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      Saracatinib Fails to Reduce Alcohol-Seeking and Consumption in Mice and Human Participants

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          Abstract

          More effective treatments to reduce pathological alcohol drinking are needed. The glutamatergic system and the NMDA receptor (NMDAR), in particular, are implicated in behavioral and molecular consequences of chronic alcohol use, making the NMDAR a promising target for novel pharmacotherapeutics. Ethanol exposure upregulates Fyn, a protein tyrosine kinase that indirectly modulates NMDAR signaling by phosphorylating the NR2B subunit. The Src/Fyn kinase inhibitor saracatinib (AZD0530) reduces ethanol self-administration and enhances extinction of goal-directed ethanol-seeking in mice. However, less is known regarding how saracatinib affects habitual ethanol-seeking. Moreover, no prior studies have assessed the effects of Src/Fyn kinase inhibitors on alcohol-seeking or consumption in human participants. Here, we tested the effects of saracatinib on alcohol consumption and craving/seeking in two species, including the first trial of an Src/Fyn kinase inhibitor to reduce drinking in humans. Eighteen male C57BL/6NCrl mice underwent operant conditioning on a variable interval schedule to induce habitual responding for 10% ethanol/0.1% saccharin. Next, mice received 5 mg/kg saracatinib or vehicle 2 h or 30 min prior to contingency degradation to measure habitual responding. In the human study, 50 non-treatment seeking human participants who drank heavily and met DSM-IV criteria for alcohol abuse or dependence were randomized to receive 125 mg/day saracatinib ( n = 33) or placebo ( n = 17). Alcohol Drinking Paradigms (ADP) were completed in a controlled research setting: before and after 7–8 days of treatment. Each ADP involved consumption of a priming drink of alcohol (0.03 mg%) followed by ad libitum access (3 h) to 12 additional drinks (0.015 g%); the number of drinks consumed and craving (Alcohol Urge Questionnaire) were recorded. In mice, saracatinib did not affect habitual ethanol seeking or consumption at either time point. In human participants, no significant effects of saracatinib on alcohol craving or consumption were identified. These results in mice and humans suggest that Fyn kinase inhibition using saracatinib, at the doses tested here, may not reduce alcohol consumption or craving/seeking among those habitually consuming alcohol, in contrast to reports of positive effects of saracatinib in individuals that seek ethanol in a goal-directed manner. Nevertheless, future studies should confirm these negative findings using additional doses and schedules of saracatinib administration.

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          Estimating the Dimension of a Model

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            The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

            Summary Background Alcohol and drug use can have negative consequences on the health, economy, productivity, and social aspects of communities. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to calculate global and regional estimates of the prevalence of alcohol, amphetamine, cannabis, cocaine, and opioid dependence, and to estimate global disease burden attributable to alcohol and drug use between 1990 and 2016, and for 195 countries and territories within 21 regions, and within seven super-regions. We also aimed to examine the association between disease burden and Socio-demographic Index (SDI) quintiles. Methods We searched PubMed, EMBASE, and PsycINFO databases for original epidemiological studies on alcohol and drug use published between Jan 1, 1980, and Sept 7, 2016, with out language restrictions, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to estimate population-level prevalence of substance use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990–2016. We also used a comparative assessment approach to estimate burden attributable to alcohol and drug use as risk factors for other health outcomes. Findings Globally, alcohol use disorders were the most prevalent of all substance use disorders, with 100·4 million estimated cases in 2016 (age-standardised prevalence 1320·8 cases per 100 000 people, 95% uncertainty interval [95% UI] 1181·2–1468·0). The most common drug use disorders were cannabis dependence (22·1 million cases; age-standardised prevalence 289·7 cases per 100 000 people, 95% UI 248·9–339·1) and opioid dependence (26·8 million cases; age-standardised prevalence 353·0 cases per 100 000 people, 309·9–405·9). Globally, in 2016, 99·2 million DALYs (95% UI 88·3–111·2) and 4·2% of all DALYs (3·7–4·6) were attributable to alcohol use, and 31·8 million DALYs (27·4–36·6) and 1·3% of all DALYs (1·2–1·5) were attributable to drug use as a risk factor. The burden of disease attributable to alcohol and drug use varied substantially across geographical locations, and much of this burden was due to the effect of substance use on other health outcomes. Contrasting patterns were observed for the association between total alcohol and drug-attributable burden and SDI: alcohol-attributable burden was highest in countries with a low SDI and middle-high middle SDI, whereas the burden due to drugs increased with higher S DI level. Interpretation Alcohol and drug use are important contributors to global disease burden. Effective interventions should be scaled up to prevent and reduce substance use disease burden. Funding Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.
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              Assessment of Alcohol Withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)

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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                31 August 2021
                2021
                : 12
                : 709559
                Affiliations
                [1] 1Department of Psychiatry, Yale University School of Medicine , New Haven, CT, United States
                [2] 2Interdepartmental Neuroscience Program, Yale University Graduate School of Arts and Sciences , New Haven, CT, United States
                [3] 3Program in Addiction Medicine, Department of Internal Medicine, Yale University School of Medicine , New Haven, CT, United States
                [4] 4Department of Biostatistics, Yale University School of Public Health , New Haven, CT, United States
                [5] 5Department of Neuroscience, Yale University School of Medicine , New Haven, CT, United States
                [6] 6Department of Psychology, Yale University , New Haven, CT, United States
                Author notes

                Edited by: Nevena V. Radonjic, Upstate Medical University, United States

                Reviewed by: Anh Dzung Le, Centre for Addiction and Mental Health (CAMH), Canada; John J. Woodward, Medical University of South Carolina, United States; Nathan James Marchant, VU University Medical Center, Netherlands; Jonathan Covault, University of Connecticut Health Center, United States

                *Correspondence: Summer L. Thompson summer.thompson@ 123456yale.edu

                This article was submitted to Psychopharmacology, a section of the journal Frontiers in Psychiatry

                †These authors share senior authorship

                Article
                10.3389/fpsyt.2021.709559
                8438169
                30f5499e-8a7d-40a6-9991-b9c4d2f56971
                Copyright © 2021 Thompson, Gianessi, O'Malley, Cavallo, Shi, Tetrault, DeMartini, Gueorguieva, Pittman, Krystal, Taylor and Krishnan-Sarin.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 14 May 2021
                : 03 August 2021
                Page count
                Figures: 2, Tables: 1, Equations: 0, References: 73, Pages: 12, Words: 9809
                Funding
                Funded by: National Institute on Alcohol Abuse and Alcoholism 10.13039/100000027
                Funded by: National Institute of Mental Health 10.13039/100000025
                Funded by: State of Connecticut Department of Mental Health and Addiction Services 10.13039/100004823
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                saracatinib,azd0530,fyn kinase,alcohol use disorders,alcohol habit,nmda receptor,glutamate,am404

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