The association of plasma acyl ghrelin level with alcohol craving in early abstinent alcohol dependent patients

Abstract

Background: Craving plays an important role in maintenance of alcohol dependence. Earlier studies have analyzed the role of ghrelin in craving and their results have been heterogenous. Acyl ghrelin is its more active form as it crosses the blood brain barrier. Hence we aimed to examine the relationship between plasma acyl ghrelin and craving in Indian patients having alcohol dependence syndrome. Methods: The present study was a hospital-based prospective study. A total of 60 drug-naive patients of alcohol dependence and 30 healthy controls were included. After taking informed consent fasting blood samples were collected from them on day 1 and tested for plasma acyl ghrelin level. Fasting blood samples were repeated in all cases on day 14. During this time, we also assessed the patients' cravings by obsessive compulsive drinking scale, and alcohol craving questionnaire; and withdrawal by clinical institute withdrawal assessment for alcohol scale. These scales were repeated on day 14. Data analysis was done by SPSS version 25.0. Results: Plasma concentrations of acyl ghrelin increased significantly during early abstinence in patients from day 1 to day 14 (P < 0.0001). Pearson correlation test revealed a trend of positive correlation between plasma concentration of acyl ghrelin on day 14 and severity of craving on day 1. Conclusion: Our results suggest the plasma concentration of acyl ghrelin may be a predictor of severity of alcohol craving during early abstinence. Anti-craving drugs acting on acyl ghrelin level in brain may open an innovative avenue for optimum treatment of alcohol dependence.

An Overview of Appetite-Regulatory Peptides in Addiction Processes; From Bench to Bed Side

“…Firstly, some, mainly earlier, plasma-association studies measured only total ghrelin and did not consider active acylated ghrelin. As previously mentioned, studies have shown associations between AUD and acylated, rather than total ghrelin (Koopmann et al, 2012 , 2019 ; Sha et al, 2021 ). Secondly, the so-called inactive form of ghrelin, des-acyl-ghrelin, may have other functions than just being inactive and thus have its own implications for addiction (Delhanty et al, 2014 ; Ardeshiripur et al, 2018 ).…”

“…Nevertheless, plasma ghrelin has been positively associated with higher alcohol craving in abstaining AUD patients (Addolorato et al, 2006 ; Wurst et al, 2007 ; Leggio et al, 2012 ). Taking into account that ghrelin can be in both acylated, traditionally called the active, and des-acylated forms, more recent studies have shown that acylated, rather than total, plasma ghrelin was associated with alcohol craving (Koopmann et al, 2012 , 2019 ; Sha et al, 2021 ). Furthermore, functional magnetic resonance imaging studies have demonstrated a positive correlation between active plasma ghrelin and neuronal alcohol-cue reactivity (Bach et al, 2019 ; Koopmann et al, 2019 ).…”

Alcohol use disorder research in India: An update

“…[ 97 220 221 222 223 224 225 226 ] A few studies explored the role of biological markers (leptin, ghrelin) as predictors of relapse. [ 227 228 ] Interpersonal factors, social support, and occupational factors emerged as being associated with abstinence. [ 220 229 230 231 ] Treatment-related factors like retention to treatment and being on regular medications predicted treatment outcomes, including abstinence.…”