Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Both genetics and dopaminergic neurotransmission have a role in delirium tremens

26.01.2007
Alcohol-dependent individuals have a five to 10 percent lifetime risk of developing delirium tremens (DT) following alcohol withdrawal. DT is characterized by a clouding of consciousness, mental confusion or disorientation, and is often accompanied by hallucinations and agitation.

Although the symptoms of DT are relatively well known, the pathophysiology of DT is less clear. A review of formerly published research has found that both genetics and the regulation of dopaminergic neurotransmission appear to play a role in the pathophysiological process of the development of DT.

Results are published in the February issue of Alcoholism: Clinical & Experimental Research.

"DT can develop one to four days after the onset of acute alcohol withdrawal in persons who have been drinking excessively for years," said Barbara C. van Munster, a researcher at the University of Amsterdam and corresponding author for the study. DT is at the extreme end of the alcohol withdrawal spectrum; most people experience minor symptoms such as insomnia and tremulousness, or possibly more severe complications such as seizures.

"The symptoms of alcohol withdrawal relate proportionally to the amount of alcohol intake and the duration of a patient's recent drinking habit," van Munster added. "However, other risk factors for developing DT include concurrent acute medical illness, older age and abnormal liver function." Although death may occur in up to five percent of patients with DT, risk of death can be reduced in patients who receive adequate medication and medical support.

As noted previously, the exact pathophysiologic mechanism for developing DT is unclear, however, the gamma-aminobutyric acid and glutamate neurosystems are believed to be involved. "My review was designed to augment knowledge about the pathophysiology of DT from genetic research and to establish commonality," said van Munster. "Finding one association between a genetic polymorphism and DT could happen easily on coincidence. Finding it twice could really mean something"

Van Munster and her colleagues collected all studies listed on the MEDLINE and EMBASE databases until February 2006 that met the following criteria: written in English; entailed an analysis of any association between a genetic polymorphism and DT; and excluded all other alcohol-withdrawal syndromes.

"We found that of the 25 studies reviewed that dealt with 30 polymorphisms, located in 19 different genes, eight positive associations seemed to support a genetic basis for DT," said van Munster.

"Specifically, we found positive associations in three different candidate genes involved in dopamine transmission, one gene involved in the glutamate pathway, one neuropeptide gene and one cannabinoid gene," van Munster said. "Only the candidate genes involved in dopamine transmission were each associated with DT in different study populations. The replication of this association makes coincidence less plausible. Moreover, both these polymorphisms are functional, which means the mutation gives a change in the final protein product. This makes it even more probable that dopaminergic neurotransmission plays an important role in the pathophysiological process of the development of DT."

Van Munster said that her review helps to shed light on the genetics of DT, an area not fully explored previously. "In the medical literature," she said, "I could not find anything about the genetic basis for DT. It appears that a genetic base was never studied by epidemiological family studies or by linkage analysis, probably because of the rare occurrence of DT in the same family. Moreover, the diagnosis is not always clear. Having hallucinations does not mean that someone has experienced DT; they have to meet DT criteria as diagnosed by an experienced physician. Probably, the cause of DT is multifactorial, with a relatively minor contribution of each genetic polymorphism."

Van Munster plans to continue with her research on delirium among elderly people. "Roughly 30 percent of elderly patients acutely admitted to the medical ward experience delirium," she said. "This delirium is not provoked by alcohol withdrawal, but by their medical condition, especially in those patients with older age and diminished cognition. Until now, this type of delirium was supposed to have another pathophysiological pathway than DT, with a larger role for the dopaminergic neurotransmission. However, based on the findings in this review, it is possible that the pathophysiological mechanisms for both types of delirium are more equal than previously supposed."

Barbara C. van Munster, M.D. | EurekAlert!
Further information:
http://www.amc.uva.nl

More articles from Health and Medicine:

nachricht Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences

nachricht What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Argon is not the 'dope' for metallic hydrogen

24.03.2017 | Materials Sciences

Astronomers find unexpected, dust-obscured star formation in distant galaxy

24.03.2017 | Physics and Astronomy

Gravitational wave kicks monster black hole out of galactic core

24.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>