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戒断的酒精依赖患者外周促炎标志物上调,但认知偏差修正对此没有影响:初步研究结果。

Peripheral proinflammatory markers are upregulated in abstinent alcohol-dependent patients but are not affected by cognitive bias modification: Preliminary findings.

机构信息

Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Basic Research and National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Bethesda, MD, USA.

Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.

出版信息

Drug Alcohol Depend. 2019 Nov 1;204:107553. doi: 10.1016/j.drugalcdep.2019.107553. Epub 2019 Sep 11.

Abstract

BACKGROUND

Inflammatory pathways are known to be negatively affected in patients with alcohol use disorder (AUD). Cognitive bias modification (CBM), an emerging behavioral treatment that involves the 're-training' of cognitive biases using computerized tasks, has been reported to reduce alcohol craving and relapse rates. The aim of this study was to compare peripheral concentrations of the proinflammatory biomarkers IL-18, IL-6, IL-1β, TNF-α and CRP in AUD patients versus controls and to identify whether CBM treatment affected these biomarkers in AUD patients.

METHODS

This 3-week double-blind randomized controlled study tested 36 male abstinent AUD patients receiving CBM or placebo-training, who were also compared to 18 male healthy controls. The approach avoidance task (AAT) was used to test the AUD patients before and after training. CBM training took place over 6 sessions, using a joystick-based approach-avoidance task. Blood samples were collected after the pre- and post-AAT test sessions for the AUD groups, and during an outpatient appointment with the controls.

RESULTS

AUD patients, versus controls, presented with significantly higher plasma levels of TNF- α (P < 0.0001) and CRP (P = 0.0031). No changes in the CBM versus placebo groups were noted in IL-18, TNF-α and CRP concentrations following pre-post change or within group pretest- posttest analysis. IL-6 and IL-1β levels fell under the lower detection limit, thus were not included in the final analyses.

CONCLUSIONS

This study confirms that the inflammatory system is altered in AUD. This was the first study that investigated whether CBM training affected proinflammatory markers in AUD patients.

摘要

背景

已知炎症途径在患有酒精使用障碍(AUD)的患者中受到负面影响。认知偏差修正(CBM)是一种新兴的行为治疗方法,涉及使用计算机任务“重新训练”认知偏差,已被报道可降低酒精渴求度和复发率。本研究的目的是比较 AUD 患者与对照组之间促炎生物标志物 IL-18、IL-6、IL-1β、TNF-α 和 CRP 的外周浓度,并确定 CBM 治疗是否会影响 AUD 患者的这些生物标志物。

方法

这项为期 3 周的双盲随机对照研究测试了 36 名接受 CBM 或安慰剂训练的男性酒精戒断 AUD 患者,他们也与 18 名男性健康对照组进行了比较。使用基于操纵杆的趋近回避任务(AAT)在训练前和训练后测试 AUD 患者。CBM 训练分 6 个疗程进行,使用基于操纵杆的趋近回避任务。在 AUD 组进行 AAT 测试前后和对照组的门诊预约期间采集血液样本。

结果

与对照组相比,AUD 患者的 TNF-α(P<0.0001)和 CRP(P=0.0031)血浆水平明显更高。在 CBM 与安慰剂组中,未注意到 IL-18、TNF-α 和 CRP 浓度在预-后变化或组内预测试-后测试分析中发生变化。IL-6 和 IL-1β 水平低于检测下限,因此未包含在最终分析中。

结论

本研究证实炎症系统在 AUD 中发生改变。这是第一项研究 CBM 训练是否影响 AUD 患者促炎标志物的研究。

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