Carbia Carina, Lannoy Séverine, Maurage Pierre, López-Caneda Eduardo, O'Riordan Kenneth J, Dinan Timothy G, Cryan John F
APC Microbiome Ireland, University College Cork, Cork, Ireland.
Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA.
Mol Psychiatry. 2021 Apr;26(4):1098-1118. doi: 10.1038/s41380-020-00970-6. Epub 2020 Dec 7.
Alcohol use disorder (AUD) has been associated with impairments in social and emotional cognition that play a crucial role in the development and maintenance of addiction. Repeated alcohol intoxications trigger inflammatory processes and sensitise the immune system. In addition, emerging data point to perturbations in the gut microbiome as a key regulator of the inflammatory cascade in AUD. Inflammation and social cognition are potent modulators of one another. At the same time, accumulating evidence implicates the gut microbiome in shaping emotional and social cognition, suggesting the possibility of a common underlying loop of crucial importance for addiction. Here we propose an integrative microbiome neuro-immuno-affective framework of how emotional dysregulation and alcohol-related microbiome dysbiosis could accelerate the cycle of addiction. We outline the overlapping effects of chronic alcohol use, inflammation and microbiome alterations on the fronto-limbic circuitry as a convergence hub for emotional dysregulation. We discuss the interdependent relationship of social cognition, immunity and the microbiome in relation to alcohol misuse- from binge drinking to addiction. In addition, we emphasise adolescence as a sensitive period for the confluence of alcohol harmful effects and emotional dysregulation in the developing gut-brain axis.
酒精使用障碍（AUD）与社会和情感认知受损有关，而社会和情感认知在成瘾的发展和维持中起着关键作用。反复饮酒会引发炎症反应并使免疫系统敏感化。此外，新出现的数据表明，肠道微生物群的紊乱是酒精使用障碍中炎症级联反应的关键调节因素。炎症和社会认知相互之间是强大的调节因子。与此同时，越来越多的证据表明肠道微生物群在塑造情绪和社会认知方面发挥作用，这表明可能存在一个对成瘾至关重要的共同潜在循环。在此，我们提出一个综合的微生物群-神经-免疫-情感框架，以解释情绪失调和与酒精相关的微生物群失调如何加速成瘾循环。我们概述了长期饮酒、炎症和微生物群改变对额叶-边缘回路的重叠影响，额叶-边缘回路是情绪失调的汇聚中心。我们讨论了社会认知、免疫和微生物群在酒精滥用（从暴饮到成瘾）方面的相互依存关系。此外，我们强调青春期是发育中的肠-脑轴中酒精有害影响与情绪失调交汇的敏感期。
