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Open AccessReview

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

by Shao-Cheng Wang 1,2,*,†, Yuan-Chuan Chen 3,4,†, Shaw-Ji Chen 5,6, Chun-Hung Lee 1,7 and Ching-Ming Cheng 1,8,9
1
Department of Forensic and Addiction Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City 717, Taiwan
2
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
3
Gloria Operation Center, National Tsing Hua University, Hsinchu City 30013, Taiwan
4
Program in Comparative Biochemistry, University of California, Berkeley, CA 94720, USA
5
Department of Psychiatry, Taitung MacKay Memorial Hospital, Taitung City 950, Taiwan
6
Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
7
Department of Informative Engineering, I-Shou University, Kaohsiung City 840, Taiwan
8
Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan City 717, Taiwan
9
Department of Natural Biotechnology, NanHua University, Chiayi County 622, Taiwan
*
Author to whom correspondence should be addressed.
The first two authors contribute equally to this review.
Int. J. Mol. Sci. 2020, 21(17), 6413; https://doi.org/10.3390/ijms21176413
Received: 23 July 2020 / Revised: 1 September 2020 / Accepted: 2 September 2020 / Published: 3 September 2020
(This article belongs to the Special Issue Mechanistic Effects of Human Variants Associated with Addiction)
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. View Full-Text
Keywords: alcohol addiction; alcoholism medication; alcohol encephalopathy; gut microbiota; alcohol liver disease; gut–brain axis; gene editing therapy; CRISPR alcohol addiction; alcoholism medication; alcohol encephalopathy; gut microbiota; alcohol liver disease; gut–brain axis; gene editing therapy; CRISPR
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Wang, S.-C.; Chen, Y.-C.; Chen, S.-J.; Lee, C.-H.; Cheng, C.-M. Alcohol Addiction, Gut Microbiota, and Alcoholism Treatment: A Review. Int. J. Mol. Sci. 2020, 21, 6413.

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