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Peripheral Biological Markers in Alcoholism (Paperback, New)
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Discovery Miles 8 680
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Peripheral Biological Markers in Alcoholism (Paperback, New)
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Alcoholism is a complicated disorder that is often characterised
with refractoriness to treatment, chronic course, high comorbidity
and frequently with aggressive and suicidal behaviour. The
neurobiological basis of alcoholism is assumed to be associated
with the altered functions of different neurotransmitter (opioid,
GABA, dopamine or serotonin (5-hydroxytryptamine, 5-HT)) systems.
The association between central serotonergic function and the
development and maintenance of alcohol abuse and dependence is
based on the preclinical and clinical data, which show decreased
5-HT function associated with alcohol abuse. Peripheral biochemical
markers might be used to improve the understanding of the
underlying neurobiology of alcoholism, but also for the screening,
establishing the diagnosis, disease staging, prediction of the
suicidal risk and prediction and monitoring of treatment. Since
5-HT synaptosomes in the central nervous system and platelets
similarly store, release and metabolise 5-HT, blood platelets have
been widely used as a limited peripheral model for the central
serotonergic synaptosomes. Various 5-HT abnormalities are
frequently found in alcoholism, and decreased plasma tryptophan
levels, decreased but also unaltered concentration of platelet
5-HT, increased platelet 5-HT uptake, and decreased and unchanged
platelet monoamine oxidase (MAO) activity in alcoholic subjects
have been reported. Deficits in central 5-HT function in alcoholic
subjects were also detected after a challenge tests with
fenfluramine, m-clorophenylpiperasine, and
6-chloro-2-1-piperazinylpyrazine, which resulted in blunted
prolactin and cortisol responses. Alcoholism is frequently
associated with different comorbid psychiatric disorders
(personality disorder, PTSD, anxious-depressive disorder, major
depression, schizophrenia), and with nicotine addiction. Clinical
diagnosis of alcoholism was made according to the DSM-IV criteria,
using Structured clinical interview and CAGE. Different clinical
symptoms were evaluated using Hamilton Rating Scale for Depression
and Anxiety. Control group consisted of drug free healthy persons
with no personal or family history of alcoholism, who did not
consume any alcohol beverage 24 h prior to sampling. All subjects
fulfilled the questionnaire regarding their smoking habits.
Biomarkers studied were platelet 5-HT concentration, platelet MAO
activity, and routine laboratory tests, determined using
spectrofluorimetric and photometric methods. Since platelet 5-HT
concentration and/or MAO activity are under influence of sex,
psychotic or depressive symptoms, suicidal behaviour, smoking
status, or different psychiatric comorbid diagnoses, the authors
determined platelet 5-HT concentration and platelet MAO activity in
the large groups of drug-free alcoholics who were admitted into
hospital due to the withdrawal syndrome related to alcohol
dependency, and compared these values in the sex-matched healthy
controls. They also investigated whether sex, smoking status, the
presence of psychotic or depressive symptoms, suicidal behavior,
number of cigarettes smoked per day, or different psychiatric
comorbid diagnoses, would affect platelet 5-HT and MAO in male and
female alcoholic patients. The data suggest that biological markers
are very important research tool in alcoholism, since they can be
used to determine the baseline characteristics of the alcoholic
groups, to predict a suicidal risk in alcoholism, to predict
efficacy in alcoholism treatment trials, to predict therapeutic
response to medications in alcoholism, to measure alcohol
consumption, and to be used in forensic toxicology.
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