3 years ago

Beneficial effect of alcohol withdrawal on gut permeability and microbial translocation in patients with alcohol use disorder

Stéphanie Pelletier, Nathalie Pansu, Hélène Donnadieu-Rigole, Florence Apparailly, Pascal Perney, Régis Alarcon, Catherine Dunyach-Remy, Lucie Gamon, Jean-Philippe Lavigne, Thibault Mura
Background The human intestinal microbiota exerts beneficial or harmful effects in several disorders. Many factors, including alcohol consumption, may influence its composition and trigger bacterial translocation. Excessive alcohol consumption increases gut permeability and translocation of endotoxin into peripheral circulation. Although plasma endotoxin concentrations have been measured often, quantitative changes following alcohol withdrawal have never been described in subjects with alcohol use disorder (AUD). The aim of this study was to measure microbial translocation (MT) and gut permeability markers in patients with AUD, to compare these markers to healthy controls (HC) and to monitor markers during the first six weeks of abstinence. Methods Sixty-five patients with AUD and hospitalized for alcohol withdrawal were included. Epidemiological, clinical, biological and addictological data were gathered. Blood samples were collected at baseline, then three and six weeks after alcohol withdrawal. A hundred healthy volunteers were used as controls. Three markers of MT were monitored in plasma samples: sCD14 and LBP were quantified using ELISA, and 16S rDNA was quantified using real time PCR. Zonulin and I-FABP blood levels were also monitored as indirect markers of gut permeability, using ELISA. Results At baseline, LBP, 16S rDNA and I-FABP markers were significantly higher in AUD patients than in HC. Six weeks after alcohol withdrawal plasma levels of sCD14 and LBP decreased significantly. Cannabis consumption and BMI before alcohol withdrawal influenced baseline MT levels and the decrease in MT markers after six weeks. Finally, markers of MT and gut permeability did not correlate with each other before and after alcohol withdrawal. Conclusions Before alcohol withdrawal, MT markers were higher in AUD patients than in HC. After six weeks of abstinence an improvement in MT markers was observed. Our data suggest that there is a link between MT, its improvement, BMI and cannabis consumption. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/acer.13527

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