Koopmann Anne, Leménager Tagrid, Wolf Nadine Donata, Reinhard Iris, Hermann Derik, Koch Jan, Wiedemann Klaus, Kiefer Falk
Corresponding author: Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, J5, D-68159 Mannheim, Germany.
Alcohol Alcohol. 2014 May-Jun;49(3):282-6. doi: 10.1093/alcalc/agt160. Epub 2013 Oct 27.
Atrial natriuretic peptide (ANP) is well known to modulate fluid and electrolyte homeostasis but also to counter-regulate hypothalamic-pituitary-adrenal (HPA) axis activity. Correspondingly, recent studies suggest an important role of ANP in the neurobiology of anxiety. Preclinical and clinical data now provide evidence for an involvement of ANP in the pathophysiology of addictive behavior. The present study aims to elucidate the effects of ANP on alcohol-dependent patients' anxiety, perceived stress and craving during alcohol withdrawal.
A sample of 59 alcohol-dependent inpatients was included in the analysis. A blood sample was taken at day 14 of detoxification in order to assess the concentrations of ANP and cortisol in plasma. In parallel, we assessed patients' alcohol craving, using the Obsessive Compulsive Drinking Scale, as well as anxiety (State-Trait Anxiety Inventory). Patients' stress levels were assessed using the Perceived Stress Scale.
We found a significant negative association between patients' ANP plasma concentrations and anxiety, craving for alcohol and perceived stress. Regression analyses suggest that ANP is a significant predictor both for patients' perceived stress and for the severity of anxiety during early abstinence. The association of patients' ANP plasma levels and craving is suggested to be mediated by perceived stress.
Our results suggest that the association of patients' ANP plasma levels and craving is mediated by their perceived stress. For this reason, intranasal application of ANP may prove to be a new avenue for the treatment of alcohol dependence in patients exhibiting high levels of perceived stress.
心房利钠肽（ANP）不仅在调节体液和电解质平衡方面广为人知，还能对抗调节下丘脑 - 垂体 - 肾上腺（HPA）轴的活动。相应地，最近的研究表明ANP在焦虑神经生物学中具有重要作用。临床前和临床数据现在为ANP参与成瘾行为的病理生理学提供了证据。本研究旨在阐明ANP对酒精依赖患者戒酒期间焦虑、感知压力和渴望的影响。
59名酒精依赖住院患者的样本纳入分析。在解毒第14天采集血样，以评估血浆中ANP和皮质醇的浓度。同时，我们使用强迫性饮酒量表评估患者对酒精的渴望，以及使用状态 - 特质焦虑量表评估焦虑情况。使用感知压力量表评估患者的压力水平。
我们发现患者血浆中ANP浓度与焦虑、对酒精的渴望和感知压力之间存在显著负相关。回归分析表明，ANP是患者感知压力和早期戒酒期间焦虑严重程度的重要预测指标。患者血浆中ANP水平与渴望之间的关联被认为是由感知压力介导的。
我们的结果表明，患者血浆中ANP水平与渴望之间的关联是由他们的感知压力介导的。因此，对于表现出高水平感知压力的患者，鼻内应用ANP可能被证明是治疗酒精依赖的新途径。
