Proceedings of the Texas A&M Medical Student Grand Rounds

Alcohol Use Disorder Effects on the BDNF Signaling Pathway Over Time Causing Signaling Pathway Abnormalities Linking to Psychiatric Disorders and Related Illnesses

July 6, 2020 Cerci Hammons

Cerci Hammons

 Introduction. Alcohol use disorder is one of the most prevalent diseases in the United States, affecting approximately 6.2% of adults, and 2.5% of youth, and comprising 3.8% of global deaths and 4.6% of global disability.1 The Co-morbidity of alcohol use disorder and psychiatric illness has a staggering 24-37% comorbidity prevalence associated with higher risks of homelessness, suicidality, and more frequent alcohol related hospitalizations.2 The co-morbidity development is endorsed by an imbalance of a neurotrophin, known as Brain Derived Neurotrophic Factor (BDNF), which is strongly concentrated in the hypothalamus, amygdala, and neocortex. 3 BDNF is of grave importance as it is needed for development, learning, and regulating the reward pathway through dopamine receptor ratios.1 Studies show that BDNF levels correlate with the comorbidity between the 2 conditions, and can be altered through single nucleotide polymorphisms (SNPs), and epigenetic mechanisms.4-6 Methods Two studies, both with comparative control groups referencing mice with differing alcohol ingestion levels.5,7 Experiment 1: Immunohistochemical assays measuring deacetylation levels secondary to stress exposure over time, with BDNF level affects.7 Experiment 2: Immunohistochemical assay. Actin and BDNF directly injected into astrocytes. Normal Valine wildtype and Methionine mutation compared, and alcohol ingestion levels measured.5 Results Epigenetic mechanisms include an increase in H3k14a, a histone deacetylase. With any kind of stress exposure histone deacetylase levels showed a 168 +/- 12% increase. 4,6,8 Deacetylation mechanisms will affect the ARC promoter region in the pro-BDNF gene and is associated with decreased promoter gene expression, secondary to decreased ARC access. 4,5 This SNP involves a replacement of a Valine to Methionine at position 66 of the BDNF gene altering intracellular trafficking of pro-BDNF on account of the Tropomyosin receptor Kinase B in the Met66 variant. 5,6,9 This pathway regulates many downstream signaling cascades through microRNAs, altering cAMP and cAMP binding protein which will go on to effect D2/D3 receptor ratios in the reward pathway causing a decreased sensitivity in alcohol withdrawal. 4,6 This decreased sensitivity results in at least a 4g/kg increase in alcohol consumption by 52+/- 10% of Val66Met variant mice. 5,6,8 Conclusion Studies show altered BDNF levels can be attributed to the two above mechanisms, further predisposing an individual to a plethora of psychiatric disorders through neuropathic changes. 4,5 Counteracting methods of the above mechanisms, help normalize BDNF levels, providing hope for new therapeutic strategies to control alcohol abuse, ultimately affecting predisposition to psychiatric disorders. 6,9

  1. Zai, C. C., Manchia, M., Zai, G. C., Woo, J., Tiwari, A. K., Luca, V. D., & Kennedy, J. L. (2018). Association study of BDNF and DRD3 genes with alcohol use disorder in Schizophrenia. Neuroscience Letters, 671, 1–6. doi: 10.1016/j.neulet.2018.01.033
  2. Andero, R., Choi, D. C., & Ressler, K. J. (2014). BDNF–TrkB Receptor Regulation of Distributed Adult Neural Plasticity, Memory Formation, and Psychiatric Disorders. Progress in Molecular Biology and Translational Science Molecular Basis of Memory, 169–192. doi: 10.1016/b978-0-12-420170-5.00006-4
  3. Han, C., Bae, H., Won, S.-D., Roh, S., & Kim, D.-J. (2015). The relationship between brain-derived neurotrophic factor and cognitive functions in alcohol-dependent patients: a preliminary study. Annals of General Psychiatry, 14(1). doi: 10.1186/s12991-015-0065-z
  4. Nubukpo, P., Ramoz, N., Girard, M., Malauzat, D., & Gorwood, P. (2017). Determinants of Blood Brain-Derived Neurotrophic Factor Blood Levels in Patients with Alcohol Use Disorder. Alcoholism: Clinical and Experimental Research, 41(7), 1280–1287. doi: 10.1111/acer.13414
  5. Kim, T. Y., Kim, S. J., Chung, H. G., Choi, J. H., Kim, S. H., & Kang, J. I. (2017). Epigenetic alterations of the BDNF gene in combat-related post-traumatic stress disorder. Acta Psychiatrica Scandinavica, 135(2), 170-179. doi: 10.1111/acps.12675
  6. Caputi, F., Palmisano, M., D’Addario, C., Candeletti, S., & Romualdi, P. (2015). Effects of acute ethanol exposure on class I HDACs family enzymes in wild-type and BDNF /− mice. Drug and Alcohol Dependence, 155, 68–75. doi: 10.1016/j.drugalcdep.2015.08.015
  7. Covington, H., Maze, I., Vialou, V., & Nestler, E. (2015). Antidepressant action of HDAC inhibition in the prefrontal cortex. Neuroscience, 298, 329–335. doi: 10.1016/j.neuroscience.2015.04.030
  8. Bohnsack, J. P., Teppen, T., Kyzar, E. J., Dzitoyeva, S., & Pandey, S. C. (2019). The lncRNA BDNF-AS is an epigenetic regulator in the human amygdala in early onset alcohol use disorders. Translational Psychiatry, 9(1). doi: 10.1038/s41398-019-0367-z
  9. Warnault, V., Darcq, E., Morisot, N., Phamluong, K., Wilbrecht, L., Massa, S. M., … Ron, D. (2016). The BDNF Valine 68 to Methionine Polymorphism Increases Compulsive Alcohol Drinking in Mice That Is Reversed by Tropomyosin Receptor Kinase B Activation. Biological Psychiatry, 79(6), 463–473. doi: 10.1016/j.biopsych.2015.06.007
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