Although it is well known that chronic alcohol abuse causes a broad range of health complications, it remains unclear how much regeneration may occur during long-term abstinence from alcohol. A new study carefully monitors major water and electrolyte regulating hormones - arginine vasopressin (AVP), atrial natriuretic peptide (ANP), aldosterone and angiotensin II - from early withdrawal up to 280 days of strict abstinence.
The results, published in Alcoholism: Clinical & Experimental Research, indicate that chronic alcohol abuse can cause severe and persistent alterations in the hormones that regulate electrolyte and water balance in the body.
"Most of the available literature on regeneration from alcoholism is restricted to the first few days up to three weeks of abstinence," said Hannelore Ehrenreich, head of Clinical Neuroscience at the Max-Planck-Institute for Experimental Medicine and corresponding author for the study. "Only rarely do papers report on persistent alterations or on patterns of regeneration associated with long-term abstinence. In fact, many disturbances are believed - but never proven - to return to normal within a few weeks."
"Both chronic alcohol consumption and alcohol withdrawal can affect cell and homeostatic functions on a variety of levels," said Claudia Spies, medical associate director of the department of anesthesiology and intensive care medicine at the University Hospital Charite Campus Mitte.
"A chronic alcohol intake of at least 60g, or 1.5l beer, per day is associated with severe complications such as higher rates of infections, cardiomyopathy, cardiac arrhythmias, bleeding complications and liver insufficiency. During withdrawal, changes in electrolyte and water homeostasis occur. We know that the interaction of different homeostatic systems is complex but the specifics are poorly understood."
The consequences, however, are clear. "The hospital stay of alcoholics is prolonged compared with that of non-alcoholics," said Spies. "A major complication is alcohol withdrawal syndrome (AWS), developed by approximately half of chronic alcoholics during their hospital stay.
The majority of the patients who develop AWS have hallucinations or delirium. AWS can also be deadly. In one study, the mortality rate in patients with AWS was approximately 18 percent, whereas alcohol abusers without AWS had a mortality rate of four to six percent, and non-alcohol abusers had a mortality rate of zero percent."
The study authors knew from previous research that various components of the physical and psychological stress-response systems can sustain damage despite many months of abstinence. "Vasopressin, or AVP, is a hormone that is also part of the stress regulatory system," said Ehrenreich. "In previous work, we showed that circulating levels of AVP are persistently suppressed in alcoholic patients over many weeks of abstinence.
This is why we chose to further elucidate the recovery of vasopressin levels in alcoholics during long-term abstinence. Since atrial natriuretic peptide, or ANP, as well as aldosterone and angiotensin II are counter-regulatory or counterbalancing hormones to AVP, it was logical to simultaneously follow these parameters of water/electrolyte homeostasis."
Part Two: Study Details
