Alcohol Addiction, Gut Microbiota, and Alcoholism Treatment: A Review

Abstract

Alcohol addiction is a leading risk factor for personal death and disability. In 2016, alcohol use caused 2.2% of female deaths and 6.8% of male deaths, and disability-adjusted life years (DALYs) were 2.3% in female and 8.9% in male. Individuals with alcohol use disorder are at high risk of anxiety, depression, impaired cognition performance, and illicit drug use and are comorbid with liver disease, such as alcoholic hepatitis and liver cirrhosis, which is a major cause of personal death and disability worldwide. Psychological interventions, such as cognitive behavior therapy and motivational interviewing, as well as medical treatments, such as disulfiram, naltrexone, acamprosate, and nalmefene, are used for the treatment of alcohol addiction in Europe and the United States. However, the effect of current interventions is limited, and the need for additional interventions is substantial. Alcohol use impairs the intestinal barrier and causes changes to the intestinal permeability as well as the gut microbiota composition. Emerging studies have tried to reveal the role of the gut–brain axis among individuals with alcohol use disorder with or without alcohol liver disease. Bacterial products penetrate the impaired intestinal barrier and cause central inflammation; changes to the gut microbiota impair enterohepatic circulation of bile acids; alcohol abuse causes shortage of vital nutrients such as thiamine. Several studies have suggested that probiotics, through either oral administration or fecal microbiota transplantation, increased intestinal levels of potentially beneficial bacteria such as bifidobacteria and lactobacilli, improving the levels of liver-associated enzymes in patients with mild alcoholic hepatitis, and demonstrating beneficial psychotropic effects on anxiety and depression. In addition to medications for alcohol addiction, gene editing therapy such as clustered regularly interspaced short palindromic repeats (CRISPRs) may be another potential research target. Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), which are associated with ADH and ALDH genes, are major enzymes involved in alcohol metabolism, and gene editing approaches may have the potential to directly modify specific genes to treat alcoholism caused by genetic defects. Further research is needed to study the effect of the combined treatment for alcohol addiction.

Potassium Channels and Their Potential Roles in Substance Use Disorders

“…Presently, there are few FDA-approved pharmacological treatments for AUD. These include disulfiram, acamprosate, and naltrexone and these medications have limited success at reducing the high rates of relapse and are not necessarily efficacious in some populations [ 66 , 67 ]. Thus, there is a need to develop other pharmacological agents based on the elucidation of neurobiological mechanisms that might be the substrates of AUD.…”

Gut Microbiota Is Involved in Alcohol-Induced Osteoporosis in Young and Old Rats Through Immune Regulation

“…And gut microbiota may change the immune state of bone, thus affecting the generation of osteoclasts, but its immune regulation ability of the body will gradually weaken as the age increases (Ticinesi et al, 2019). Moreover, it has been found that alcohol can cause changes to the gut microbiota composition and is closely related to personal health (Wang et al, 2020). However, the relationship between AOP and gut microbiota in different ages was not clear.…”

Pairing Binge Drinking and a High-Fat Diet in Adolescence Modulates the Inflammatory Effects of Subsequent Alcohol Consumption in Mice

“…In parallel, alcohol consumption has been associated with dysbiotic changes in gut microbiome, breakdown of the intestinal barrier integrity and increased permeability of the intestinal mucosa [ 25 , 26 ]. One important source of brain damage and neurodegeneration caused by alcohol use is neuroinflammation [ 27 , 28 , 29 , 30 , 31 ].…”