Gut microbiome in alcohol use disorder:Implications for health outcomes and therapeutic strategies-a literature review

Alcohol use disorder(AUD)represents a major public health issue which affects millions of people globally and consist a chronic relapsing condition associated with substantial morbidity and mortality.The gut microbiome plays a crucial role in maintaining overall health and has emerged as a significant contributor to the pathophysiology of various psychiatric disorders.Recent evidence suggests that the gut microbiome is intimately linked to the development and progression of AUD,with alcohol consumption directly impacting its composition and function.This review article aims to explore the intricate relationship between the gut microbiome and AUD,focusing on the implications for mental health outcomes and potential therapeutic strategies.We discuss the bidirectional communication between the gut microbiome and the brain,highlighting the role of microbiotaderived metabolites in neuroinflammation,neurotransmission,and mood regulation.Furthermore,we examine the influence of AUD-related factors,such as alcohol-induced gut dysbiosis and increased intestinal permeability,on mental health outcomes.Finally,we explore emerging therapeutic avenues targeting the gut microbiome in the management of AUD,including prebiotics,probiotics,and fecal microbiota transplantation.Understanding the complex interplay between the gut microbiome and AUD holds promise for developing novel interventions that could improve mental health outcomes in individuals with AUD.

Risk of alcohol use relapse after liver transplantation for alcoholic liver disease

AIMTo investigate factors, including psychosocial factors, associated with alcoholic use relapse after liver transplantation (LT) for alcoholic liver disease (ALD).METHODSThe clinical records of 102 patients with ALD who were referred to Nagoya University Hospital for LT between May 2003 and March 2015 were retrospectively evaluated. History of alcohol intake was obtained from their clinical records and scored according to the High-Risk Alcoholism Relapse scale, which includes duration of heavy drinking, types and amount of alcohol usually consumed, and previous inpatient treatment history for alcoholism. All patients were assessed for eligibility for LT according to comprehensive criteria, including Child-Pugh score, Model for End-Stage Liver Disease score, and psychosocial criteria.RESULTSOf the 102 patients with ALD referred for LT, seven (6.9%) underwent LT. One (14.3%) of these seven patients returned to heavy drinking, but that patient was able to successfully quit drinking following an immediate intervention, consisting of psychotherapeutic education and supportive psychotherapy, by a psychiatrist. A comparison between the transplantation/registration (T/R) group, consisting of the seven patients who underwent LT and 10 patients listed for deceased donor LT, and 50 patients who did not undergo LT and were not listed for deceased donor LT (non-T/R group), showed statistically significant differences in duration of abstinence period (P < 0.01), duration of heavy drinking (P < 0.05), adherence to medical treatment (P < 0.01), and declaration of abstinence (P < 0.05).CONCLUSIONPatients with ALD referred for LT require comprehensive evaluation, including evaluation of psychosocial criteria, to prevent alcoholic recidivism.

Diagnostic challenges in alcohol use disorder and alcoholic liver disease

Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods.

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components.Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte.The liver is the central organ in the metabolism of alcohol,a process that also involves other organs and tissues such as the brain,heart and muscles,but the most relevant organ is the liver.The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes,to cirrhosis and hepatocellular carcinoma.Alcohol abuse frequently leads to liver disease such as steatosis,steatohepatitis,fibrosis,cirrhosis,and tumors.Following the spread of coronavirus disease 2019(COVID-19),there was an increase in alcohol consumption,probably linked to the months of lockdown and smart working.It is known that social isolation leads to a considerable increase in stress,and it is also recognized that high levels of stress can result in an increase in alcohol intake.Cirrhotic patients or subjects with liver cancer are immunocompromised,so they may be more exposed to COVID-19 infection with a worse prognosis.This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

Alcohol Use Disorders and Associated Factors among an Elderly Community Sample in Nigeria: A Cross-Sectional Survey

Background: Alcohol Use Disorders (AUDs) in the elderly are associated with impairments in physical, psychological, social and cognitive functioning. Both the elderly men and women who drink alcohol are at a greater risk of social isolation and economic deprivation and the women in particular are in the danger of rapid development of dependence a phenomenon termed “telescoping” dependence. This study seeks to determine the prevalence of alcohol use disorders as well as their associated factors among the elderly in Jos South LGA, Plateau State, Nigeria. Methods: A community-based cross-sectional study of elderly (≥60 years) men and women. A total of 400 out of a total of 422 elderly community dwellers identified were interviewed with the aid of a composite questionnaire incorporating the socio-demography, Alcohol Smoking and Substance Involvement Screening Test (ASSIST), Mini International Neuropsychiatric Interview (MINI) and the 12-item General Health Questionnaire (GHQ-12). Results: The lifetime and current prevalence of alcohol use were 69.8% and 45.5% respectively. The prevalence of AUDs was (n = 52, 13.0%). AUDs was significantly associated with being male (OR = 2.57, 95%CI: 1.35 - 3.77, p < 0.01). Participants with AUDs were more likely to report difficulty ambulating (χ2 = 0.34, 0.56), cardiovascular (χ2 = 0.42, p = 0.52), respiratory (χ2 = 0.55, p = 0.46), and digestive (χ2 = 0.17, p = 0.68) problems, though not statistically significant. Similarly, no significant associations were seen with probable psychiatric co-morbidity (χ2 = 2.35, p = 0.13) and chronic pain (χ2 = 0.52, p = 0.47). Conclusions: Alcohol use and use disorders were common in this elderly cohort. AUDs were associated with poorer health indices.

＂Why Do They Drink？＂ Alcohol Uses and Opinions Towards Alcohol Marketing Communication Messages of Thai Teens

Problem about adolescent drinking has accelerated. Although the alcohol advertisements are restricted by Thai law, nevertheless the alcohol manufactures could still find their way to convey the message about their products to their consumers, including the adolescents in the school system through several marketing communication tactics. To this study, investigated opinion of Thai teens on alcohol use specific to.. （1） types of alcoholic beverages preferred; （2） reason at first alcohol use; （3） future drinking intention; and （4） perceptions toward alcohol marketing communication. The cross-sectional survey was conducted on 5184 students from grades 4th-12th and vocational school in seven regions of Thailand. The data from questionnaires were analyzed using simple descriptive statistic, frequency distribution, and percentages. Those teens reported to start drinking beer because of wanting to experiment with alcohol （41.3%）, to celebrate in special occasion （29.2%）, and due to friends involved （15.7%）. Majority of teens in this study （〉 80%） disagree or strongly disagree with persuasive message of alcohol advertised through several media channels. Most of the samples have good media literacy, know the intention of the marketing communication of the alcohol manufacturers, and could not be persuaded easily. The results required further evaluation for influence of alcohol marketing communication on students＇ alcohol expectancy and alcohol use for proper policy recommendation and management.

The Differences in Alcohol Use between Urban and Rural Students of Inner Mongolia Medical University, China

Objective: The purpose of this study was to evaluate the difference in alcohol use between urban and rural students of Inner Mongolia Medical University. Methods: A cross-sectional census was conducted on medical students on campus in 2013. We use multivariate logistic regression models to assess the factors associated with alcohol use. We further use chi-square test assess on differences in alcohol use between urban and rural people among significance factors in logistic regression models. Results: The prevalence of alcohol use among students in rural area was higher than that in urban area (p = 0.016). Alcohol use was associated with Gender, monthly expenses, residence, ethnic and faculty. The odds of alcohol use for Mongolia students were 1.139 times higher than that for Han students. The prevalence of alcohol consumption among students from pharmacy or Traditional Chinese Medicine and Mongolian Medicine faculties in rural area was higher than that among student in urban area (p = 0.03;p = 0.001). The prevalence of alcohol use among female students in rural area was higher than that among female students in urban area (p < 0.043). The proportion of alcohol use among students with <600 in rural area was higher than that among students in urban area (p < 0.001). Conclusion: Considering the differences in the prevalence of alcohol use between rural area and urban area, university administrators aiming at students from various regions develop various approaches.

Efficacy of Addiction Pharmacotherapy in Alcohol Use Disorder and Their Effects on Liver Health

Both alcohol-associated liver disease(ALD)and metabolic dysfunction-associated steatotic liver disease are leading contributors to chronic liver diseases.These conditions often coexist,exacerbating disease progression.Despite ALD being a leading cause of liver transplantation,many individuals with alcohol use disorder(AUD)do not receive treatment.In this review,we discussed the epidemiology of ALD in AUD,various treatment options for AUD,and their efficacy on liver health.Our critical analysis of current evidence underscores the need for integrated models involving multiple stakeholders to improve ALD management.

Alcohol associated liver disease and bariatric surgery:Current perspectives and future directions

Bariatric surgery is a routinely performed procedure and is associated with a reduction in all-cause mortality in patients with obesity.However,bariatric sur-gery has also been linked to increased alcohol use with up to 30%of these patients developing alcohol use disorder(AUD).The mechanism of AUD after bariatric surgery is multifactorial and includes anatomic,metabolic,and neurohumoral changes associated with post-surgical anatomy.These patients are at increased risk of alcohol associated liver disease and,in some cases,require liver trans-plantation.In this article,we provide a scoping review of epidemiology,patho-physiology,and clinical outcomes of alcohol-related health conditions after bariatric surgery.

Telehealth interventions for alcohol use disorder:A systematic review

Alcohol use disorder(AUD)is a worldwide problem for individuals of varying ages and backgrounds and is associated with the underlying cause of alcoholic liver disease,liver cirrhosis,liver cancer,or many other common diseases and health conditions.Existing treatments such as cognitive behavioral therapy(CBT)have been demonstrated as an evidence-based treatment to aid individuals struggling with AUD.However,these treatments have excessive costs and time demand with trained experts.In this paper,we examine the efficacy and long-term impacts of digitally delivered CBT and other online telehealth tools and apps for AUD patients.Results show the effectiveness in the ability of digitally delivered CBT to decrease alcohol use in AUD patients.The additional use of online technologies and smartphone apps for post-CBT care demonstrates that such computer-aided apps could have long-term effects when it is continually employed,which opens the door for AUD patients who were not seeking treatment elsewhere.Further longitudinal examination research is needed to evaluate the lasting effects in liver health and other chronic diseases associated with digitally delivered alcohol reduction for AUD patients.

Alcohol and drug use disorders in adult attentiondeficit/hyperactivity disorder:Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation

BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.

The Prevalence and Pattern of Use of Alcohol among Undergraduate Students in Jos Plateau State, Nigeria

Introduction: Alcohol abuse is a recognized phenomenon among university students in Nigeria and harms the education and performance of students. This may include disruption of interpersonal relationships, especially within the family, criminal behaviour, academic failure, vocational failure, and a lack of commensurate achievement. Methodology: A cross-sectional descriptive study aimed at assessing the Prevalence and Pattern of Use of Alcohol Among Undergraduate Students In Jos Plateau State, Nigeria. It involved 290 Undergraduates selected using the Multistage sampling method. Results: The prevalence of current use of alcohol was 33.7% while two-thirds were not taking alcohol. There was a statistically significant association between current use of alcohol and sex (χ2 = 12.168, p ≤ 0.001), where more males than females use alcohol. Most (44.4%) undergraduates use alcohol weekly, 11.1% use it daily, and 14.3% Two times weekly. A majority (52.4%) take it after lectures and 27.0% take whenever they like. There was a statistically significant association between alcohol use and the level/year of study (χ2 = 27.258, p ≤ 0.001). More students in higher classes (5th year and 4th year) are taking alcohol when compared with new students and lower classes (1st year and 2nd year). A significant association was also found between alcohol use and respondent's Cumulative Grade Point Average-CGPA (χ2 = 22.809, p ≤ 0.001), as the majority of students using alcohol had a low CGPA (1.1 to 2.0) when compared to those with higher. Conclusion: The University and government should collaborate with students to establish peer support groups and programs that discourage the use of alcohol during school hours and while studying.

Advances in neuroimaging studies of alcohol use disorder(AUD)

Alcohol use disorder(AUD)is a worldwide problem and themost common substance use disorder.Chronic alcohol consumptionmay have negative effects on the body,the mind,the family,and even society.With the progress of current neuroimaging methods,an increasing number of imaging techniques are being used to objectively detect brain impairment induced by alcoholism and serve a vital role in the diagnosis,prognosis,and treatment assessment of AUD.This article organizes and analyzes the research on alcohol dependence concerning the main noninvasive neuroimaging methods,structural magnetic resonance imaging,functional magnetic resonance imaging,and electroencephalography,as well as the most common noninvasive brain stimulation-transcranial magnetic stimulation,and intersperses the article with joint intra-and intergroup studies,providing an outlook on future research directions.

Construction and evaluation of an alcohol vapor chamber system

An increasing number of studies demonstrated that alcohol vapor chamber is an effective way to model physical signs of alcohol use disorders. Although researchers are developing different vapor chambers to study chronic alcohol exposure model worldwide, few studies build and modify their own vapor chambers in China.Here, we designed and established an alcohol vapor chamber system for small animals. We described a paradigm showing how to control and monitor alcohol concentration in whole system. The vapor chamber system with several advantages including accommodating up to ten standard mouse cages. Furthermore, the system was tested by evaluating the blood alcohol concentration and neuron injury in mice. Importantly, the alcohol withdrawal after vapor exposure caused motor coordination impairment, anxiolytic-and depression-like behavior. Finally, the Nmethyl-D-aspartate receptor(NMDAR)-mediated glutamatergic transmissions in the medial prefrontal cortex was changed after alcohol vapor exposure-induced behaviors. The frequency and amplitude of spontaneous excitatory postsynaptic currents between control and alcohol groups were not different, suggesting that alcohol exposureinduced behaviors are associated with the change in NMDAR response. Taken together, the new alcohol vapor chamber system was constructed, which would help to research the relationship between the stable alcohol exposure and withdrawal behaviors and to study chronic alcohol exposure-induced disorders in China.

Alcohol,inflammation,and gut-liver-brain interactions in tissue damage and disease development

Chronic inflammation is often associated with alcoholrelated medical conditions. The key inducer of such inflammation, and also the best understood, is gut microflora-derived lipopolysaccharide (LPS). Alcohol can significantly increase the translocation of LPS from the gut. In healthy individuals, the adverse effects of LPS are kept in check by the actions and interactions of multiple organs. The liver plays a central role in detoxifying LPS and producing a balanced cytokine milieu. The central nervous system contributes to anti-inflammatory regulation through neuroimmunoendocrine actions. Chronic alcohol use impairs not only gut and liver functions, but also multi-organ interactions, leading to persistent systemic inflammation and ultimately, to organ damage. The study of these interactions may provide potential new targets for therapeutic intervention.

Predicting Alcohol Consumption in Hospitality Populations Using Sense of Coherence

This paper aims to introduce the claim that hospitality students and hospitality employees drink more alcohol than other students and employee groups and to explore and explain this alcohol consumption disparity using the sense of coherence （SOC） construct. Using a web-based questionnaire, college students were recruited, surveyed, and classified into hospitality and non-hospitality majors. Self-reported alcohol consumption, SOC, and a variety of demographic variables were measured. A total of 930 students participated of which 59.4% were female and 28% were hospitality majors. About 47% of hospitality students, 33% of other majors, 43% of women, and 38% of men were classified as at-risk consumers of alcohol. The overall SOC score was about 139 with a range of 69-191. None of the sub-populations differed significantly in SOC. While SOC does not predict major or occupational choice, SOC is a predictor of risky alcohol consumption.

Differentiation of Positional Isomers of Propyl Alcohols Using Filament-Induced Fluorescence

We experimentally demonstrate the recognition of positional isomers of propyl alcohol vapor through nonlinear fluorescence induced by high-intensity femtosecond laser filaments in air. By measuring characteristic fluorescence of n-propyl and isopropyl alcohol vapors produced by femtosecond filament excitation, it is found that they show identical spectra, that is, those from molecular bands of CH, C2, Nit, OH and CN, while the relative intensities are different. By comparing the ratios of the CH and C2 signals, the two propyl alcohol isomers are differentiated. The different signal intensities are ascribed to different ionization potentials of the two isomer molecules, leading to different production efficiencies of fluorescing fragments.

Alcohol-related liver disease

Among individuals with known alcohol use disorder(AUD),the prevalence of alcoholic fatty liver disease(AFLD)is present in 25-90%of cases(1).Shroff et al.(1)report that the annual progression to cirrhosis is 3%in the presence of AFLD,10%in case of alcohol-related steatohepatitis(ASH)and 8%with any grade of pre-cirrhotic fibrosis.Alcohol-related liver disease(ALD)is the cause of 36%of cases of cirrhosis in the United States and nearly one half of cirrhosis-related deaths worldwide(1).Ethanol is a recognized carcinogen for several malignancies with the risk starting at low dose(10 gr/1 unit/day)(2).The link between alcohol consumption(AC)and hepatocellular carcinoma(HCC)is well known:various evaluations carried out by both USA and Italian groups indicate that such a correlation is present in 32%to 45%of cases(2).With the reduction of hepatitis C virus(HCV)cases,AC will become the main cause of HCC in Western countries.Furthermore,ALD and metabolic syndrome(MS)are currently the main causes of liver transplantation(LT)(3).

Marchiafava-Bignami disease:A case report

Rationale:Clinicians encounter multiple alcohol-related illnesses in practice,and Marchiafava-Bignami disease is a rare and devastating entity among them.It is a toxic-demyelinating disease and seen in chronic alcoholics,although it may be occasionally observed in chronically malnourished teetotalers.The clinical presentations are diverse.The symptoms and signs are non-specific,and the onset can be acute or chronic.Patient’s concerns:A 45-year-old right-handed patient suffered from alcohol use disorder with multiple non-specific neuropsychiatric manifestations.Diagnosis:Marchiafava-Bignami disease.Interventions:Thiamine,folate,vitamin B12,and steroid therapy.Outcome:The patient’s behaviour was significantly improved but dysarthria and pyramidal signs persisted.He was left with permanent cognitive impairment.Lessons:Though prompt therapy may halt the demyelinating process in this disease,the treatment remains a challenge in clinical practice.The recognition of the neuro-radiologic features is crucial to establish an early diagnosis.

Perception and Attitude of Employers towards Employees with AUD in an Emerging Economy: A Qualitative Enquiry

Background: The disease, addiction to chemical substances or drugs such as alcohol (ethanol, C2H5OH) is still not accepted as a diagnostic nosology by many in Ghana. Many consider addiction as a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUD) and to ascertain the level at which employee assistance programs (EAPs) are implemented in organizations. Methods: To infer outcomes, the study adopted the qualitative approach. In-depth interviews and observations which describe the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of some selected hospitals (private and public) in the Greater-Accra Metropolis. The interview was conducted face-to-face using an interview guide, which included open-ended questions. The structure of the guide helped the researchers to observe the participants and the conversations were also audio-taped after seeking the consent of the participants. On average, the interview lasted between 45 and 60 minutes. Results: Findings from the 10 interviews revealed that a number of factors such as biological, environmental, social and psychological accounted for AUD among employees regardless of the nature of their work. Although the HR managers had knowledge on the possible causes of AUD, some of them explained that they could not identify alcohol use in their organisations. The few that admitted to AUD at their workplace reported that alcohol use did not have any effect on their productivity and most of these workers were temporal or causal workers, hence were not perceived as permanent staff. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no EAPs and the few that had policies on AUD were not implementing them. Conclusions: This paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their employees’ mental wellbeing which is AUD in a work setting. However, there are other pertinent issues that are crucial to employee total wellbeing that can be addressed in future research.