Exploring Gut-Brain and Brain-Gut Interactions in Alcohol Use Disorder Via Microbiota Investigations: A Pilot Study

• ClinicalTrials.gov Identifier: NCT03152760
• Recruitment Status: Completed
• First Posted: May 15, 2017
• Last Update Posted: November 30, 2020
• Sponsor: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
• Collaborators: National Institute on Drug Abuse (NIDA); The Peter G. Dodge Foundation (PGDF)
• Information provided by (Responsible Party): National Institutes of Health Clinical Center (CC) ( National Institute on Alcohol Abuse and Alcoholism (NIAAA) )

Study Description

Brief Summary:

Background:

Alcohol use disorder (AUD) affects about 10 percent of people in the U.S. Studies show a relationship between the bacteria (microbiota) in the gut and the brain. Researchers think this may influence AUD. They want to learn more about changes in gut bacteria that may occur in people with AUD.

Objectives:

To study gut microbiota differences in current drinking versus abstinent people with AUD. Also to test if gut microbiota are related to alcohol cue-induced craving.

Eligibility:

People ages 21-70 who have AUD (both abstinent and current heavy drinkers) or are healthy, moderate drinkers

Design:

Participants will be screened in Protocol 14-AA-0181.

Participants will have a first visit. They will have 4 more visits within about 10 days. Visits include:

Fecal sample collection

Physical exam

Blood tests

Assessment of diet and alcohol use

X-rays to test body composition,

They will sit under a ventilation hood to measure metabolism. They must fast 12 hours before this test.

They will drink a solution. Their urine is collected over 5 hours.

Ultrasound of the liver area. They must fast overnight before this test.

At 2 visits, they will be in a bar-like setting. They will be exposed to stimuli associated with eating and drinking. They will rate their urge to drink alcohol and their food cravings.

Participants will collect their stool throughout the study. They will also record information about their diet and daily activities like sleep and exercise.

At the end of the study, participants will discuss their drinking. They will receive counseling if needed.

...

Condition or disease
Alcoholism

Detailed Description:

Objective:

An increasing body of preclinical literature suggests a role of the gut microbiota in a wide range of medical disorders, including neuropsychiatric diseases like autism, anxiety, and depression. Preliminary studies have reported alterations in microbiota composition, inflammation, and intestinal permeability in alcohol-dependent patients. However, there is little research on the association between these alterations and behavioral outcomes associated with alcohol use disorder (AUD), such as alcohol craving and drinking. The main goal is to investigate gut microbiota differences in current drinking versus abstinent individuals with AUD, and whether microbial profiles are correlated with alcohol cue-induced craving. Finally, another goal of this project will be to conduct preliminary translational bed-to-bench work using rodent models of excessive alcohol use via collaborations with basic science laboratories.

Study population:

Alcohol use disorder participants (current drinkers and abstinent) and healthy controls.

Study Design:

Between subject, observational study

Outcome measures:

We will compare the gut microbiota of AUD participants who have been abstinent to that of current drinkers. In addition, we will further compare the gut microbiota of these two groups to a third group of healthy controls with no prior or current diagnosis of AUD. The secondary aim of this study is to examine whether the overall microbial community composition, function and individual taxa correlate with alcohol cue-induced craving.

Study Design

• Study Type: Observational
• Actual Enrollment: 35 participants
• Observational Model: Case-Control
• Time Perspective: Prospective
• Official Title: Exploring Gut-Brain and Brain-Gut Interactions in Alcohol Use Disorder Via Microbiota Investigations: A Pilot Study
• Actual Study Start Date: August 28, 2017
• Actual Primary Completion Date: March 4, 2020
• Actual Study Completion Date: November 24, 2020

Groups and Cohorts

Group/Cohort
Abstinent Group (AB); Current AUD diagnosis, currently abstaining from alcohol
Current Drinking Group (CD); Current AUD diagnosis, not seeking AUD treatment
Healthy Control Group (HC); NO current or past AUD diagnosis

Outcome Measures

Primary Outcome Measures :

1. Observed differences in composition and function of microbiome between cohorts [ Time Frame: 10-day time frame ]
   To investigate the primary aim, participants' gut microbiota will be collected and analyzed to compare the three groups.

Secondary Outcome Measures :

1. The secondary aims will be to examine whether participants' gut microbiota composition is associated with biobehavioral correlates as alcohol cue- induced craving during a Cue-reactivity procedure. [ Time Frame: 10-day time frame ]
   1.To examine whether participants' gut microbiota composition is associated with biobehavioral correlates as alcohol cue-induced craving during a Cue-reactivity procedure.

Eligibility Criteria

• Ages Eligible for Study: 21 Years to 70 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No
• Sampling Method: Non-Probability Sample

Study Population

Male or female individuals 21-70 years oldIndividuals may come to the NIH/NIAAA from a variety of community settings ranging from primary residences, shelters and/or other health care facilities

Criteria

• INCLUSION CRITERIA:
• Male or female individuals 21-70 years old (inclusive)

Specific For Abstinent Group; AB

• Current Alcohol Use Disorder (AUD) by DSM-5 criteria
• Being alcohol abstinent for at least 4 weeks, with a minimum of 2 weeks in a non-protective environment at the time of study screening.

Specific For Current Drinking Group; CD

• Current Alcohol Use Disorder (AUD) by DSM-5 criteria
• Participants not seeking treatment for their alcohol use will be included.
• Satisfying heavy drinking criteria during the 4-weeks prior to screening (i.e., for men, >14 standard drinks in any one week or greater than or equal to 4 drinks per occasion at least once per month over the past 30 days; for women, >7 drinks per week or greater than or equal to 3 drinks per occasion at least at least once per month over the past 30 days) and any drinking during the 2-day prior to signing the study-specific consent.

Specific For Healthy Control Group; HC

• No current or past diagnostic of AUD by DSM-5 criteria
• Moderate alcohol consumers: i.e., up to 1 drink per day on average and not meeting NIAAA criteria for:
• -heavy (i.e., for men, >14 standard drinks in any one week or greater than or equal to 4 drinks per occasion at least once per month over the past 30 days; for women, >7 drinks per week or greater than or equal to 3 drinks per occasion at least at least once per month over the past 30 days)
• -or binge drinking (i.e., drinking 5 or more standard drinks on the same occasion on at least 1 day in the past 30 days for both male and female)

If any answer is No , subject may not be enrolled.

EXCLUSION CRITERIA:

Exclusion - All Participants (at the time subject are evaluated for this protocol)

• Current pregnancy or lactation
• Positive Urine Drug Test for illegal drugs
• Body Mass Index (BMI) less than or equal to 18.5 kg/m(2) or BMI greater than or equal to 40 kg/m(2)
• Presence of active implantable electronic devices (e.g., defribillators, pumps, pacemakers)

• Current medical history of the following medical conditions:

  --diabetes; chronic gut inflammatory diseases; GI or any other type of cancer; short bowel syndrome; conditions requiring parenteral nutrition;

• Diarrhea or other symptoms of possible enteritis in the past 7 days (self-reported)
• Recent history of sigmoidoscopy or colonoscopy (past 30 days)

• Current use (past 90 days) of the following medications:

  --oral antimicrobials (specifcally: antiviral, antifungal, or antibiotics); prebiotics; probiotics; laxatives; antispasmodic drugs; oral, IM or IV steroids

• Any other reason or clinical condition that the PI, or Medical Advisory Investigator (MAI) considers unsafe or not in the best interest of the study research integrity

If any answer is Yes , subject may not be enrolled.

Contacts and Locations

Locations

United States, Maryland

National Institutes of Health Clinical Center

Bethesda, Maryland, United States, 20892

Sponsors and Collaborators

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

National Institute on Drug Abuse (NIDA)

The Peter G. Dodge Foundation (PGDF)

Investigators

• Principal Investigator: Lorenzo Leggio, M.D.; National Institute on Drug Abuse (NIDA)

More Information

Additional Information:

NIH Clinical Center Detailed Web Page 

• Responsible Party: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
• ClinicalTrials.gov Identifier: NCT03152760
• Other Study ID Numbers: 170093; 17-AA-0093
• First Posted: May 15, 2017
• Last Update Posted: November 30, 2020
• Last Verified: November 24, 2020

Keywords provided by National Institutes of Health Clinical Center (CC) ( National Institute on Alcohol Abuse and Alcoholism (NIAAA) ):

Alcoholism; Healthy Volunteers; Craving; Gut

Additional relevant MeSH terms:

Alcoholism; Alcohol-Related Disorders; Substance-Related Disorders; Chemically-Induced Disorders; Mental Disorders