Alcohol & Genes
Alcohol dependence is a major global
problem, associated with lower quality of physical and mental health, higher
mortality and an enormous familial and social cost. Prevention strategies and
treatment of this condition are therefore crucial. Success of psychosocial
programs and pharmacological treatments has been frequently reported, but a
better understanding of the etiology of this chronic disease is needed. For
this purpose, the identification of associated factors in different populations
is of great significance.
It has been clearly demonstrated by
twin and adoption studies and supported by animal models that both genetic and
environmental components play a substantial role in alcohol dependence.
Heritability estimates range from 40 to 60%, depending on the specific analyzed
sample.
Most research points to an
association between alcohol dependence and genes related with alcohol
metabolism, with neurotransmission of dopamine, GABA, serotonin, glutamate,
endogenous opioids, and cannabinoids, signal transduction within the mesolimbic
dopamine reward system, and stress response system, among others.
During pregnancy, there are several
non-genetic factors that may have an important impact on vulnerability to
alcohol dependence. Given that the Central Nervous System is developing
throughout the entire pregnancy and that
alcohol consumed by the mother can reach the fetus through the placental
barrier, the brain of a baby is always vulnerable to harm caused by alcohol
exposure. Children born to alcoholic mothers may inherit genetic susceptibility
variants but at the same time they may be exposed to early effects of ethanol.
Heavy alcohol exposure during pregnancy has been associated with mental
retardation, epilepsy, attention deficit/ hyperactivity disorder, learning
disabilities, and later on with substance abuse, anxiety, personality,
affective and psychotic disorders, as well as with engagement in antisocial
behaviors and school or work problems.
Furthermore, it has been shown that
animals exposed to prenatal stress exhibit persisting modifications related to
dopamine and glutamate transmission in limbic structures associated with
dependence to alcohol and other substances. These alterations may later
contribute to increase motivation to drink, to use large amounts of drugs of
abuse or to relapse after periods of drug withdrawal. It was shown that after
exposure to prenatal stress, male mice consumed more ethanol during alcohol
reinforcement in adulthood.
Adolescence is a critical period for
initiation of alcohol intake, experimentation, and establishment of regular
drinking patterns. Substance use at this age is considered a risk factor for
the development of later alcohol and other drug-related problems, as well as
for externalizing disorders such as antisocial personality disorder. Alcohol
use initiation is affected by environmental factors such as ethanol
availability, parental attitudes, and peer pressure. It has been reported that heavy drinking during adolescence
can have a negative impact on brain development. Moreover, dopaminergic and
GABA systems undergo important changes during adolescence, and they can be
affected by alcohol intake. Dopamine is implicated in the rewarding effects of
ethanol, and GABA in its sedating effects and development of tolerance.
The way an adult copes with
environmental challenges is notably influenced by early life experiences and by
the familial environment he or she had as an infant, which affects
neurodevelopmental behavior.
While environmental factors tend to
have a crucial role in drinking habits in adolescence, adulthood may be
characterized by a weaker effect of environment and a higher effect of genetic
components.
It is probable that a complex set of
gene–environment interactions determine the risk to alcohol dependence.
Environmental factors that may affect this vulnerability appear at different
stages from pregnancy to adulthood.
References: Salud Mental; mar2011,Vol. 34 Issue 2, p157-166, 10p, 1 Diagram, 1 Chart-