Alcohol use disorder, or AUD, is a brain disorder that affects millions of people with fewFDA approved effective treatments at reducing relapse, with none preventing relapse episodes.
Therefore, more research is necessary in order to find a targetable biochemical pathway for
therapeutics to treat AUD and prevent relapse in alcoholics. Recent data in rodent models of
moderate to severe AUD has demonstrated a correlation between higher levels of ethanol
seeking behavior and increased levels of PECAM-1 in the prefrontal cortex of the brain, a region
implicated in relapse to alcohol seeking. More notable is that increases in PECAM-1 is
associated with blood-brain barrier (BBB) leakage, suggesting endothelial cell damage in
relapsing alcoholics. Furthermore, published work from rodent studies and human postmortem
tissue analysis have indicated severe neuroimmune responses in the brain that is correlated with
increased relapse to drinking behavior. However, it remains unclear whether the activation state
of microglia, a major player in the neuroimmune response that occurs due to alcohol metabolism,
is associated with BBB leakage and endothelial cell damage in the prefrontal cortex. It was
hypothesized that endostatin, an angiogenic inhibitor, would inhibit PECAM-1 and thus decrease
BBB leakage. This was expected to reduce the peripheral neuroimmune response and prevent
alteration in microglial activation. In order to test this, the brain tissue of male rats with moderate
to severe AUD were analyzed. Specifically, quantitative immunohistochemistry and
stereological cell analysis were used to evaluate microglial activation which was positively
correlated to ethanol seeking behavior from the additional behavioral studies that were
performed. It was found that endostatin reduced PECAM-1 expression in the prefrontal cortex,
however, did not decrease ethanol seeking behavior of male rats. Additionally, microglial
activation remained similar to the rats that were not treated with endostatin. Therefore, it is
suggested that the peripheral immune response mediated by PECAM-1 is not directly linked to
ethanol seeking behavior and microglial activation in the prefrontal cortex in male rats. From
this, a new study investigating the internal neuroinflammation or immune response could help
determine the mechanism to decrease microglial activation and thus lower relapse. This would be
a significant advance in the effort to create an effective therapeutic for AUD.