Angiotensin converting enzyme inhibitors: animal experiments suggest a new pharmacological treatment for alcohol abuse in humans

Cardiovascular autonomic modulation by nitric oxide synthases accounts for the augmented enalapril-evoked hypotension in ethanol-fed female rats

In this study, we investigated the role of nitric oxide synthase (NOS) isoforms in the enhanced enalapril-evoked hypotension in ethanol-fed female rats by examining the effect of the selective inhibitors of eNOS [N(5)-(1-iminoethyl)-l-ornithine; l-NIO], nNOS (N(ω)-propyl-l-arginine; NPLA), or iNOS (1400W) inhibition on the cardiovascular effects of enalapril in ethanol- (5% w/v) fed rats and in their pair-fed controls. In liquid diet-fed control rats, enalapril- (10 mg/kg) evoked hypotension was abolished by l-NIO (20 mg/kg), but not by NPLA (1 mg/kg) or 1400W (5 mg/kg), suggesting a preferential role for eNOS in this response. Enalapril had no effect on spectral indices of hemodynamic variability or +dP/dtmax (myocardial contractility). However, in ethanol-fed rats, the greater enalapril-evoked hypotension was associated with reductions in (i) +dP/dtmax, (ii) low-frequency/high-frequency ratio of interbeat intervals (IBILF/HF), suggesting cardiac parasympathetic dominance, and (iii) low-frequency spectral band of systolic blood pressure (BP), a marker of vasomotor sympathetic tone. While NPLA or 1400W attenuated the enalapril-evoked hemodynamic and autonomic responses in ethanol-fed rats, l-NIO virtually abolished the hypotensive response and was more efficacious in rectifying autonomic responses to enalapril. Together, these findings implicate NOS isoforms, particularly eNOS, in the altered cardiovascular autonomic control that leads to the augmented enalapril-evoked hypotension in ethanol-fed female rats.

Plasticity and impact of the central renin–angiotensin system during development of ethanol dependence

Pharmacological and genetic interference with the renin-angiotensin system (RAS) seems to alter voluntary ethanol consumption. However, understanding the influence of the RAS on ethanol dependence and its treatment requires modeling the neuroadaptations that occur with prolonged exposure to ethanol. Increased ethanol consumption was induced in rats through repeated cycles of intoxication and withdrawal. Expression of angiotensinogen, angiotensin-converting enzyme, and the angiotensin II receptor, AT1a, was examined by quantitative reverse transcription polymerase chain reaction. Increased ethanol consumption after a history of dependence was associated with increased angiotensinogen expression in medial prefrontal cortex but not in nucleus accumbens or amygdala. Increased angiotensinogen expression also demonstrates that the astroglia is an integral part of the plasticity underlying the development of dependence. The effects of low central RAS activity on increased ethanol consumption were investigated using either spirapril, a blood-brain barrier-penetrating inhibitor of angiotensin-converting enzyme, or transgenic rats (TGR(ASrAOGEN)680) with reduced central angiotensinogen expression. Spirapril reduced ethanol intake in dependent rats compared to controls. After induction of dependence, TGR(ASrAOGEN)680 rats had increased ethanol consumption but to a lesser degree than Wistar rats with the same history of dependence. These data suggest that the central RAS is sensitized in its modulatory control of ethanol consumption in the dependent state, but pharmacological or genetic blockade of the system appears to be insufficient to halt the progression of dependence.

Central Overexpression of Angiotensin AT1AReceptors Prevents Dopamine D2Receptor Regulation of Alcohol Consumption in Mice

BACKGROUND

While angiotensin receptors are found on the soma and terminals of dopaminergic neurons, controversy surrounds the potential role of angiotensin in alcohol consumption.

METHODS

Using a transgenic mouse with a brain-specific overexpression of angiotensin AT(1A) receptors (NSE-AT(1A) mice), we have examined the role of angiotensin in alcohol consumption and alcohol-induced regulation of the dopaminergic system.

RESULTS

The functional relevance of the overexpressed AT(1A) receptors was confirmed by an exaggerated rehydration response following 24-hour dehydration. NSE-AT(1A) mice showed a high preference for alcohol (similar to wild-type mice); yet, raclopride treatment had no effect on alcohol consumption in NSE-AT(1A) mice, while significantly reducing consumption in wild-type mice. In contrast, NSE-AT(1A) mice showed enhanced sensitivity to raclopride compared with wild types in terms of D(2) receptor up-regulation within the ventral mesencephalon. In addition, striatal D(2) receptors in NSE-AT(1A) mice were sensitive to up-regulation by chronic alcohol consumption.

CONCLUSIONS

Collectively, these data imply that while expression of angiotensin AT(1A) receptors on striatal neurons has no impact upon basal alcohol consumption or preference, AT(1A) receptors do modulate the sensitivity of dopamine D(2) receptors to regulation by alcohol and the ability of a D(2) receptor antagonist to reduce consumption.

Persistent alterations of vasopressin and N-terminal proatrial natriuretic peptide plasma levels in long-term abstinent alcoholics

BACKGROUND

During alcohol withdrawal and early abstinence, severe alterations of electrolyte and water homeostasis and their regulating hormones are well recognized. Almost nothing is known about regeneration of these functions with long-term abstinence. This cohort study was designed to monitor determinants of electrolyte and water balance over 280 days of abstinence in alcohol-dependent men compared with healthy controls.

METHODS

Vasopressin (AVP), N-terminal proatrial natriuretic peptide, aldosterone, angiotensin II, and electrolytes, together with major parameters of kidney and liver function, were monitored in 35 male alcoholics aged 44 +/- 8 years. Of these, 21 could be followed up to 280 days of strictly controlled abstinence due to their participation in the Outpatient Long-Term Intensive Therapy for Alcoholics. The control group comprised 20 healthy male volunteers aged 39 +/- 7 years.

RESULTS

Basal AVP levels were found to be suppressed over the whole study period. In contrast, N-terminal proatrial natriuretic peptide remained increased over all 280 days. No persistent alterations were found for aldosterone or angiotensin II. Sodium and potassium in plasma and urine returned to normal within a few weeks. Creatinine clearance, urea nitrogen in plasma and urine, urinary osmolality, hematocrit, and hemoglobin remained low as compared with controls over the entire study.

CONCLUSIONS

Chronic alcohol abuse causes severe and persistent alterations in the hormonal regulatory systems of electrolyte and water balance. The suppressed basal secretion of AVP may reflect a dysregulation in the brain that influences the hypothalamic-pituitary-adrenal axis function, mood, memory, addiction behavior, and craving during alcohol abstinence. These findings may provide a ground for future therapeutic approaches to stable abstinence.

Gene expression and activity of specific opioid-degrading enzymes in different brain regions of the AA and ANA lines of rats

There is increasing evidence that alcoholism runs in families suggesting that genetic factors may play a role. In support of this hypothesis, the alcohol-preferring (AA) and the alcohol-avoiding (ANA) rat lines have been developed through selective outbreeding. Numerous studies indicate that the endogenous opioid system may be involved in controlling ethanol consumption. Changes in opioid peptides and opioid receptors have been described after ethanol intake. But, the influence of ethanol on peptidolytic degradation of opioid peptides has been largely ignored, although the peptidase-mediated metabolism of neuropeptides is known as an important regulatory site of peptidergic transmission. Neutral endopeptidase 24.11 (NEP) and angiotensin-converting enzyme (ACE) degrade neuropeptides, including enkephalin and are expressed in the brain. Furthermore, a good correspondence between the regional distribution of NEP and opioid receptors in rat brain has already been reported pointing to a possible role of NEP in regulating opioid peptides. For both enzymes studied, the gene expression pattern was found to be in good agreement with the corresponding enzyme activities in the brain regions investigated, showing the highest levels for both specific mRNAs and enzyme activities in the striatum. Differences in both measured parameters were detected in distinct brain regions of AA and ANA rats. Furthermore, in some brain regions discrepancies between ACE and NEP mRNA levels and the corresponding enzyme activities were observed. For example, in olfactory bulb and striatum such discrepancies were found for both enzymes studied. In tegmentum/colliculi a higher NEP gene expression in AA rats was associated with a higher NEP enzyme activity compared to the amounts found in ANA rats.

Effect of captopril on voluntary consumption of ethanol, water and solid food by UChA and UChB rats

Angiotensin converting enzyme inhibitors (ACEI) have been reported to reduce ethanol consumption in rats, but it is unclear whether this effect is specific for ethanol or secondary to effects on appetite or satiation for calories or water. In the present study we assessed the effect of captopril, an ACEI, on the voluntary consumption of 10% ethanol solution, water and solid food in our strain of rats genetically selected for their voluntary consumption of ethanol, namely UChA (low consumer) and UChB (high consumer). Captopril (30 mg/kg) was injected intraperitoneally for 3 consecutive days to UChA and UChB rats and ethanol, water and food intake were measured before, during and after captopril treatment; these results were compared with those produced by a control saline solution. Results showed that captopril produced a significant reduction of alcohol voluntary consumption in UChB but not in UChA rats. However, this effect was not specific for ethanol since captopril also induced a significant decrease in food intake leading to a loss of weight in both rat strains, suggesting that it seems to be secondary to changes in appetite for calories.

Acetaldehyde inhibits serum aminopeptidases

Aminopeptidase A (APA)- and aminopeptidase M (APM)-like activity were assayed in Moni-Trol ES with L-alpha-aspartyl-beta-naphthylamide and L-alanyl-beta-naphthylamide, respectively. Upon preincubation of the serum with 89.4, 223.5, and 447 mM acetaldehyde at room temperature for 30 min, a reduction in 26.8%, 55.3%, and 75.8% aminopeptidase A activity was observed. Similarly, aminopeptidase M activity was reduced by 26.5% and 53.1% upon preincubation with 223.5 and 447 mM acetaldehyde. Ethanol at 84.9, 212.3, and 427.9 mM did not significantly affect the enzymic activity. Because aminopeptidase A and aminopeptidase M also degrade the pressor substance, angiotensin II, it is suggested that inhibition of aminopeptidase A- and aminopeptidase M-like activity by acetaldehyde, the product of ethanol metabolism, may lead to higher levels of circulating angiotensin II and, consequently, hypertension, in alcoholics. The hydrolysis of lysine-p-nitroanilide, an aminopeptidase B substrate, was also inhibited upon addition of acetaldehyde to Moni-Trol ES serum.

The reduction in alcohol intake produced by enalapril is not attenuated by centrally administered angiotensin inhibitors

Angiotensin-converting enzyme (ACE) inhibitors, which prevent the conversion of angiotensin I to angiotensin II, reduce alcohol intake when injected peripherally. The mechanism by which ACE inhibitors produce this effect on alcohol intake is unknown. A rise in the biosynthesis of angiotensin II in the periphery is known to reduce alcohol intake. In this experiment, we examine the possibility that the reduction in alcohol intake produced by an ACE inhibitor, enalapril, is mediated by a rise in angiotensin II in the brain. Enalapril, 20 mg/kg, injected intraperitoneally, produced a 40% reduction in alcohol intake. This reduction was not attenuated by the concurrent administration into the lateral ventricle of either the ACE inhibitors captopril or ceranapril (1, 10, or 25 micrograms), or the angiotensin II receptor antagonist Sar1-Thr8-Angiotensin II (5 micrograms). These findings suggest that the ACE inhibitors do not reduce alcohol intake by raising angiotensin II in the brain.

Brain angiotensin receptor subtypes in the control of physiological and behavioral responses

This review summarizes emerging evidence that supports the notion of a separate brain renin-angiotensin system (RAS) complete with the necessary precursors and enzymes for the formation and degradation of biologically active forms of angiotensins, and several binding subtypes that may mediate their diverse functions. Of these subtypes the most is known about the AT1 site which preferentially binds angiotensin II (AII) and angiotensin III (AIII). The AT1 site appears to mediate the classic angiotensin responses concerned with body water balance and the maintenance of blood pressure. Less is known about the AT2 site which also binds AII and AIII and may play a role in vascular growth. Recently, an AT3 site was discovered in cultured neoblastoma cells, and an AT4 site which preferentially binds AII(3-8), a fragment of AII now referred to as angiotensin IV (AIV). The AT4 site has been implicated in memory acquisition and retrieval, and the regulation of blood flow. In addition to the more well-studied functions of the brain RAS, we review additional less well investigated responses including regulation of cellular function, the modulation of sensory and motor systems, long term potentiation, and stress related mechanisms. Although the receptor subtypes responsible for mediating these physiologies and behaviors have not been definitively identified research efforts are ongoing. We also suggest potential contributions by the RAS to clinically relevant syndromes such as dysfunctions in the regulation of blood flow and ischemia, changes in cognitive affect and memory in clinical depressed and Alzheimer's patients, and angiotensin's contribution to alcohol consumption.

Angiotensin converting enzyme inhibitors and alcohol abuse

Angiotensin converting enzyme plays a key role in the regulation of blood pressure and inhibitors of the enzyme are effective antihypertensive agents. An association between hypertension and alcohol abuse has long been recognized and manipulations of the renin-angiotensin system in laboratory animals has been shown to alter their consumption of ethanol. Procedures that decrease the renin-angiotensin system increase ethanol consumption. Paradoxically, inhibitors of angiotensin converting enzyme also diminish drinking. Several possible explanations for this observation have been proposed. However, observations on the relationship between stress-induced drinking and the antidipsogenic action of a fragment of adrenocorticotropic hormone suggest another possibility: angiotensin converting enzyme may be involved in the metabolism of this peptide and thereby exert an influence on drinking behavior.

Bradykinin suppresses alcohol intake and plays a role in the suppression produced by an ACE inhibitor

The possible role of the endogenous kinins in the control of alcohol intake was assessed in two experiments. In Experiment 1, naive rats, maintained on ad lib food and water, were given daily 40-min access to a 6% (w/v) alcohol solution and water. Daily intraperitoneal (IP) injections of captopril (20 mg/kg) significantly reduced alcohol intake, while pretreatment with subcutaneous (SC) injections of the bradykinin antagonist [D-Phe7]-bradykinin (100-300 micrograms/kg) attenuated the suppressive effect of captopril on alcohol intake. The saline vehicle or the bradykinin antagonist alone did not alter alcohol intake. In Experiment 2, bradykinin was administered daily at 100, 200, and 400 micrograms/kg doses SC either alone or in combination with captopril 10 mg/kg IP. Neither bradykinin nor captopril by themselves changed alcohol or water intake. Bradykinin combined with captopril stimulated water intake and reduced alcohol intake by up to 70%. This effect was not due to drug-induced changes in the pharmacokinetics of alcohol. The angiotensin II receptor antagonist [Sar1,Thr8]-angiotensin II at 250 and 500 micrograms/kg SC attenuated the stimulation of water intake but not the reduction in alcohol intake. It is suggested that by inhibiting kininase II, ACE inhibitors extend the duration of action of bradykinin and thereby unmask a potent inhibition of alcohol intake mediated by kinins--an effect that is dissociable from the accompanying stimulation of water intake. Taken together, these results point to an involvement of the kinin system in the regulation of alcohol intake and in particular to a role of bradykinin in the suppressive effect of ACE inhibitors on alcohol intake.

Captopril and hydrochlorothiazide (Capozide) combine to enhance the reduction in voluntary alcohol intake in rats

The effect of Capozide, the combination of captopril with a hydrochlorothiazide diuretic, on voluntary alcohol intake was assessed in two experiments. In experiment 1 naive rats who were maintained on ad libitum food and water were given daily 40-min access to a 6% (w/v) alcohol solution and water. Daily intraperitoneal injections of captopril (10 mg/kg) reduced alcohol intake, but the combination of captopril (5 and 10 mg/kg) and hydrochlorothiazide (2.5, 5, and 10 mg/kg) enhanced the reduction in intake. In experiment 2, captopril alone, hydrochlorothiazide alone, and the combination of captopril and hydrochlorothiazide were again administered daily in the limited access procedure. Captopril (10 mg/kg) again reduced alcohol intake as did all three doses of hydrochlorothiazide (2.5, 5, and 10 mg/kg). Compared with the individual effects of captopril and hydrochlorothiazide, Capozide exerted a supra-additive reduction in alcohol intake. These effects were not due to drug-induced changes in the pharmacokinetics of alcohol. Taken together these results demonstrate an enhanced potency of Capozide in suppressing alcohol intake and invite their testing in a population of hypertensive alcoholics and alcohol abusers.

Angiotensin and captopril increase alcohol intake

Reportedly both angiotensin II (ANG II) and angiotensin-converting enzyme (ACE) inhibitors reduce ethanol intake when they are injected SC into certain chronic experimental conditions in the rat. The ACE inhibitors are suggested to reduce ethanol intake by increasing ANG II synthesis in the brain. The present results show that several different methods can produce opposite effects of ANG II and the ACE inhibitor captopril on ethanol intake. Continuous intraventricular infusions of ANG II for 7 days or low doses of oral or SC-infused captopril for up to 12 days increased the intake of ethanol. The only reduction of ethanol intake resulted from a universal blockade of all ACE in both the brain and periphery, a condition in which ANG II could not possibly mediate the decrease. The results contradict the hypothesis that ethanol intake is suppressed by centrally acting or centrally synthesized ANG II. ACE inhibitors may reduce ethanol intake only when they affect the brain as well as the periphery.

Reducing the desire to drink. Pharmacology and neurobiology

The past decade has witnessed major advances in understanding of neural functioning and neurobiological bases of alcohol consumption. Concurrent with this, a range of exciting investigations have been conducted on pharmacologic agents that may curb drinking behavior. Research is reviewed on several promising medications influencing neurotransmitter and endocrine systems with particular attention to the serotonergic and opioid systems. Following this overview, recommendations are offered regarding research methodology to support future pharmacotherapy trials.

Effects of angiotensin II and an angiotensin converting enzyme inhibitor on alcohol intake in P and NP rats

While it is known that randomly bred normotensive Wistar stock and hypertensive rats alter their alcohol consumption when activity in the renin-angiotensin (R-A) system is modified, the effect of manipulations to the R-A system on alcohol intake in genetically selected alcohol-preferring P and -nonpreferring NP rats has not been assessed. In Experiment 1, nine P rats and 8 NP rats were injected with the saline vehicle and offered limited access to 10% (v/v) alcohol for 40 min each day for 7 days. When intake stabilized both groups were given daily intraperitoneal injections of the angiotensin converting enzyme inhibitor, ceranapril (20 mg/kg) 45 min prior to alcohol access for 11 days. Ceranapril (SQ 29,852) reduced alcohol intake in both the P and NP animals, while saline had no effect. In Experiment 2, these same two groups of P and NP rats were injected with three doses of angiotensin II (ANG II) (100, 200, 400 micrograms/kg) immediately prior to alcohol access. Each dose was tested for 10 consecutive days, with a 14-day period of no drug preceding and following the ANG II treatments. ANG II reduced alcohol intake in the NP rats and produced a dose-dependent reduction in the alcohol consumption of the P rats. These findings indicate that the renin-angiotensin system can modify alcohol consumption in rats selectively bred for high and low alcohol intake.

Manipulations of the renin-angiotensin system and intake of a sweetened alcoholic beverage among rats

Standard laboratory rats were maintained on a daily regimen involving deprivation of fluids for 22 h followed by a 2-h opportunity to drink water and a sweetened alcoholic beverage. Angiotensin II, in doses ranging from 0.1 to 1.25 mg/kg, dose relatedly decreased rats' mean intake of ethanol. All doses increased rats' mean intake of water. Angiotensin II, 0.25 mg/kg, reliably reduced intake of ethanol when it was presented alone during the 1st h of the daily 2-h drinking session, and reliably increased intake of water when it was subsequently presented alone during the 2nd h. Thus the reduction in intake of ethanol seen when the alcoholic beverage is presented concurrently with water is probably not merely due to the increase in intake of water. Lisinopril, an angiotensin converting enzyme inhibitor, in doses of 0.3, 1.0, and 3.0 mg/kg, dose relatedly decreased intake of ethanol, but only after several days of injections. Concurrent intake of water was increased dose relatedly. When injections of lisinopril ceased, intakes of both ethanol and water took several days to return to control levels. Pretreatment with lisinopril, 3.0 mg/kg, for 8 days, had no effect on subsequent intakes of either water or ethanol. Lisinopril, 3.0 mg/kg, had no effect on rats' intake of a sweet solution without ethanol. These results confirm previous work and extend the data base supporting the idea that the renin-angiotensin system plays a role in modulating intake of ethanol.

The amino acid composition of angiotensin alters its ability to reduce alcohol consumption in rats

The voluntary consumption of alcohol has been shown to be reduced by a variety of manipulations which enhance activity in the renin-angiotensin system, including the administration of the bovine form of angiotensin II-[Val5]-ANG II. The present study investigated the relationship between the amino acid composition of angiotensin II and its ability to reduce alcohol intake by administering a number of different forms or fragments of the parent peptide. [Ile5]-Angiotensin II ([Ile5]-ANG II), two endogenous fragments of angiotensin II [( Des-Asp1]-ANG II and [Des-Phe8]-ANG II) were administered subcutaneously in rats across a range of doses. [Ile5]-ANG II reduced alcohol intake at all doses tested between 20 and 400 micrograms/kg while [Des-Asp1]-ANG II reduced alcohol intake only at the 400 micrograms/kg dose. [Des-Phe8]-ANG II had no effect on alcohol intake at any dose tested. Administration of the antagonist [Sar1-Thr8]-ANG II by itself did not enhance alcohol intake. While the pressor and dipsogenic properties of these fragments sometimes correlated with the reduction in alcohol intake they were not a causal factor in decreasing the intake. These results indicate that variations in the peptide composition of angiotensin can significantly alter its ability to reduce the consumption of alcohol.

Regulation of alcohol consumption by the renin-angiotensin system: a review of recent findings and a possible mechanism of action

The renin-angiotensin system has traditionally been associated with the regulation of fluid and electrolyte balance. In this review we summarize the data which ascribes a completely new function to this system, i.e., the regulation of alcohol consumption. In addition, we suggest a possible mechanism for this effect based on the concept of a satiety or stop process. The approach taken was to examine the effect on alcohol intake of a wide variety of drug, genetic, dietary, surgical and neurosurgical manipulations, each of which has a range of biological effects characteristic of that manipulation, but all of which share the common property of altering activity in the renin-angiotensin system. The effect of these manipulations on alcohol intake was most parsimoniously explained by reference to their ability to raise or lower activity in the renin-angiotensin system. Any intervention which modulates activity in this system, either directly or indirectly, is likely to have consequences for alcohol consumption.

Effects of the novel compound Hoe 065, a central enhancer of cholinergic activity, on voluntary alcohol consumption in rats

Hoe 065 is a compound structurally related to the angiotensin converting enzyme inhibitors and capable of increasing central cholinergic activity. The effects of this compound were studied on alcohol intake and on the reduction in alcohol intake produced by abutapril, an angiotensin converting enzyme inhibitor. Hoe 065 failed to alter alcohol intake or to modify the reduction in alcohol intake produced by abutapril. These findings suggest that enhanced cholinergic activity may not play a role in the control of alcohol consumption and may not be part of the mechanism by which the angiotensin converting enzyme inhibitors reduce alcohol intake.

Proteases and their inhibitors: today and tomorrow

A major incentive in inhibitor research is that control of limited proteolysis constitutes a valuable pharmacological tool. Protease inhibitors have proved to be successful in influencing pathogenesis in many experimental models but a breakthrough to use in human therapy has mainly been restricted to aprotinin and angiotensin converting enzyme (ACE) inhibitors. However, the success of ACE inhibitors as pharmacological tools in hypertension has proved to be a strong stimulant for new protease inhibitor approaches to drug therapy. While emphasis in the search for next generations of ACE inhibitors may move from the circulation renin-angiotensin system to the local tissue systems, including heart, brain and genital tract, persistent and insightful design of renin inhibitors has already yielded highly specific molecules with potent activities in several in vivo models. The development of orally effective long-acting inhibitors will finally allow an evaluation to be made of their therapeutic profile with regard to the family of ACE inhibitors. The close relationship between renin and HIV-1 protease presents an exceptional opportunity for transfer of the knowledge acquired in renin inhibitor development during the past decade, to an accelerated generation of specific HIV-1 protease inhibitors as effective agents in treatment of AIDS. The self-assembly of 2 identical monomers into a symmetrical structure in HIV-1 protease is not only an elegant way to create an active enzyme while encoding a minimal amount of genetic information, but is also in concordance with the bilobular active-site found in mammalian aspartic proteases.(ABSTRACT TRUNCATED AT 250 WORDS)

Vasopressin does not mediate the inhibition of ethanol drinking by the renin-angiotensin system

Manipulations which are known to enhance activity in the renin-angiotensin system (RAS) have been found to reduce the voluntary consumption of ethanol in rats. Since angiotensin II is a potent stimulus for the release of vasopressin (VP), it is possible that the RAS modulates ethanol (ETOH) consumption through a mechanism involving VP. The present investigation examined the effect of peripheral injections of arginine-VP (AVP) and desglycinamide-AVP (DGAVP) on ETOH consumption in rats given daily one-hour access to ETOH. Daily subcutaneous treatment with AVP or DGAVP had no effect on ETOH consumption at doses ranging from 2 to 200 micrograms/kg (SC). Blood pressure was substantially elevated following a single 20 microgram/kg injection of AVP, indicating that AVP was biologically active at doses which failed to alter ethanol consumption. These findings indicate the VP does not affect established ETOH drinking and furthermore is not likely a critical factor in the reduction of ETOH intake by the RAS.

Angiotensin converting enzyme inhibitors reduce alcohol consumption: some possible mechanisms and important conditions for its therapeutic use

Alcoholism is a prevalent problem of contemporary society, yet there are virtually no clinically effective drugs for the management of this disorder. A previous study demonstrating the ability of angiotensin-converting enzyme (ACE) inhibitors to attenuate voluntary alcohol intake in rats prompted the suggestion that these drugs, currently marketed for the treatment of hypertension, may also be useful in dealing with human alcohol abuse. The present experiments explored in more detail the effect and possible mechanisms of action of this class of drug on alcohol consumption in rats. Experiment one demonstrated that Abutapril, a new ACE inhibitor, significantly reduced alcohol intake and that this effect could not be blocked by either an ANG II or an opiate receptor antagonist suggesting that neither the peripheral renin-angiotensin system (RAS) nor the endogenous enkephalins are involved in the ability of ACE inhibition to attenuate alcohol intake. Experiments two and three showed that ACE inhibition effectively reduced alcohol drinking faster in animals with elevated RAS activity and not at all in animals with suppressed RAS activity indicating that initial levels of RAS activity may determine the speed and ability of ACE inhibition to attenuate alcohol intake. ACE inhibitors may reduce alcohol intake by elevating a nonapeptide fragment or by elevating central ANG II levels. The assessment of this class of drugs to reduce alcohol intake in humans should include a monitoring of the initial level of activity in the renin-angiotensin system since this may be a predictor of the effectiveness of treatment with the ACE inhibitors.

The beta adrenergic agonist isoproterenol suppress voluntary alcohol intake in rats

The effects of isoproterenol on alcohol consumption were examined to investigate whether beta adrenergic stimulation can reduce voluntary alcohol intake. Two and one-half, 5 and 10 micrograms/kg isoproterenol administered subcutaneously (SC) just prior to alcohol availability produced a dose-dependent reduction in alcohol intake and elevation in water intake. Blood alcohol levels measured subsequent to a SC injection of 5 micrograms/kg isoproterenol or vehicle followed by an intraperitoneal injection of 2.5 g/kg alcohol showed that the adrenergic agonist did not alter the distribution or metabolism of alcohol. Since beta adrenergic agonists such as isoproterenol are potent releasers of renin, these findings support previous work showing that different kinds of interventions which share the common property of elevating activity in the renin-angiotensin system (beta adrenergic stimulation in the present case) consistently result in the reduction of voluntary alcohol intake.

Alcohol intake is inversely related to plasma renin activity in the genetically selected alcohol-preferring and -nonpreferring lines of rats

Studies involving both animals and humans strongly suggest that alcoholism is, in part, genetically determined. One approach to studying this genetic component is to determine whether rats, genetically selected to prefer (P line) or avoid (NP line) alcohol, show differences in those physiological systems which modulate alcohol intake. It has previously been shown that alcohol intake in randomly bred stock rats is sensitive to and inversely related to manipulations which alter activity in the renin-angiotensin (R-A) system. In the present report the basal level of activity in the R-A systems of the P and NP rats as measured by plasma renin activity (PRA) was first assessed following which continuous access to alcohol (10% v/v) and water was offered for a period of five days. PRA was found to be inversely related to the amount of alcohol that was consumed. The P rats drank significantly larger amounts of alcohol than the NP rats who basically avoided the drug. The P rats had a significantly lower PRA than the NP rats. It is suggested that the genetic selection that favored different levels of alcohol consumption in the P and NP rats may have brought about this effect through differences in the activity of the renin-angiotensin systems in the two lines.

Angiotensin II-induced suppression of alcohol intake and its reversal by the angiotensin antagonist Sar-1 Thr-8 angiotensin II

The effects of three doses of angiotensin II (AII) on alcohol consumption using the limited access procedure were studied. Fifty and 100 micrograms/kg AII administered subcutaneously (SC) did not alter alcohol intake while 200 micrograms/kg suppressed alcohol intake. These findings confirm previous work and show that AII begins to be effective in reducing alcohol intake in the range of 200 micrograms/kg. In the second part of the study, the AII antagonist Sar-1 Thr-8 AII (500 micrograms/kg SC) was given immediately prior to the administration of either saline or 200 micrograms/kg AII. In the control group treated with saline, the antagonist had no effect of its own on intake but completely blocked the suppressive effect of the 200 micrograms/kg dose AII on alcohol consumption. These findings indicate that the reduction in alcohol intake produced by AII is mediated by events occurring at the receptor level.

Area postrema and alcohol: effects of area postrema lesions on ethanol self-administration, pharmacokinetics, and ethanol-induced conditioned taste aversion

An investigation was carried out to test the hypothesis that the area postrema (AP) may detect ethanol as a blood-borne toxin and thereby mediate aversive postingestinal effects of the drug. These aversive effects in turn may impose an upper limit on the amount of drug that can be consumed. In Experiment 1 rats had continuous access to water and a 4% ethanol solution. Animals with AP lesions drank more ethanol than sham-operated controls. No differences in drug disposition or metabolism were found when these rats were injected with ethanol and blood ethanol levels were measured. If the AP lesions resulted in increased ethanol drinking because of a reduction in the aversive effects of the drug, then the lesions might also be expected to attenuate a conditioned taste aversion induced by ethanol. In Experiment 2, groups of lesioned and sham-operated rats drank a novel tasting fluid and then were given i.p. injections of ethanol (0.9, 1.2, or 1.6 g/kg) or vehicle. Similar degrees of aversion to the taste of the fluid developed in both the lesioned and the sham-control groups. Since the AP lesion did not result in the attenuation of the ethanol-induced conditioned taste aversion, it was suggested that the AP may not mediate the aversive consequences of ethanol and that the increased ethanol self-administration observed in Experiment 1 may be due to other effects of the lesion.

Ethanol as a reinforcer for rats: factors of facilitation and constraint

This review examines some particular approaches that have been used to investigate factors that facilitate or constrain the self-administration of ethanol by rats. A technique for increasing ethanol self-administration in rats, the prandial drinking method, was examined and the effect of body-weight reduction on drug intake was discussed. Emphasis was placed on how ethanol intake may be controlled by processes in addition to the direct pharmacological actions of the drug in the CNS. These processes may be physiological. Evidence was presented for a relationship between activity in the renin-angiotensin system and the self-administration of ethanol. These processes may also be environmental. Using the place-conditioning technique, demonstrations were presented of how the context or situation in which ethanol is experienced may determine whether preference or aversion for the drug develops. Such a diversity in the factors that can potentially control ethanol intake may complicate the identification of the causes of alcohol abuse, but this same diversity also holds out greater hope that manipulations may be found to reduce excessive drinking in humans.

Attenuation of alcohol intake by a serotonin uptake inhibitor: evidence for mediation through the renin-angiotensin system

Although the serotonin uptake inhibitors have been shown to reduce alcohol intake in both animals and man, the mechanism of this effect is unclear. It is known that enhanced serotonergic activity can stimulate activity in the renin-angiotensin system and that elevated activity in the renin-angiotensin system can reduce voluntary alcohol intake. Therefore, serotonin uptake inhibitors such as fluoxetine might exert their effect on alcohol intake, in part, through the renin-angiotensin system. The present experiment assesses this possibility by examining the effect of the angiotensin converting enzyme inhibitor, enalapril, on the fluoxetine-induced decrease in alcohol intake. Four groups of rats were offered limited access to alcohol for 1 hr each day. When intake stabilized each group was injected with 2.5, 5.0 or 10.0 mg/kg of fluoxetine or the saline vehicle 1 hr prior to the access to alcohol. Fluoxetine produced a dose-dependent decrease in alcohol intake. Following this, all groups received injections of 1 mg/kg of the angiotensin converting enzyme inhibitor, enalapril, 40 min prior to the fluoxetine. Enalapril had no effect on alcohol intake in the saline group, but reversed the suppression in alcohol intake produced by the 2.5 mg/kg and 5.0 mg/kg doses of fluoxetine and partially reversed the effect of the 10.0 mg/kg dose. These findings indicate that the fluoxetine-induced reduction in alcohol intake may, in part, be mediated through the renin-angiotensin system.

Voluntary alcohol intake is attenuated in two-kidney, one-clip, but not in one-kidney, one-clip Goldblatt hypertensive rats

Voluntary alcohol intake was examined in two models of renovascular hypertension known to differ in their effects on the renin-angiotensin system. In experiment 1, Two-Kidney, One-Clip (renin-dependent) hypertensive rats (T-K,O-C) or their sham operated controls were offered limited access to alcohol for 1 hr each day. Over a four week period the T-K,O-C rats drank significantly less 3% and 6% (w/v) alcohol solution than the sham operated controls. In experiment 2, One-Kidney, One-Clip (renin-independent) hypertensive rats or their sham operated controls were offered alcohol on a similar limited access basis. Over a four week period, the O-K,O-C rats did not show a reduction in the intake of either a 3% or 6% alcohol solution compared to the sham operated controls. These results provide further documentation for the role of the renin-angiotensin system in modulating alcohol intake. The process by which this system might influence alcohol intake is outlined.