises a clinical-histologic spectrum including fatty liver, alcoholic hepatitis (AH), and cirrhosis with its complications. Most...
Alcoholic liver disease (ALD) comprises a clinical-histologic spectrum including fatty liver, alcoholic hepatitis (AH), and cirrhosis with its complications. Most patients are diagnosed at advanced stages and data on the prevalence and profile of patients with early disease are limited. Diagnosis of ALD requires documentation of chronic heavy alcohol use and exclusion of other causes of liver disease. Prolonged abstinence is the most effective strategy to prevent disease progression. AH presents with rapid onset or worsening of jaundice, and in severe cases may transition to acute on chronic liver failure when the risk for mortality, depending on the number of extra-hepatic organ failures, may be as high as 20-50% at 1 month. Corticosteroids provide short-term survival benefit in about half of treated patients with severe AH and long-term mortality is related to severity of underlying liver disease and is dependent on abstinence from alcohol. General measures in patients hospitalized with ALD include inpatient management of liver disease complications, management of alcohol withdrawal syndrome, surveillance for infections and early effective antibiotic therapy, nutritional supplementation, and treatment of the underlying alcohol-use disorder. Liver transplantation, a definitive treatment option in patients with advanced alcoholic cirrhosis, may also be considered in selected patients with AH cases, who do not respond to medical therapy. There is a clinical unmet need to develop more effective and safer therapies for patients with ALD.
Topics: Alcohol Withdrawal Delirium; Alcoholism; Hepatitis, Alcoholic; Humans; Liver Diseases, Alcoholic; Liver Transplantation; Prognosis
PubMed: 29336434
DOI: 10.1038/ajg.2017.469 -
The Lancet. Gastroenterology &... May 2020Alcoholic hepatitis is an acute, inflammatory liver disease associated with high morbidity and mortality both in the short term and long term. Alcoholic hepatitis often... (Review)
Review
Alcoholic hepatitis is an acute, inflammatory liver disease associated with high morbidity and mortality both in the short term and long term. Alcoholic hepatitis often arises in patients with a background of chronic liver disease and it is characterised by the rapid onset of jaundice and the development of myriad complications. Medical therapy for severe alcoholic hepatitis relies on corticosteroids, which have modest effectiveness. Abstinence from alcohol is critically important in patients with alcoholic hepatitis, but recidivism is high. Because of the absence of effective medical treatments for alcoholic hepatitis and alcohol dependency, there is a pressing need to develop new and effective therapeutics. Supported by promising preliminary and preclinical studies, many ongoing clinical trials of new therapies for alcoholic hepatitis are currently underway and are discussed further in this Series paper.
Topics: Adrenal Cortex Hormones; Alcohol Abstinence; Alcoholism; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antioxidants; Dietary Supplements; Hepatitis, Alcoholic; Humans; Pentanoic Acids; Probiotics; Receptors, Interleukin-1; Signal Transduction; Tumor Necrosis Factor-alpha
PubMed: 32277902
DOI: 10.1016/S2468-1253(19)30326-7 -
Alcohol Research : Current Reviews 2015The excessive use of alcohol is a global problem causing many adverse pathological health effects and a significant financial health care burden. This review addresses... (Review)
Review
The excessive use of alcohol is a global problem causing many adverse pathological health effects and a significant financial health care burden. This review addresses the effect of alcohol consumption on the microbiota in the gastrointestinal tract (GIT). Although data are limited in humans, studies highlight the importance of changes in the intestinal microbiota in alcohol-related disorders. Alcohol-induced changes in the GIT microbiota composition and metabolic function may contribute to the well-established link between alcohol-induced oxidative stress, intestinal hyperpermeability to luminal bacterial products, and the subsequent development of alcoholic liver disease (ALD), as well as other diseases. In addition, clinical and preclinical data suggest that alcohol-related disorders are associated with quantitative and qualitative dysbiotic changes in the intestinal microbiota and may be associated with increased GIT inflammation, intestinal hyperpermeability resulting in endotoxemia, systemic inflammation, and tissue damage/organ pathologies including ALD. Thus, gut-directed interventions, such as probiotic and synbiotic modulation of the intestinal microbiota, should be considered and evaluated for prevention and treatment of alcohol-associated pathologies.
Topics: Alcohol Drinking; Alcoholism; Anti-Infective Agents, Local; Bacterial Translocation; Dysbiosis; Endotoxemia; Ethanol; Gastrointestinal Microbiome; Humans; Intestines; Liver Diseases, Alcoholic; Permeability; Probiotics
PubMed: 26695747
DOI: No ID Found -
Nutrients Sep 2021Alcohol is inextricably linked with the digestive system. It is absorbed through the gut and metabolised by hepatocytes within the liver. Excessive alcohol use results... (Review)
Review
Alcohol is inextricably linked with the digestive system. It is absorbed through the gut and metabolised by hepatocytes within the liver. Excessive alcohol use results in alterations to the gut microbiome and gut epithelial integrity. It contributes to important micronutrient deficiencies including short-chain fatty acids and trace elements that can influence immune function and lead to liver damage. In some people, long-term alcohol misuse results in liver disease progressing from fatty liver to cirrhosis and hepatocellular carcinoma, and results in over half of all deaths from chronic liver disease, over half a million globally per year. In this review, we will describe the effect of alcohol on the gut, the gut microbiome and liver function and structure, with a specific focus on micronutrients and areas for future research.
Topics: Alcohol-Related Disorders; Alcoholism; Gastrointestinal Microbiome; Humans; Intestinal Mucosa; Intestines; Liver; Liver Diseases, Alcoholic; Micronutrients
PubMed: 34579046
DOI: 10.3390/nu13093170 -
World Journal of Gastroenterology Oct 2014The harmful use of alcohol is a worldwide problem. It has been estimated that alcohol abuse represents the world's third largest risk factor for disease and disability;... (Review)
Review
The harmful use of alcohol is a worldwide problem. It has been estimated that alcohol abuse represents the world's third largest risk factor for disease and disability; it is a causal factor of 60 types of diseases and injuries and a concurrent cause of at least 200 others. Liver is the main organ responsible for metabolizing ethanol, thus it has been considered for long time the major victim of the harmful use of alcohol. Ethanol and its bioactive products, acetaldehyde-acetate, fatty acid ethanol esters, ethanol-protein adducts, have been regarded as hepatotoxins that directly and indirectly exert their toxic effect on the liver. A similar mechanism has been postulated for the alcohol-related pancreatic damage. Alcohol and its metabolites directly injure acinar cells and elicit stellate cells to produce and deposit extracellular matrix thus triggering the "necrosis-fibrosis" sequence that finally leads to atrophy and fibrosis, morphological hallmarks of alcoholic chronic pancreatitis. Even if less attention has been paid to the upper and lower gastrointestinal tract, ethanol produces harmful effects by inducing: (1) direct damaging of the mucosa of the esophagus and stomach; (2) modification of the sphincterial pressure and impairment of motility; and (3) alteration of gastric acid output. In the intestine, ethanol can damage the intestinal mucosa directly or indirectly by altering the resident microflora and impairing the mucosal immune system. Notably, disruption of the intestinal mucosal barrier of the small and large intestine contribute to liver damage. This review summarizes the most clinically relevant alcohol-related diseases of the digestive tract focusing on the pathogenic mechanisms by which ethanol damages liver, pancreas and gastrointestinal tract.
Topics: Alcohol Drinking; Alcoholism; Animals; Disease Progression; Ethanol; Gastrointestinal Diseases; Gastrointestinal Tract; Humans; Liver; Liver Diseases, Alcoholic; Pancreas; Pancreatic Diseases; Prognosis; Risk Assessment; Risk Factors
PubMed: 25356028
DOI: 10.3748/wjg.v20.i40.14652 -
Revue Medicale de Liege May 2019Chronic alcohol consumption results in multiple peripheral and central nervous system dysfunctions. Some are due to the direct action of alcohol or its derivatives,... (Review)
Review
Chronic alcohol consumption results in multiple peripheral and central nervous system dysfunctions. Some are due to the direct action of alcohol or its derivatives, others are induced by the vitamin deficiencies associated with alcoholism, others are eventually related to the failure of other vital organs, such as the liver. In this short review, we describe alcohol-induced neuropathy, Gayet-Wernicke syndrome, Korsakoff syndrome, alcoholic dementia, Marchiafava-Bignami syndrome, hepatic encephalopathy, alcoholic epilepsy and manifestations of alcohol withdrawal.
Topics: Alcoholism; Dementia; Hepatic Encephalopathy; Humans; Wernicke Encephalopathy
PubMed: 31206272
DOI: No ID Found -
Magnesium Research Nov 2017Increasing evidence supports a role of magnesium (Mg) in skeletal muscle function. However, no systematic review or meta-analysis has summarized data on Mg... (Meta-Analysis)
Meta-Analysis Review
Increasing evidence supports a role of magnesium (Mg) in skeletal muscle function. However, no systematic review or meta-analysis has summarized data on Mg supplementation in relation to muscle fitness in humans. Thus, this study aimed to quantitatively assess the effect of Mg supplementation on muscle fitness. A meta-analysis and systematic review. Medline database and other sources were searched for randomized clinical trials through July 2017. Studies that reported results regarding at least one of the following outcomes: leg strength, knee extension strength, peak torque, muscle power, muscle work, jump, handgrip, bench press weights, resistant exercise, lean mass, muscle mass, muscle strength, walking speed, Repeated Chair Stands, and TGUG were included. Measurements of the association were pooled using a fixed-effects model and expressed as weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). Fourteen randomized clinical trials targeting 3 different populations were identified: athletes or physically active individuals (215 participants; mean age: 24.9 years), untrained healthy individuals (95 participants; mean age: 40.2 years), and elderly or alcoholics (232 participants; mean age: 62.7 years). The beneficial effects of Mg supplementation appeared to be more pronounced in the elderly and alcoholics, but were not apparent in athletes and physically active individuals. The results of the meta-analysis suggested that no significant improvements in the supplementation group were observed regarding isokinetic peak torque extension [WMD = 0.87; 95% CI = (-1.43, 3.18)], muscle strength [WMD = 0.87; 95% CI = (-0.12, 1.86)] or muscle power [WMD = 3.28; 95% CI = (-14.94, 21.50)]. Evidence does not support a beneficial effect of Mg supplementation on muscle fitness in most athletes and physically active individuals who have a relatively high Mg status. But Mg supplementation may benefit individuals with Mg deficiency, such as the elderly and alcoholics.
Topics: Adult; Aged; Alcoholism; Athletes; Dietary Supplements; Exercise; Female; Humans; Magnesium; Male; Muscle Strength
PubMed: 29637897
DOI: 10.1684/mrh.2018.0430