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Minutes of the 141st Meeting of the NATIONAL ADVISORY COUNCIL ON ALCOHOL ABUSE AND ALCOHOLISM
DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
141st Meeting of the
NATIONAL ADVISORY COUNCIL ON ALCOHOL ABUSE AND ALCOHOLISM
February 12, 2016
- Budget: NIAAA’s Fiscal Year (FY) 2015 budget was $447.2 million. In FY15, NIAAA supported 668 research projects grants, with an 18% success rate among applicants. Eighteen research centers ($28 million) and 135 other research grants ($37.2 million) were also funded. NIAAA supported 227 full-time training positions ($12.7 million), an R&D contract portfolio ($36.6 million) and intramural research ($49.5 million). The Consolidated Appropriations Act, 2016 (H.R. 2029) was signed into law on December 18, 2015, providing a $2 billion increase to NIH’s budget for a total of $32.3 billion. The good news is the FY 2016 NIAAA budget is increasing to $467.7 million, a 5% across-the-board increase. An increase in the number of new research project grants and competing awards is anticipated. There will also be an increased number of individual National Research Service Awards (NRSAs), rather than increasing the number of T32 training slots, which sometimes go unfilled. Preliminary work has begun on the FY 2017 budget, which will be presented to Congress in February 2016.
- Staff Transitions: New staff at NIAAA include Mohammed Akbar, Med. Sc.D., Program Officer in the Division of Metabolism and Health Effects; Janos Paloczi, Ph.D., Visiting Research Scientist in the Laboratory of Cardiovascular Physiology and Tissue Injury; Balazs Nemeth, M.D., an NIH Graduate Student in the Laboratory of Cardiovascular Physiology and Tissue Injury; and Grace Tato and Christie Cunningham-Charles in the NIAAA Administrative Services Branch. The following individuals retired: Dr. Kenneth R. Warren, NIAAA Deputy Director; Dr. Ellen Witt, Deputy Director of the Division of Neuroscience and Behavior; and Debbie Hendry, NIAAA Grants Management Branch.
- Honors and Awards: Dr. Beata Buzas received the NIH Office of the Director Honor Award as part of the NIH Vertebrate Animal Section Update Workgroup. Dr. Resat Cinar was awarded an American Thoracic Association grant to study the therapeutic potential of a novel antifibrotic medication to treat Hermansky-Pudlak syndrome with pulmonary fibrosis. Dr. Mehdi Farokhnia received the American Society of Clinical Psychopharmacology New Investigator Award, and the NIDA-International Society of Addiction Medicine (ISAM) Fellowship for Young Investigators. He was also named the winner of the abstract with the highest rating for international scientific merit by the ISAM Scientific Program Committee. Dr. Bob Freeman received the NIH Director’s Award as a member of the NIH Sexual and Gender Minority Research Coordinating Committee. Drs. Peggy Murray, Kenneth Warren, Antonio Noronha, and John Matochik received the NIH Director’s Award in recognition of their work on the NIH team that developed, implemented, and awarded the grants for the ABCD Study. Dr. Pal Pacher received the title of Doctor Honoris Causa from Semmelweis University for extraordinary achievements in natural and technological sciences, and was Included among the 128 highly cited researchers in “Highly Cited Researchers 2015” by Thomson Reuters in the field of Pharmacology and Toxicology.
- CollegeAIM: CollegeAIM, an evidence-based resource about prevention programs for college administrators, was launched in September 2015 at a briefing at the National Press Club that was disseminated as a webinar. Dr. Jonathan Gibraltar, who is Chair of the President's Committee, and Mary Larimer were featured speakers at a Friends of NIAAA Congressional Addiction Treatment and Recovery Caucus, which also focused on CollegeAIM. The Institute is hoping it will provide a framework for other efforts that are underway, including one on treatment, particularly for disparity populations, and one to help anyone who wants to help someone with an alcohol use disorder (AUD).
- New FOAs: NIAAA has released two new Funding Opportunity Announcements (FOAs), one for Integrative Neuroscience Initiative on Alcoholism (INIA) Consortia (U01/U24) and the other for Multi-Site Randomized Controlled Clinical Trail Research Center on Alcohol’s Health Effects (U10).
“Leptin Levels are Reduced by Intravenous Ghrelin Administration and Correlated with Cue-Induced Alcohol Craving” published in Translational Psychiatry provides evidence of a ghrelin-leptin cross-talk in individuals with AUD and suggests that the relationship between ghrelin and leptin may play a role in alcohol craving which, in turn, may be associated with relapse and may predict alcohol-related outcomes.
“Dissociating Motivational from Physiological Withdrawal in Alcohol Dependence: Role of Central Amygdala K-Opioid Receptors” published in Neuropsychopharmacology reveals the selective involvement of the kappa-opioid receptor in the motivational post-withdrawal syndrome but not the acute physiological syndrome, and lends support to its potential value as a medication target.
“TLR2 and TLR4 Expression and Inflammatory Cytokines are Altered in the Airway Epithelium of Those with Alcohol Use Disorders,” published in Alcoholism: Clinical and Experimental Research, provide evidence of alcohol’s modification of alveolar epithelial cells and the resulting change in the inflammatory state of the airways. This hypothesized to be a mechanism by which alcohol consumption disturbs pulmonary lines of defense, which is noteworthy because people with AUD have higher rates of pneumonia than the general population.
“Short- or Long-term High Fat Diet Feeding Plus Acute Ethanol Binge Synergistically Induce Steatohepatitis in Mice: An Important Role for CXCL1,” a study published in Hepatology, demonstrated that feeding mice a high-fat diet combined with acute ethanol consumption synergistically induces acute liver inflammation and injury through the elevation of hepatic or serum free fatty acids and subsequent up-regulation of hepatic CXCL1 expression and promotion of hepatic nutrophil infiltration. Such work provides evidence for the observation that obesity and alcohol consumption often coexist and work synergistically to promote steatohepatitis.
“Unhealthy Alcohol Use is Associated with Monocyte Activation Prior to Starting Antiretroviral Therapy” in Alcoholism: Clinical and Experimental Research, addressed the fact that alcohol use may accelerate HIV disease progression, but the plausible biological mechanisms have not been clearly elucidated. It found that unhealthy alcohol use was independently associated with a marker of monocyte activation (i.e., higher sCD14) that predicts mortality in treated HIV-infected individuals.
“Association Between Physical Pain and Alcohol Treatment Outcomes: The Mediating Role of Negative Affect” in the Journal of Consulting and Clinical Psychology, used a secondary analysis of two clinical trials for AUD to show that pain scores were positively associated with both drinking outcomes and negative affect and negative affect mediated the association between pain and drinking outcomes.
“Finding Translation in Stress Research” in Nature Neuroscience provides a perspective on how translational research across rodents and humans on stress-related mental disorders is being powered by an ever-developing appreciation of the shared neural circuits and genetic architecture that moderate the response to stress across species. This paper emphasizes research approaches that have the potential to deliver a new generation of risk biomarkers and therapeutic strategies for stress-related disorders.
“Management of Alcohol Use Disorder in Patients Requiring Liver Transplant” in the American Journal of Psychiatry critically reviews and discusses the clinical, public health, and bioethical issues related to the treatment of AUD in patients before and after liver transplant. The conclusions of the study are that an integrated team approach, use of comprehensive contextual evaluation of substance use, and behavioral, psychosocial, and pharmacologic interventions before transplant optimize outcomes in AUD patients.
“Can a Criminal Justice Alcohol Abstention Programme with Swift, Certain, and Moderate Sanctions (24/7 Sobriety) Reduce Population Mortality? A Retrospective Observational Study” in The Lancet Psychiatry reported on a rigorous evaluation of a 24/7 sobriety program for alcohol-involved offenders in South Dakota that found the program was linked to a surprisingly large (4.2%) reduction in all-cause mortality.
“Sex Differences in Animal Models: Focus on Addiction” in Pharmacological Reviews provides a review of the literature on sex differences in animal models and concludes that female rats, in general, acquire the self-administration of drugs and alcohol more rapidly, escalate their drug taking with extended access more rapidly, show more motivational withdrawal, and (where tested in animal models of "craving") show greater reinstatement. The one exception is that female rats show less motivational withdrawal to alcohol than do males.
“Converging Patterns of Alcohol Use and Related Outcomes Among Females and Males in the United States, 2002-2012,” published in Alcoholism: Clinical and Experimental Research, used National Survey on Drug Use and Health (NSDUH) data to explore changes in alcohol use and associated outcomes among females and males aged 12 and up between 2002 and 2012, and concludes that differences in alcohol consumption and related outcomes have narrowed for females and males.
“A Randomized Controlled Trial Targeting Alcohol Use and Sexual Assault Risk Among College Women at High Risk for Victimization” in Behaviour Research and Therapy, assessed the effectiveness of a web-based, combined sexual assault risk and alcohol use reduction program for college women using a randomized controlled trial. Findings suggest that web-based personalized feedback programs targeting sexual assault may be a cost-effective option for reducing sexual assault and heavy episodic drinking on college campuses. Dr. Koob concluded by noting that he wants NIAAA to continue to pursue the domains covered by these studies, particularly those related to health disparities. He encouraged researchers to be optimistic because there may often be a breakthrough after years of research.
Discussion: Dr. Patricia Molina commended Dr. Koob for not ignoring the biomedical consequences of alcohol abuse and giving credit to research beyond the areas of the brain, his personal interest. In particular, she championed the importance of physiology, because many physiological mechanisms are impacted by alcohol, but not always in the same direction in different organs, citing TLR4 expression as an example. She urged all Divisions within NIAAA to take physiology into consideration. Dr. Koob concurred that the innate immune system is a significant area to study. Dr. Rajita Sinha endorsed Dr. Molina’s emphasis on physiology and recommended translating knowledge about physiology and the brain to human studies and treatment outcomes, using a collaborative team science approach. Dr. Koob agreed, noting that the Integrative Neuroscience Initiatives on Alcoholism (INIA) are starting to integrate neuroscience initiatives and that the Division of Medications Development is setting up human studies laboratory. NIAAA will consider how to adopt this approach in future FOAs. Dr. Arun Sanyal urged that NIAAA go beyond Dr. Sinha’s recommendation for translational studies to actual clinical practice, pointing to the need for evidence if liver transplantation guidelines are to change. Dr. Koob said the NIAAA Liver Consortia could address this issue. Dr. Gary Murray commented that the American Association for the Study of Liver Diseases (AASLD) held several sessions at a recent meeting with behavioral experts on how to address liver transplantation and treatment, citing the importance of cooperation across fields. Dr. Sanyal stated that the ultimate goal is the development of drugs to treat liver disease; he urged that NIAAA engage more broadly with the FDA around a larger umbrella of alcohol-associated disorders in an integrated manner, rather than the focused discussions that have occurred around alcoholic hepatitis. Dr. Koob encouraged Dr. Raye Litten, Acting Director of the Division of Medications Development, to follow up.