Early onset of parturition induced by acute alcohol exposure in C57BL/6J mice: role of uterine PGE and PGF2alpha

These studies were designed to determine the effect of acute alcohol treatment on gestational length and to probe for a mechanism underlying alcohol-induced early onset of parturition (EOP) in mice. Experiment 1: alcohol increases the incidence of EOP. Pregnant C57BL/6J mice were given alcohol (0, 4, 5 or 6 g kg(-1), i.g.) on Gestational Day (GD) 10, 15, 16, 17 or 18. Deliveries were monitored every 6 h from GD 18. Results indicated that 6 g kg(-1) alcohol treatment on GD 17 or 18 increased the incidence of EOP. Experiment 2: prostaglandins (PGs) play roles in parturition. The purpose of Experiment 2 was to determine whether PGs mediate alcohol-induced EOP in mice. The results indicated that pretreatment on GD 17 with aspirin, a prostaglandin synthesis inhibitor, prevented alcohol-induced EOP. These data suggest that alcohol-induced EOP in mice may be mediated by PGs. Experiment 3: PGs are influenced by alcohol and are triggers of labour. Experiment 3 measured uterine PGs associated with the onset of alcohol-induced EOP in mice. Alcohol increased uterine PGE and PGF2alpha, with PGE levels higher than control before labour, and elevated PGF2alpha levels correlating with labour. Changes in gestational length have important implications for pregnancy outcome, as well as for normal fetal growth and development.

Ethanol and parturition: a role for prostaglandins

A common pattern of birth defects was reported in children born to alcoholic women over 20 years ago. Shortly thereafter the constellation of defects became known as the Fetal Alcohol Syndrome, and reports from around the world served to acknowledge the pervasiveness of the disorder. Simultaneously with the clinical reports, animal models were developed to characterize the full spectrum of the teratogenic effects of ethanol. Not only did these animal models serve to define the actions of ethanol on fetal growth and development at the molecular pharmacological, neuroanatomical, and behavioral level, but unintentionally, they have resulted in renewed scientific interest in the effects of ethanol on pregnancy and parturition itself. The purpose of this review is twofold. First we will consolidate and summarize data from both clinical and basic research that pertains to ethanol and parturition. These data will demonstrate that ethanol consumption during pregnancy results in both delayed as well as premature delivery depending upon the pattern of consumption and timing of exposure. With these data as a background, the second objective will be to present a theoretical case for prostaglandins as possible mediators of ethanol-induced effects on the onset of parturition.

Teratogenic actions of ethanol in the mouse: a minireview

The deleterious effects of prenatal ethanol exposure have been extensively documented in clinical and experimental studies. This paper provides an overview of work conducted with mice to examine the myriad of adverse consequences that result from embryonic/fetal exposure to ethanol. All of the hallmark features of the clinical fetal alcohol syndrome have been demonstrated in mice, including prenatal and postnatal growth retardation, structural malformations and behavioral abnormalities associated with central nervous system dysfunction. As expected, the severity and profile of effects is related to both dosage level and timing of exposure. In addition, these effects have been demonstrated following acute and chronic exposure, with a variety of routes of administration employed. Furthermore, a number of strains have been used in these studies and the variant response (susceptibility) to the teratogenic actions of ethanol exhibited among different mouse strains support the notion that genetic factors govern, at least in part, vulnerability to these effects of ethanol. More recent studies using mouse models have focused on examining potential mechanisms underlying the full spectrum of ethanol's teratogenic actions.

Increase in vasoactive prostaglandin E production after perfusion in human placental cotyledons

Studies from our laboratory indicate that prostaglandins may be mediators of at least some of the teratogenic actions of ethanol in both mouse and human tissue model systems. The present studies were designed to evaluate the relationship between ethanol and prostaglandin E (PGE) production in isolated human placental cotyledons. Placentas were obtained immediately after cesarean section delivery. A fetal artery supplying a single cotyledon was identified and cannulated, and the isolated cotyledon was placed in a perfusion chamber where maternal circulation was established and dual circulation continued throughout the perfusion procedure. Antipyrine clearance, oxygen consumption, and placental production of human chorionic gonadotropin were measured to verify tissue viability. PGE levels of the perfusate were measured by radioimmunoassay. Study 1 evaluates the effect of perfusion with 25 and 100 mM ethanol on placental PGE production. It was found that PGE production increased after perfusion with 25 mM ethanol, but not during the perfusion period per se. The paradigm for study 2 was identical to that of study 1, with the addition of a buffer washout period after 100-mM ethanol perfusion. Again, results indicate that perfusate PGE levels were increased in the buffer washout periods after the 25-mM and the 100-mM ethanol perfusions. The effect was not concentration dependent. An increase in circulating PGE associated with ethanol administration may be teratogenic actions and represent a potential mechanism underlying at least some aspects of fetal alcohol syndrome.

Effect of acute ethanol and cocaine administration on gestation days 14-17 in mice

The teratogenic effects of the coadministration of alcohol and cocaine on gestation days 14-17 were investigated using an acute exposure model. Pregnant C57BL/6J mice were assigned randomly to treatment groups generated from a 2 (0 or 6 g/kg alcohol) x 2 (0 or 60 mg/kg cocaine) x 4 (day of treatment) factorial design. An untreated control group was also employed. On GD14, 15, 16, or 17, females were intubated with alcohol or an isocaloric solution and injected (SC) 10 min later with cocaine or saline. Litters were evaluated on GD19 following cesarean delivery. A significant number of females in the alcohol-only group treated on GD16 or GD17 delivered litters prior to GD19. The results indicated that, in general, prenatal alcohol exposure was associated with decreased fetal body weight and suggested a possible increase in malformations of vascular origin. Cocaine and the alcohol/cocaine interaction did not affect the outcome variables in any reliable manner. Thus, with the animal model employed, cocaine did not exert teratogenic effects on its own nor did it influence alcohol-induced teratogenesis.

Cocaine does not affect prostacyclin, thromboxane or prostaglandin E production in human umbilical veins

Vasoactive prostaglandins have been reported to mediate umbilical/placental blood flow in humans. Since it has been suggested that cocaine exerts its teratogenic action via vasoconstriction and a corresponding reduction in blood flow, it is reasonable to hypothesize that cocaine influences the vasoactive prostaglandins such that blood flow would be affected. The purpose of this study, therefore, was to determine the effects of cocaine on the vasoactive prostaglandins prostacyclin, thromboxane, and prostaglandin E, using human umbilical veins. Prostacyclin (PGI2), thromboxane (TXA2), and prostaglandin E (PGE) levels were measured from human umbilical veins collected at term. The veins were perfused in a closed system with either a 50 micrograms/ml, a 100 micrograms/ml, a 200 micrograms/ml, or a 400 micrograms/ml cocaine solution for 60 min, and the prostaglandins were measured by radioimmunoassay of their stable metabolites. Data were analyzed by ANOVA, and post-hoc analyses were performed by Fisher's Protected Least Significant Difference Test. Cocaine did not influence PGI2, TXA2, or PGE production (Ps > 0.05) in this series of studies. Thus, contraction of human umbilical vessels and decreased blood flow in human umbilical vessels does not appear to be mediated by changes in the vasoactive prostaglandins.

Alcohol treatment: measurement of effectiveness by global outcome

Traditional methods of data analysis in alcohol studies focus only on alcohol consumption as dependent variables rather than considering a global, person-in-environment perspective. The purpose of this study was to evaluate treatment outcome in a clinical trial using dimensions of life functioning in addition to quantity-frequency measures of alcohol use. Subjects were male veterans suffering from high levels of anxiety in addition to alcohol dependence who were randomly assigned to treatment with a placebo or buspirone. Results show that global outcome measures did not reveal differences from standard treatment outcome measures in this study. All of those subjects who were drinking heavily, and most of those drinking moderately, were experiencing life problems. However, studies with other designs and with larger sample sizes are needed.

Acute gestational cocaine exposure alone or in combination with low-dose ethanol does not influence prenatal mortality or fetal weight in mice

The teratogenic effects of cocaine and ethanol were investigated using an acute treatment model of C57BL/6J mice treated on gestation day 15 (GD15) with evaluation on GD17. Females were intubated once with a subteratogenic dose of ethanol (0 or 4 g/kg) and injected subcutaneously twice, 1 h apart, with equal doses of cocaine HCl (0 or 60 mg/kg), for a final daily dose of 120 mg/kg. The first cocaine injection followed ethanol by 10 min. Blood ethanol levels (BEL) and plasma cocaine levels were determined, and pair-feeding was employed. The results revealed no group differences on pregnancy outcome. That is, maternal weight gain, total number of implants, prenatal mortality, and fetal body weight were not statistically different. No significant differences in BEL or plasma cocaine levels were found among the various treatment groups. These results suggest that, under these conditions, relatively high levels of cocaine (120 mg/kg, SC), given alone or in combination with subteratogenic doses of ethanol late in pregnancy, are not teratogenic in mice.

Features of cocaine dependence with concurrent alcohol abuse

In order to assess differences between cocaine dependence alone and cocaine dependence complicated by alcohol abuse, 34 subjects who met DSM-III-R criteria for alcohol abuse and cocaine dependence (COC-ETOH group) were compared with 39 subjects who met criteria for cocaine dependence only (COC-only group) with regard to demographics, substance use, and psychopathology. There were no differences between groups in age, race, employment or socio-economic status. The baseline depression and global severity scores in the COC-ETOH group were significantly higher than in the COC-only group. The COC-ETOH group was significantly more likely to experience a paranoid psychosis with cocaine use and significantly more likely to have abused additional substances in the month prior to study entry. The COC-ETOH group also attended significantly fewer medication management sessions during the 12-week trial. There were no differences between groups in the type or frequency of Axis 1 or Axis II disorders.

Effect of ethanol on prostacyclin, thromboxane, and prostaglandin E production in human umbilical veins

The purpose of this study was to determine the effects of ethanol on prostacyclin (PGI2), prostaglandin E (PGE), and thromboxane (TXA2) production in perfused human umbilical veins. PGI2, PGE, and TXA2 levels were measured from human umbilical veins perfused with either 25, 50, or 100 mM ethanol by radioimmunoassay of their stable metabolites. Alcohol content was measured by an enzymatic spectrophotometric assay. Data were analyzed by ANOVA and Fisher's Protected Least Significant Difference Test. Ethanol decreased PGI2 production in a concentration-dependent manner (p < 0.05). In a concentration of 25 mM, ethanol did not affect PGI2 production, whereas 50 mM decreased levels after 60 min of perfusion (p < 0.01). With 100 mM ethanol, PGI2 production was decreased after 15, 30, and 60 min of perfusion (ps < 0.05), and the TXA2/PGI2 ratio was significantly elevated at all time points (p < 0.01). Ethanol (100 mM) did not affect TXA2 or PGE production. Reduction of PGI2 levels and the increase in the TXA2/PGI2 ratio seen after ethanol perfusion in umbilical veins may cause vascular disruption in the umbilical-placental circulation. This may, in part, be a contributing mechanism to the teratogenic effects of ethanol.

Issues in the development of subject recruitment strategies and eligibility criteria in multisite trials of matching

Decision-making in selecting and recruiting subjects for treatment matching research is a complex process involving conceptual, methodological and practical considerations. In selecting clients, concerns arise about whether the criteria will produce a subject population that is (1) relevant to the dimensions associated with the treatment matching, (2) representative of persons typically seen in alcohol treatment settings and, for practical purposes, (3) able or willing to comply with the requirements of the study protocol. Also, in order to fulfill sampling requirements, it may be necessary to employ a variety of creative outreach methods. However, these recruitment mechanisms can pose additional logistical and methodological problems for the research. This article focuses on various issues arising in the selection and recruitment of subjects in matching research. Project MATCH serves to highlight issues related to client eligibility and recruitment and to discuss effective strategies for resolving these matters.

Multisite clinical trials in alcoholism treatment research: organizational, methodological and management issues

Multisite clinical trials have two major advantages over single-site studies: the large sample size of multisite studies allows for adequate statistical power and better representativeness of the population being studied. However, they are more complex to implement than single-site studies. This article reviews previous multisite clinical trials of alcohol abuse and alcoholism, reasons for selecting a multisite design, management of such studies, and some statistical issues.

Issues in the definition and measurement of drinking outcomes in alcoholism treatment research

This article reviews methodological and conceptual issues regarding the choice of drinking outcome measures in alcoholism treatment research. The following issues are discussed: Should drinking outcomes be conceptualized in terms of an underlying unitary disorder, or should provision be made for independent outcomes that cover a wide variety of dimensions? Which drinking outcomes are typically measured in treatment evaluation studies and how are they operationalized? What are the empirical associations among drinking outcome measures? If multiple outcomes are measured, which should be given primary importance? Over what period of time should treatment outcome be evaluated? What procedures can be used to detect, correct or prevent the response bias associated with verbal report methods? Because outcome measures need to fit the hypotheses and practical needs of a particular study, it is unlikely that complete standardization can be achieved across all studies. Nevertheless, given the importance of drinking outcomes and the need for economy, two primary dependent measures are recommended: (1) proportion of available drinking days abstinent; and (2) intensity of drinking, as defined by the total amount consumed (in ounces absolute alcohol) during the follow-up period divided by the number of actual drinking days. This article also proposes a strategy that may help to guide the selection of outcome measures in future research.

Cocaine does not influence the teratogenic effects of acute ethanol in mice

The teratogenic effects of the coadministration of alcohol (ethanol) and cocaine to pregnant C57BL/6J mice were investigated using an acute treatment model on gestation day 10 (GD10). The day of mating was designated as GD1. Pregnant mice were assigned to treatment groups generated from a 3(0, 4, 6 g/kg alcohol) x 3 (0, 40, 60 mg/kg cocaine) factorial design to explore possible interactive effects of these commonly abused drugs. Females were treated on GD10 (alcohol gavage followed by SC cocaine injection) and their litters were evaluated on GD19 by cesarean delivery. Two additional free-fed groups, as well as a pair-fed group, were employed. Food and water intake was recorded in treated groups. Results indicated that only the high dose alcohol produced a significant decrease in fetal body weight and a significant elevation of the incidence of kidney and limb malformations. These effects could not be attributed to restricted food intake. Cocaine was not found to produce any significant perturbations of development, either alone or in combination with alcohol. These results suggest that acute prenatal cocaine exposure on GD10 does not produce teratogenic effects when administered alone or in combination with acute alcohol in C57BL/6J mice, at least under the present experimental conditions.

Effects of prenatal ethanol exposure on later sensitivity to the low-dose stimulant actions of ethanol in mouse offspring: possible role of catecholamines

The purpose of this study was to examine whether prenatal ethanol (EtOH) exposure alters later sensitivity to the low-dose stimulant effects of EtOH. Because the locomotor stimulant effects of EtOH are thought to be mediated, at least in part, by activation of brain monoamine systems, and because prenatal EtOH exposure has been shown to alter brain monoamine activity, it was hypothesized that prenatal EtOH exposure may alter sensitivity to the stimulant actions of EtOH. To test this hypothesis, sensitivity to the locomotor stimulant effects of various challenge doses of EtOH was examined in male and female offspring from prenatal alcohol (A), pair-fed (PF), and lab chow (LC) groups at different ages. In addition, to address the hypothesis further, sensitivity to the catecholamine synthesis inhibitor alpha-methyl-p-tyrosine (AMPT) was examined in these offspring, as well. Results indicated that male offspring prenatally exposed to EtOH exhibited reduced baseline activity and a blunted stimulant response to all challenge doses of EtOH (0.75-1.5 g/kg) in comparison with control offspring at 30 days of age, but these effects appeared to "normalize" at 70 days of age. Female EtOH-exposed offspring also exhibited a reduced baseline level of activity relative to control offspring, as well as a blunted stimulant response to the lowest challenge dose of EtOH (0.75 g/kg) at 30 days of age, and these effects persisted into adulthood. The stimulant response to higher doses of EtOH did not significantly differ among prenatal treatment groups in young or adult female offspring. However, because baseline activity was significantly lower in female EtOH-exposed offspring than control offspring, the stimulant response to these doses of EtOH (1.125 and 1.5 g/kg) was relatively greater than that for PF and LC offspring. Importantly, none of the differences in performance among the prenatal treatment groups could be attributed to an alteration in EtOH pharmacokinetics, because blood EtOH levels measured immediately following the 10-min test session were similar for all prenatal treatment groups across all of the EtOH test doses. Further, a similar response profile as that observed following EtOH challenge at 70 days of age was obtained following phenobarbital challenge (10-40 mg/kg). Finally, whereas AMPT (50-400 mg/kg) dose-dependently antagonized the stimulant effects of EtOH in all prenatal treatment groups, this effect of AMPT was significantly greater in mice prenatally exposed to EtOH in comparison with control offspring.(ABSTRACT TRUNCATED AT 400 WORDS)

A placebo-controlled trial of buspirone in anxious inpatient alcoholics

The present study is a double-blind control trial of buspirone versus placebo in highly anxious alcoholics who recently completed inpatient detoxification for alcoholism. Subjects met DSM-III-R criteria for generalized anxiety syndrome and/or other nonpanic forms of anxiety disorders and alcohol dependence. Male veterans aged 21 to 65 were randomized to 45 to 60 mg/day of buspirone (n = 33) or placebo (n = 34). Anxiety scores, as measured by the Hamilton Anxiety Scale and other anxiety measures, declined significantly for both groups, but there were no differential group differences throughout the 6-month treatment period. Survival analysis measuring time to study drop out, time to first drink, time to 5 consecutive drinking days, and time to first intoxication indicated no significant differences between groups. The number of standard drinks per drinking day for nonabstainers also did not differ between groups. In the present study anxious alcoholics taking buspirone did not receive any benefit over placebo on a number of anxiety and alcohol use measures.

Aspirin pretreatment reduces ethanol withdrawal severity in a mouse model of binge drinking

Nonsteroidal antiinflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and indomethacin, which inhibit prostaglandin (PG) synthesis, have a pronounced effect on a broad range of ethanol (EtOH) actions. Given this, it is somewhat surprising that NSAID treatment has not been found to alter major signs of ethanol withdrawal. To date, the only effect found has been indirect, that is, NSAID treatment reduces the efficacy of PG precursor administration in the treatment of ethanol withdrawal via the inhibition of PG formation. However, in those studies reporting negative results NSAID administration was delayed until EtOH withdrawal. Studies demonstrating NSAID-related attenuation of other actions of EtOH have typically employed a pretreatment paradigm in which NSAIDs are administered prior to, not after, ethanol exposure. Thus, it may be that the point in the ethanol exposure/withdrawal episode at which NSAIDs are administered could be crucial in determining their effects of the ethanol withdrawal syndrome. To address this issue, we employed a multiple-exposure "binge drinking" model. On each of 6 treatment days, male BALB/c mice were injected subcutaneously with either acetylsalicylic acid (ASA, 150 mg/kg) or the buffer vehicle, followed 1 h later by either ethanol (4.0 g/kg) or saline (0.9%) by gavage. Ethanol withdrawal severity, as measured by handling-induced convulsions, was determined 2, 4, 6, 8, 10, 12, and 24 h after EtOH gavage. ASA pretreatment was found to significantly reduce handling-induced convulsions in ethanol-intubated animals. In fact, the attenuation was of such a magnitude that the ASA-pretreated ethanol group did not significantly differ in withdrawal severity from non-ethanol-exposed controls. This effect was not likely due to ASA-related alterations in ethanol pharmacokinetics. These findings have relevance for the understanding of the basic mechanisms underlying ethanol dependence, as well as the potential role of PGs in this phenomenon.

Hypogastric arterial-vaginal fistula following multiple surgeries and pelvic radiotherapy

A patient with recurrent sigmoid colon cancer developed an arterial-vaginal fistula after multiple surgeries and postoperative radiotherapy. Angiography revealed a fistula between the hypogastric artery and vaginal wall. Gelfoam and coil embolization controlled the hemorrhage and she recovered without incident. This case illustrates development of malignant fistula and intervention with embolization in a patient with multiple surgeries and postoperative irradiation in the pelvis.

The effect of prenatal ethanol exposure on scentmarking in the C57BL/6J and C3H/He mouse strains

In utero exposure to ethanol has been shown to alter sexually dimorphic behaviors in rats. However, it is not clear whether this phenomenon is robust in other species, such as the mouse, which is sensitive to ethanol-induced birth defects. Further, it is not known whether significant differences exist across murine strains. If similar to the classic teratogenic effects of ethanol, it would be expected that strain differences in sensitivity should be evident, with some strains demonstrating an alteration in sexually dimorphic behavior and other strains demonstrating little or no effect. As a first attempt to address these issues, we have examined two mouse strains widely used in prenatal alcohol research, the inbred C3H/He and C57BL/6J strains. Scentmarking was selected as the behavior of interest. It is robustly sexually dimorphic in the rat and mouse, with males marking more than females and preliminary reports have demonstrated that in utero ethanol exposure reduces this behavior in the male rat. In the mouse strains selected for study, pregnant females were provided with either a liquid diet consisting of 25% ethanol-derived calories or pair-fed an isocaloric liquid diet from gestation days 6-18. An additional control group was included which was fed laboratory chow ad lib throughout gestation. Male and female offspring of each strain were tested for scentmarking at 65-75 days of age. As expected, results showed that the effect of prenatal ethanol exposure on scentmarking varied with both strain and sex. In the C3H/He strain, scentmarking was reduced significantly in male ethanol-exposed offspring (i.e., the males were feminized).(ABSTRACT TRUNCATED AT 250 WORDS)

Aspirin dose-dependently reduces alcohol-induced birth defects and prostaglandin E levels in mice

The purpose of the present study was threefold. The first purpose was to determine if aspirin (ASA) decreases alcohol-induced birth defects in mice in a dose-dependent fashion. The second purpose was to see if the antagonism of alcohol-induced birth defects afforded by ASA pretreatment was related to dose-dependent decreases in prostaglandin E (PGE) levels in uterine/embryo tissue. The third purpose was to determine if ASA pretreatment altered maternal blood alcohol level. In experiments 1 and 2, pregnant C57BL/6J mice were administered ASA (0, 18.75, 37.5, 75, 150, or 300 mg/kg) on gestation day 10. One hour following the subcutaneous injection of ASA, mice received alcohol (5.8 g/kg) or an isocaloric sucrose solution intragastrically. In experiment 1 the incidence of birth defects was assessed in fetuses delivered by caesarean section on gestation day 19. In experiment 2 uterine/embryo tissue samples were collected on gestation day 10 1 hr following alcohol intubation for subsequent PGE analysis. In experiment 3 blood samples were taken at five time points following alcohol intubation from separate groups of alcohol-treated pregnant mice pretreated with 150 mg/kg ASA or vehicle. The results from the three experiments indicated that 1) ASA dose-dependently reduced the frequency of alcohol-induced birth defects in fetuses examined at gestation day 19, (2) ASA decreased the levels of PGE in gestation day 10 uterine/embryo tissue in a similar dose-dependent fashion, and 3) ASA pretreatment did not significantly influence maternal blood alcohol levels. These results provide additional support for the hypothesis that PGs may play an important role in mediating the teratogenic actions of alcohol.

Effect of ibuprofen on alcohol-induced teratogenesis in mice

The purpose of the present study was to examine the effect of the prostaglandin synthetase inhibitor ibuprofen (IBU) on the teratogenic actions of alcohol. On day 10 of pregnancy, C57BL/6J mice were injected subcutaneously with 25 mg/kg IBU or vehicle control. One hour later, the mice were intubated with 5.8 g/kg alcohol or an isocaloric control solution. A group injected subcutaneously with 150 mg/kg aspirin, followed by 5.8 g/kg alcohol 1 hr later, served as a positive control. The results showed that maternal alcohol treatment resulted in significantly decreased fetal weight and an increased number of fetuses with limb and kidney defects. Implantation sites and prenatal mortality were not affected. IBU did not have any effect on these dependent variables. IBU statistically antagonized the teratogenic effects of alcohol on fetal weight and dysmorphology. These effects, however, were not as marked as in the Aspirin-Alcohol positive control group. These results are discussed in the context of clarifying the role of prostaglandins in the etiology of alcohol-induced birth defects.

Increased severity of alcohol withdrawal in in-patient alcoholics with a co-existing anxiety diagnosis

The purpose of this study was to determine whether alcoholics with a co-existing anxiety disorder (dual-diagnosed group) experienced different withdrawal symptomatology from alcoholics without an anxiety disorder (alcohol-only group). Symptoms of alcohol withdrawal were measured on admission to an in-patient treatment program and throughout treatment (days 0, 2, 7, 14 and 21) using the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. The dual-diagnosed group exhibited more severe alcohol withdrawal, as indicated by higher total CIWA-Ar scores, at all time points than the alcohol-only group. The possibility that anxiety disorders and alcohol withdrawal share a common neurochemical basis and that the CIWA-Ar scale may be useful as a screening instrument for anxiety disorders in alcoholics is discussed.

Symptoms of anxiety in inpatient alcoholics with and without DSM-III-R anxiety diagnoses

Self- and observer-rating scales were administered to alcohol-dependent inpatients during acute withdrawal and regularly for 3 weeks. Following a structured diagnostic interview (SCID) at the end of the 3rd week of hospitalization, subjects were divided into two groups: a dual-diagnosed group (alcohol dependence and anxiety disorder) and an alcohol-only group (no other current Axis I diagnosis). The results demonstrated that the dual-diagnosed subjects experienced higher anxiety levels during and after acute alcohol withdrawal. All rating scales (i.e., Sheehan Patient Rated Anxiety Scale, Spielberger State Anxiety Inventory, Zung Rating Scale for Anxiety, and Hamilton Rating Scale for Anxiety) were analyzed to obtain the best combination of sensitivity and specificity. Taken together, the results indicate that it may be possible to identify alcoholics who require additional psychiatric evaluation early in treatment. This would allow a treatment plan which could be used to address both psychiatric and substance abuse problems.

Psychosocial and psychopathology differences in hospitalized male and female cocaine abusers: a retrospective chart review

While considerable amounts of psychological and pharmacological data have been collected on male substance abusers in public treatment facilities, relatively little information is available about the psychosocial characteristics of men in private treatment settings and of women presenting for substance abuse treatment. The present study reviewed the records of 100 male and female cocaine abusers admitted to a private substance abuse treatment program between 1987 and 1989. Patterns of cocaine use and levels of impairment were found to be similar for men and women, with male cocaine abusers more likely to abuse additional substances. Male cocaine abusers were employed more frequently than women and held higher status jobs despite equivalent levels of education. Female cocaine abusers were more likely to be diagnosed with concurrent psychiatric disorders and were more likely to report family histories of substance abuse. Both groups produced elevations on MMPI scales indicating depression, anxiety, paranoid features, and acting-out tendencies. These data suggest that while male and female cocaine abusers show similarities on some measures, there are significant gender differences that may have implications for both research and treatment.

Perspectives on the pathophysiology of fetal alcohol syndrome

Fetal alcohol syndrome (FAS) is a major known cause of fetal malformations and mental retardation. Prevention/intervention of FAS can only be achieved with identification of the mechanisms by which alcohol induces birth defects. The purpose of this paper is to discuss the data on possible mechanisms of FAS, and to give a number of suggestions for future research areas.

Ethanol increases PGE and thromboxane production in mouse pregnant uterine tissue

The teratogenic effect of ethanol in the C57BL/6J mouse can be attenuated by pretreatment with aspirin (ASA). One prominent effect of ASA is to inhibit prostaglandin (PGE) and thromboxane (TXB2) production. We examined the effect of in vivo ethanol exposure on PGE and TXB2 production in a uterine-embryo tissue sample of C57BL/6J mice either before or after in vivo ASA pretreatment on day 10 of gestation. Ethanol increased both PGE and TXB2 production by approximately 20%. ASA caused a marked reduction of PGE and TXB2 in both control and ethanol groups by approximately 80-90%. The mouse strain, gestation time, and study parameters used in this study were the same as in the previously reported ASA attenuation of the teratogenic effect of ethanol. Therefore, the present data add additional support to the hypothesis that prostaglandin and/or thromboxane production may be involved in at least some aspects of fetal alcohol syndrome.

Effects of prenatal ethanol exposure in C57BL mice on locomotor activity and passive avoidance behavior

The purpose of this study was to examine the long-term behavioral effects of prenatal ethanol exposure in C57BL mice. Pregnant mice received free access to a liquid diet containing 25% ethanol-derived calories (EDC) from gestation days 6 to 18. Control animals were pair-fed an isocaloric 0% EDC diet during the same period of time. An additional control group was included that was maintained on standard lab chow and water throughout pregnancy. At 30 days of age, female offspring were tested for spontaneous locomotor activity in an open field under two lighting conditions (dim or bright illumination). Male offspring were tested in a passive avoidance task at 25 days of age. The activity results demonstrated that the 25% EDC female progeny were more active than controls. This hyperactivity was observed under both lighting conditions, despite the fact that all groups evidenced suppressed activity when tested under bright lights. With regard to passive avoidance behavior, male EtOH-exposed offspring required a greater number of trials to reach criterion than controls. Additionally, they exhibited shorter latencies to enter the shock-associated chamber after receiving a single shock. Taken together, these results confirm our previous findings and demonstrate that C57BL mice are sensitive to both the deleterious behavioral and morphological consequences of prenatal ethanol exposure.

PGE measurement in mouse embryos and uterine/embryo tissue

Embryonic tissue of rodents and other species has been reported to produce prostaglandins (PG) of the E series during gestation. We attempted to establish the presence of PGE in C57BL/6J mouse embryos and peri-embryonic tissue as an initial step in examining the role of maternal ethanol treatment on PG production. Gestation day 10 embryos were found not to produce or degrade PGE. However, a tissue complex which included embryonic tissue, peri-embryonic membranes, placenta and uterus was capable of producing PGE from both endogenous and exogenous arachidonic acid. Furthermore, in vivo and in vitro aspirin was able to suppress PGE production from this tissue. It is concluded that gestation day 10 C57BL/6J mouse embryonic tissue, unlike that of rat, is not capable of measurable PGE production. However, uterine and peri-embryonic tissues, needed to support pregnancy, are capable of significant PGE production.

Role of alcohol-induced hypothermia in mediating the teratogenic effects of alcohol in C57BL/6J mice

The purpose of this study was to determine the role of alcohol-induced maternal hypothermia in the teratogenic actions of alcohol. C57BL/6J mice were administered an acute dose of alcohol (5.8 g/kg orally) or isocaloric sucrose on day 10 of gestation. One half of each group was placed for 6 hr in an incubator set at 32 degrees C and the other half was housed in the incubator at room temperature (22 degrees C). As expected, acute prenatal alcohol exposure at this time of gestation was associated with decreased birth weight and an increase in limb and kidney malformations. The significant alcohol x environmental temperature interaction on these dependent variables indicated that the teratogenic insult was not attenuated, but was in fact even greater for the 32 degrees C/alcohol group. An absence of a main effect of environmental temperature indicated that the 32 degrees C environment, per se, was not teratogenic. Thus, maternal hypothermia is probably not an etiological factor in animal models of fetal alcohol syndrome. Moreover, antagonism of alcohol-induced maternal hypothermia exacerbates the teratogenic actions of alcohol observed at room temperature.

Effect of prenatal ethanol exposure on response to abrupt reward reduction

The purpose of this study was to examine the effects of prenatal ethanol exposure on an appetitively-motivated behavioral task (consummatory negative contrast) that involves quantification of an animal's response to an abrupt, unexpected reduction in reward (sucrose solutions). Pregnant Long-Evans rats received isocaloric liquid diets containing either 35% or 0% ethanol-derived calories on days 6-20 of gestation. A pair-feeding procedure was employed, and a lab chow control group also was included. Adult male offspring from these three prenatal treatment groups were used for behavioral testing. Results indicated all groups exhibited suppressed responding subsequent to reward reduction. This effect gradually diminished in all prenatal treatment groups over several test sessions. While there was a numerical tendency for ethanol-exposed offspring to exhibit a smaller initial contrast effect (less response inhibition) and recover to control levels at a faster rate than the sucrose and lab chow control groups, this effect was not statistically significant. Thus, prenatal ethanol exposure does not appear to greatly influence the response to abrupt, partial reward reduction in adult rat offspring.

Prenatal ethanol exposure in C57 mice: effects on pregnancy and offspring development

Pregnant mice were fed lab chow or isocaloric liquid diets containing different concentrations of ethanol or sucrose from Day 5 through Day 17 of gestation. Ethanol added to the diet reduced ad lib consumption compared to that of the diet with sucrose. The reduced consumption was accompanied by an attenuated weight gain during pregnancy. The attenuated weight gain, however, was not specific to alcohol as evidenced by an equivalent attenuation for sucrose controls pair-fed to the ethanol group. Prenatal ethanol exposure increased neonatal mortality which appeared to be unrelated to the prenatal attenuated weight gain or to postnatal nurturance. Surviving offspring, reared by their biological mothers, had body weights similar to controls at birth and during lactation. However, in contrast to previous reports, mice prenatally exposed to ethanol manifested weight reductions near weaning that extended into adulthood (60 days). In spite of the increased mortality and reduced body weight, motor activity assessed by either longitudinal or cross-sectional methods was not influenced by the treatments. Possible mechanisms for the delayed weight reduction include retarded maturation and/or dysfunction of neural systems involving food regulation.

Stereotypic wall climbing in mice during ethanol withdrawal: a new measure of physical dependence

A new potentially useful measure for assessing physical dependence in mice chronically exposed to ethanol is described. C3H/He mice continuously exposed to ethanol vapor for four (Experiment 1) or three (Experiment 2) days spent more time engaged in stereotypic climbing behavior than controls. This stereotypic climbing behavior correlated well, both temporally as well as in intensity, with other previously described signs of ethanol withdrawal. All measures of withdrawal behavior (including climbing) peaked at eight hours after withdrawal and returned to control levels by 30-33 hours. The utility of this behavioral assay for assessing physical dependence on ethanol is further discussed with reference to possible underlying neurochemical events.

Effect of indomethacin on alcohol-induced morphological anomalies in mice

The purpose of the present study was 1) to examine the effect of indomethacin (INDO), a prostaglandin synthesis inhibitor, on alcohol-induced growth and morphological impairment in C57BL/6J mice (Study 1) and 2) to determine if INDO crosses the placenta (Study 2). On day 10 of gestation, mice were injected (s.c.) acutely with either 0, 5, 10, or 20 mg/kg INDO, followed one hour later by alcohol (5.8 g/kg orally) or isocaloric sucrose. Fetuses were removed on day 19 of pregnancy, weighed, and examined for anomalous development. As expected, Study 1 demonstrated that maternal alcohol treatment decreased fetal weight and increased the number of fetuses with birth defects. INDO alone decreased fetal weight but did not affect morphologic development. More importantly, INDo antagonized alcohol-induced birth defects, but only at the highest dose. The results of Study 2 suggest that the relative ineffectiveness of INDO may be related to its inability to readily cross the placenta. Since high doses of INDO also caused maternal toxicity, the usefulness of this compound in future studies of this type was questioned.

Stimulatory effects of ethanol in C57BL/6 mice

Although ethanol stimulation is well documented in several species including humans, there is some controversy about whether the stimulation occurs in the highly inbred mouse strain, C57BL/6. Since inbred mouse strains are frequently used to elucidate mechanisms for individual differences in reaction to alcohol, the present study was undertaken to more completely characterize the behavioral effects of ethanol and to help resolve some of the controversy regarding the drug's stimulatory effect on C57 mice. Activity of female C57BL/6cr mice was assessed in either a lighted or dark environment for 20 min after injections of water or ethanol at doses of 0.5, 1.0, 2.0, 4.0 g/kg. Elevated activity (stimulation) was observed in mice injected with relatively low ethanol doses and tested in the light. The 2.0 g/kg dose produced a transient elevation in activity which declined rapidly across time. Animals tested under the dark condition were not stimulated by the drug but had activity reductions to high doses of ethanol. The detection of ethanol-induced stimulation appears to be related to the performance of control mice rather than a light-related difference in ethanol sensitivity.

Two generations of maternal alcohol consumption in mice: effect on pregnancy outcome

This study investigated whether female offspring of alcohol-treated mothers are, themselves, more or less susceptible than control offspring to the deleterious effects of alcohol on the outcome of their own pregnancy. One group of pregnant C57BL mice was fed a liquid diet containing 25% ethanol-derived calories (EDC) and another group was pair-fed an isocaloric (0% EDC) control diet. A third group was fed lab chow ad libitum (LC). The female offspring resulting from those matings were subsequently mated upon reaching 90 days of age. These pregnant mice were then separated into three prenatal treatments (25% EDC, 0% EDC, and LC). On gestation-day 19, second generation fetuses were removed by cesarean section, weighed, and sexed. Results indicated that number of implants, live births, and percent prenatal mortality did not differ between groups. However, fetal weight was lower in groups prenatally exposed to ethanol than in controls, regardless of the prenatal history of the mothers, themselves. More importantly, the data suggest that offspring of alcohol-treated mothers who do not consume alcohol themselves during their own pregnancy may still have a tendency to have offspring of lower birth weight. On the other hand, if mothers prenatally exposed to alcohol do consume alcohol during their own pregnancy, the impact of fetal weight suppression is even greater than expected for in utero alcohol exposure alone. These effects may be due to the fact that mothers who were prenatally exposed to alcohol weighed less than controls at the time of becoming pregnant.(ABSTRACT TRUNCATED AT 250 WORDS)

Central nervous system prostaglandins and ethanol

There is growing interest in the effect of ethanol on cellular membranes, generally, and neuronal membrane systems, in particular. Perturbations of membranes have led to numerous enzymatically mediated processes, one of which is prostaglandin production. This paper reviews the nature and role of prostaglandins in the central nervous system, and what is known about the effect of ethanol on prostaglandin production in brain. Areas of central nervous system physiological function in which prostaglandins may mediate the actions of ethanol are discussed. Methodological considerations and future directions for research in the area of ethanol and prostaglandins are highlighted.

Alcohol, pregnancy, and prostaglandins

Basic scientists and clinicians alike are in agreement that children of alcoholic mothers are at risk for a variety of birth defects. These defects have been labeled fetal alcohol syndrome or, in a milder form, fetal alcohol effects. Prevention or therapeutic intervention of this disorder requires an understanding of the mechanism of action of alcohol on the developing fetus. This paper addresses the possible role of prostaglandins as biochemical mediators of the teratogenic actions of alcohol.

Pre-pregnancy alcohol experience attenuates typical decrease in gestational alcohol consumption in mice

The influence of pre-pregnancy alcohol consumption on alcohol self-selection during pregnancy and lactation was examined in C57BL mice. One group of animals was given a two-bottle choice between water and a 10% w/v ethanol solution for three weeks prior to breeding, throughout pregnancy, and during lactation, while a second group was given the alcohol-water choice beginning on the first day of pregnancy. Relative alcohol intake (g ethanol/kg body weight) as well as alcohol "preference" decreased below pre-pregnancy levels during both pregnancy and lactation. That is, voluntary alcohol consumption was attenuated in pregnant and lactating mice, regardless of strain-typical pre-pregnancy high consumption. However, mice given a choice between alcohol and water prior to pregnancy did not decrease their alcohol consumption during pregnancy as much as mice not given the pre-pregnancy alcohol choice. There was no correlation between pre-pregnancy alcohol consumption and subsequent intake. The mechanism underlying decreased voluntary alcohol consumption during pregnancy remains to be elucidated, but it is clear that prior experience with alcohol influences the phenomenon.

Sensitivity to ethanol in female mice: effects of ovariectomy and strain

Two experiments were conducted to investigate the influence of ovariectomy (OVX) on alcohol sensitivity in mice. In the first experiment, OVX, sham-operated, and nonsurgical control C57BL mice were examined for brain alcohol levels associated with alcohol-induced motor incoordination, alcohol-induced loss of righting reflex, and voluntary alcohol consumption. The second experiment employed four strains of mice (C57BL, C3H, DBA, and Swiss Webster) to evaluate the influence of OVX on alcohol-induced spontaneous activity. Taken together, the results indicated that surgical removal of the ovaries in mice does not influence alcohol-induced motor incoordination, loss of righting reflex, or spontaneous activity. Voluntary alcohol consumption, however, was affected by ovariectomy, since mice in the OVX group consumed less alcohol relative to body weight (g/kg) than controls.

Effects of ethyl alcohol on human peripheral lymphocytes

Chronic alcoholics are more susceptible to infection and have increased incidences of certain types of carcinomas. One explanation for this may be suppressed immune responses secondary to ethyl alcohol consumption. This project was initiated to study the effect of ethyl alcohol on lymphocyte responses in vitro by monitoring tritiated thymidine uptake. Lymphocytes were incubated in the presence of phytohemagglutinin-P, concanavalin A, and pokeweed mitogen. The response of normal lymphocytes was noted after mitogen stimulation in the presence of ethyl alcohol in graded doses. Ethyl alcohol levels greater than or equal to 50 mg/dL suppressed tritiated thymidine uptake of normal lymphocytes for phytohemagglutinin-P and concanavalin A. Since ethyl alcohol exposure in concentrations consistent with blood levels that may be attained during routine ingestion significantly decreased lymphocyte blastogenesis, it is speculated that chronic ethyl alcohol ingestion may alter immune surveillance sufficiently to be responsible in part for the increased incidence of infection and/or neoplasms seen in alcoholic subjects.

Aspirin reduces alcohol-induced prenatal mortality and malformations in mice

Oral alcohol administration (5.8 g/kg) on gestation day 10 resulted in an increase in both prenatal mortality and birth defects as well as decreased fetal weight in C57BL/6J mice. Aspirin pretreatment (150 mg/kg subcutaneously) significantly reduced the number of malformed pups and prevented the increase in prenatal mortality produced by alcohol. The mechanism of action remains to be elucidated.

Adrenalectomy reduces alcohol-stimulated activity: Blood and brain alcohol content

It has been shown that adrenal glucocorticoids have a permissive role in some of the actions of alcohol. To determine if an intact adrenal was necessary for the stimulation of locomotor activity, 24 female C3H mice were tested for open field activity with ethanol or saline. Two weeks after adrenalectomy or sham surgery, animals were tested for activity again with ethanol or saline. One week later, alcohol disappearance curves were generated for blood and brain. Adrenalectomy reduced but did not abolish the alcohol-stimulated locomotor activity. In addition, adrenalectomy significantly reduced estimated peak alcohol levels in blood and brain but significantly reduced the disappearance rate for alcohol only in brain. These data suggest that adrenalectomy significantly changes alcohol distribution, with greater impact on brain alcohol levels than on blood levels, and that this may be responsible, at least in part, for the reduction in stimulated locomotor activity.

Amoxapine elevates serum prolactin in depressed men

It has been suggested that the antidepressant amoxapine might have neuroleptic properties. Clinically, an increase in serum prolactin occurs during neuroleptic treatment secondary to post-synaptic dopamine blockade. Ten men who met DSM-III criteria for major depression exhibited a significant increase in their serum prolactin over drug-free baseline values during treatment with amoxapine. A comparison group of 12 depressed men treated with desipramine showed no such increase. Combined with that of others, our study suggests that amoxapine might have antipsychotic properties and, therefore, be useful in treating conditions where a combined antidepressant and neuroleptic effect is required.

Inhibition of prostaglandin synthesis by indomethacin does not affect alcohol consumption in inbred mice

The prostaglandin system has been implicated in mediating both the acute and chronic pharmacologic effects of alcohol. The effect of blockade of prostaglandin synthesis by indomethacin on genetically based alcohol preference in C57BL/6, C3H/He, and BALB/c mice was examined. Although strain typical alcohol preference patterns were observed, there was no effect of indomethacin on either naive or preestablished alcohol preference and consumption. Genetically transmitted alcohol preference may be a complex system in which prostaglandin synthesis does not play a part.

In vivo regional levels of PGE and thromboxane in mouse brain: effect of decapitation, focused microwave fixation, and indomethacin

A focused microwave fixation technique was tested for use in determining basal PGE and thromboxane B2 levels of mouse brain. Focused microwave irradiation (3.5 Kw/0.4 sec) to the head of C3H mice produced basal values of PGE and TXB2 which were five-fold less than those in animals killed by decapitation. Indomethacin (10 mg/kg) pretreatment blocked the decapitation rise in PGE and TXB2 levels and gave values similar to focused microwave irradiation. Indomethacin pretreatment combined with microwave fixation did not reduce PG levels more than microwave treatment alone. When microwave fixation was used, there was no difference in regional (cerebral cortex, whole cerebellum, midbrain, hypothalamus) levels of either PGE or TXB2. However, PGE levels were significantly higher than TXB2 in all regions. After decapitation there was a greater increase in TXB2 than PGE. The cerebellum produced less PGE and TXB2 after decapitation compared to the other regions. Our results confirm the usefulness of the focused microwave irradiation technique for examining in vivo basal prostaglandin levels in mouse brain.

Alcohol use, negative mood states, and menstrual cycle phases

This study investigated the hypothesis that alcohol consumption patterns among normally menstrually cycling women would be influenced by increased negative mood states and phase of the menstrual cycle. A time-series, within-groups design was used to allow for comparisons among normally cycling women, women maintained on oral contraceptives, and men. Thirty-two adults recorded daily estimates of ongoing behaviors in the areas mentioned for two menstrual cycles or equivalent periods. Radioimmunoassay and temperature data were used to confirm ovulation and to define ovulatory, premenstrual, and menstrual phases. Estimates of anxiety, depression, and hostility were highly intercorrelated, but negative moods were not significantly related to frequency/amount of alcohol consumption. However, normally cycling women reported significantly more negative moods, were frequent drinking to relieve tension/depression, and more frequent solitary drinking at menstruation. These relationships were not observed among oral contraceptive women or men. Collected among psychologically robust, working subjects of high intelligence, these data provide estimates of baseline functioning for future studies exploring the progression of pathological alcohol use patterns among women.

Acute alcohol intoxication, mood states and alcohol metabolism in women and men

The course of alcohol absorption and elimination was investigated in seven women and nine men administered a moderate (0.66 ml/kg) dose of 95% ethanol. Women were tested during the postmenstrual phase (Day 6-7), when levels of estrogen and progesterone were estimated to be relatively low. Data reflecting alterations in physical sensations, perceived levels of intoxication, and positive and negative mood states were also collected. Women reached significantly higher peak blood alcohol concentrations (BAC's) than men (p less than 0.01). However, differences in peak BAC's between men and women could be explained by differences in body water content between the sexes. When the raw data on BAC's were corrected for differences in body water content between men and women, no difference in the amount of alcohol metabolized, or in the length of time necessary to metabolize that amount of alcohol, could be found between the sexes. Although women attained higher blood and, presumably, brain levels of ethanol, men did not differ from women in perceived levels of intoxication, physical sensations and mood states. Acute alcohol intoxication appeared to elevate positive mood states during the ascending limb of the BAC curve, but was associated with increased negative affect during the descending limb.