Following an inpatient detoxification period of two to three weeks, 21 of the 35 alcoholics were successfully monitored for the full length of the study period, 280 days. Researchers collected data from all of the participants on their AVP, ANP, aldosterone, and angiotensin II levels, as well as measures of kidney and liver function.
They found that basal AVP levels were suppressed during the entire study period. In contrast, ANP levels were elevated for the entire time. No persistent alterations were found for aldosterone or angiotensin II.
"We learned that we are dealing with profound, long-lasting alterations of key hormones of water and electrolyte balance notwithstanding at least nine months of controlled abstinence," said Ehrenreich. "These observations imply a number of causes and consequences: they may explain excessive thirst and fluid intake, what we call diabetes insipidus; may explain how alcohol-related cardiomyopathy develops; and may show that there is a subclinically impaired renal function in these patients which clearly underlines the concept of multi-organ involvement in alcoholism, that is, not only are the liver and brain affected, but basically all organs are."
Both Ehrenreich and Spies believe these results can be used to develop new therapeutic options to support abstinence in alcoholics.
"One possibility would be to substitute AVP," said Ehrenreich, "which might not only contribute to recovery of water and electrolyte homeostasis but also benefit cognitive functions such as memory. The findings of the present study imply that at least some features of craving, such as drinking behaviour and thirst, might be explained by biological alterations in the regulation of salt and water homeostasis. Therefore, approaches to substitute for vasopressin, or to normalize vasopressin regulation, might result in a reduction of craving-induced relapses."
Ehrenreich added that one of the most important findings of this study is that "chronic alcoholism is associated with long-term persistent alterations of various organs and systems even with controlled abstinence. There is no immediate recovery to be expected," she stressed.
"Both for psychological as well as medical reasons, we need to consider that we are dealing with individuals severely compromised over many months of controlled abstinence. Detoxification treatments are important and necessary to overcome life-threatening withdrawal symptoms, but with respect to organic and psychological alterations in this group of patients, they only reach the tip of the iceberg."
Part One: Harmone Damage
Source: Max-Planck-Institute for Experimental Medicine News Release.
