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Alcohol Use Disorder and the Gut Microbiome

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Abstract

Purpose of Review

Alcohol use Disorder (AUD) is a widely prevalent health concern, and it profoundly impacts an individual’s mental, physical, and psychosocial well-being. AUD and alcohol-associated liver disease (ALD) therapies are limited and rapidly evolving. Over the past few years, there has been a growing interest in the disruption of the gut microbiome caused by chronic alcohol use and how new therapies targeting the microbiome could be potentially used to alter the course of this disease.

Recent Findings

There are significant changes in the gut microbiome caused by alcohol consumption. These changes lead to the breakdown of the intestinal mucosal barrier, allowing the translocation of gut-derived inflammation agents, which subsequently cause inflammation in the brain and liver. Therapies focused on restoring a normal gut microbiome in patients with AUD are being explored. The alterations in microbiome constitution and gut dysfunction could be relatively easy to reverse by following abstinence within a short period of time. Preliminary data strongly show that supplementing the microbiome with probiotics and fecal microbiota transplantation may be a useful intervention strategy. Elimination of the state of abundant pathological organisms with antibiotic therapy has also been investigated, with potential implications in microbiome modulation to obtain beneficial effects.

Summary

There is a huge potential for the use of microbiome-directed therapies for the management of AUD and ALD. Further long-term and controlled studies in humans are highly needed.

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Funding

NIAAA NIH USA: K23 AA 029198 (VV).

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Authors and Affiliations

  1. University of Louisville School of Medicine, Louisville, KY, USA

    K. S. Gala, E. Winrich, S. K. Jha, R. Parthasarathy & V. Vatsalya

  2. Clinical Laboratory for Intervention Development of AUD and Organ Severity, Louisville, KY, USA

    K. S. Gala, E. Winrich, S. K. Jha, R. Parthasarathy & V. Vatsalya

  3. Mayo Clinic, Rochester, MN, USA

    K. S. Gala & V. Vatsalya

  4. Robley Rex VA Medical Center, Louisville, KY, USA

    R. Parthasarathy & V. Vatsalya

  5. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Clinical and Translational Research Building, University of Louisville, Suite 514A, 505 S. Hancock St., Louisville, KY, 40202, USA

    V. Vatsalya

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  1. K. S. Gala
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Correspondence to V. Vatsalya.

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Gala, K.S., Winrich, E., Jha, S.K. et al. Alcohol Use Disorder and the Gut Microbiome. Curr Addict Rep 11, 105–112 (2024). https://doi.org/10.1007/s40429-023-00527-x

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