The Stress-Hormone System in Alcohol-Dependent Subjects
Condition: Alcoholism
MeSH terms: Alcoholism
Study type: Observational

Summary: 
      This study, conducted at the University of Texas Southwestern Medical Center and the Parkland
      Hospital in Dallas, will examine the stress hormone system of alcohol-dependent people. This
      system is weakened in alcohol-addicted people. This study will determine how long it is
      weakened, whether other hormone systems are also weakened and whether changes in the hormone
      system are associated with previous trauma or stress.

      Healthy normal men and men who are alcohol-dependent may be eligible for this study.
      Candidates must be between 21 and 60 years of age and have at least a 5-year history of
      active alcohol dependence. They are screened with a medical history, blood and urine tests
      and questions about alcohol and drug use, psychiatric problems, history of trauma and recent
      stress.

      Participants undergo the following procedures:

      Day 1 - Public Speaking Task

      At 6:00 PM subjects have an I.V. line (needle attached to a small plastic tube) inserted into
      a vein in each arm to draw blood samples and give medication. They are then given a light
      dinner and then lie down and rest. They rinse their mouth out with water and a drop of lemon
      juice is placed on their tongue. In 30 to 40 seconds they spit into a funnel attached to a
      collecting tube. A blood sample is collected to measure levels of cortisol (a stress hormone)
      ACTH (a hormone responsible for the release of cortisol) and neurosteroids (hormones that
      affect the brain). Subjects then give a 5-minute speech (telling an ending to a story) and
      solve a math problem in front of a small group of people. They are then asked how they are
      feeling. Saliva and blood samples are then collected every 10 minutes for the next 60
      minutes.

      Day 2 - Cosyntropin Study

      At 6:30 p.m. subjects have an I.V. line inserted into a vein in each arm. At 7:45 PM and 8:30
      PM saliva is collected as described above. Starting at 7:30 PM, blood samples are collected
      every 10 minutes until 9:00 PM and then every 20 minutes until 10:00 PM. At 8:00 PM
      cosyntropin (a medicine that stimulates production of cortisol) is given through the I.V.
      over 1 minute.

      Day 3 - oCRH Study

      At 6:30 p.m. subjects have an I.V. line inserted into a vein in each arm. At 7:45 PM and 8:30
      PM saliva is collected as described above. Starting at 7:30 PM, blood samples are collected
      every 10 minutes until 9:00 PM and then every 20 minutes until 10:00 PM. At 8:00 PM ovine CRH
      (a medicine that stimulates production of cortisol) is given through the I.V. over 1 minute.

      Participants may be asked to repeat these studies 3 months later.
    

Detailed description: 
      The hypothalamic-pituitary-adrenal (HPA) axis provides a key biologic link between the brain
      and the body's behavioral and physiologic responses to stress, recovery, and adaptation. Both
      mental trauma and chronic alcohol use may produce disturbances in the HPA response to stress.
      Thus, changes in this system during a period when there is no alcohol intake may impair the
      body's ability to mount an appropriate response to environmental stressors, heightening the
      probability of additional alcohol intake. However, the relationship between trauma, stress,
      and HPA axis disturbances requires further study. In this study, the NIH investigators will
      attempt to determine if the sensitivity of glucocorticoid gene induction varies with stress.
      Blood samples will be obtained at The University of Texas Southwestern Medical Center (TSMC)
      in collaboration with the Veteran's Affairs Medical Center (VA) at Dallas, Texas under a
      protocol and consent forms approved by TSMC IRB. Only samples collected as described in the
      TSMC protocol will be studied at NIH.
    

Time perspective: Prospective
Keywords: Glucocorticoid; Steroids; Dose-Responsive Curve; EC50; Stress Response; Alcoholism