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The Impact of Alcohol Addiction on “The ICH Inflammatory Triad ” (intestine-brain-liver). Is Alcohol Abuse a Contagious Facilitating Factor of COVID-19 Infections?

( This article by no means, is or pretends to be a scientific research paper, is aimed to summarized data, and raised some questions and doubts. Neither could be used as a guide for treatment. Always consult your family physician, and read further.”

As I have mentioned in previous writings, alcohol addiction is associated with many diseases. In this writing I will elaborate a little more on some of them that we know are manifested more frequently.
As we said earlier, alcohol addiction is associated with impaired absorption in the duodenum leading to malnutrition and poor storage of thiamine in the liver, which requires the intake of supplemental doses of these and other vitamins. Alcohol induced liver disease is one of the most common duodenal etiologies causing malnutrition and impaired storage of thiamine in the liver.

In the same category, alcoholic liver disease is today one of the most common preventable diseases in the world, and that include asymptomatic hepatic steatosis, fibrosis and cirrhosis, in addition to alcoholic hepatitis. Among patients with Alcohol Abuse Disorder, fibrosis, cirrhosis, and alcoholic hepatitis continue to be one of the most common liver diseases, and alcoholic liver disease remains the number one cause of death.

In the last decade, it has been possible to demonstrate without a doubt that in people addicted to alcohol there is a clear association between the intestine, particularly between the intestinal flora or microbiota and duodenal intestinal malabsorption. Among people with alcohol addiction, studies carried out in the last decade clearly show that the alcohol consumed ends up breaking the intestinal barrier function, which is also called leaky gut.

That intestinal barrier is normally composed of enterocytes, goblet cells and antimicrobial substances that affect the barrier or microbiome that are protected within a mucous layer along with numerous immune cells that together form what is known as the ‘lamina propria’. We clearly do not have a microbiome within a mucus layer, and numerous immune cells in the lamina propria. There is still clearly not understanding on how alcohol, or its metabolite acetaldehyde, leads to the transformation of permeable to impermeable gut. However, it is suspected that dysbiosis or damage to the intestinal flora, the activation of the immune system and the resulting inflammation, can play an important and essential role in intestinal damage.

Intestinal dysbiosis is nothing other than the alteration of the normal intestinal flora, which is characterized by a reduction in the levels of anti-inflammatory bacteria, including changes that include numbers, proportions and type of bacteria and a greater abundance of Proteobacteria. Recent studies indicate that improving the health of the intestinal barrier may improve liver damage from alcohol. Of course, stopping the use of alcohol is the first step in implementing the treatment of any consequent illness.

Continued alcohol abuse can change fecal pH, which is why they often show elevated levels of cytokines in the blood, such as TNFα, interleukin 10, and CRP, indicators of chronic systemic inflammation, elevations shared by systemic inflammatory deseases of none alcoholic origin.

Finally, we must not forget that there is a clear association between systemic inflammation and psychiatric disorders, including depression. Studies have revealed that there is an association between systemic inflammation and mental conditions. However, the mechanism of interaction between systemic inflammation and psychiatric disorders such as depression and autism is not fully understood.

A possible mechanism of systemic inflammation in alcohol addiction is that intestinal bacterial products activate peripheral blood mononuclear cells, inducing the entry of cytokines into the bloodstream, causing low-grade systemic inflammation among people with alcohol dependence, characteristics also present in similar inflammatory states of different ethnology. In other words, users addicted to alcohol may be in a state of “constant systemic inflammation.”

Alcohol addiction is highly associated with other psychiatric illnesses, such as major depressive disorder, bipolar disorders, and anxiety disorders. Mood disorders, such as major depressive disorders, often precede the onset of alcohol addiction; for example, people consume alcohol to cope with a bad mood. The severity of alcohol addiction is correlated with the intensity of your craving, cognitive dysfunction, anxiety, and depressive symptoms. As we mentioned earlier, systemic inflammation can play an important role in the development of alcohol addiction; intestinal barrier dysfunction and inflammation in both the intestine and the liver can contribute to peripheral inflammation and cause inflammation of the brain, inducing inflammation of brain cells of supporting tissue, such as microglia or astrocytes, which have recently become discovered they exert important cognitive functions.

Finally, the modern theory that explains this disease can link systemic inflammation to both alcohol addiction and mood disorders. This theory supports that both peripheral inflammation and leaky gut activate the immune system and produce cytokines that can reach the brain, causing fever, fatigue, lassitude, inability to concentrate and withdrawal from social interactions, again all present in many other inflammatory states of different etiologies,like COVID-19 reported inflammatory reactions.

When the above behaviors persist, depressive symptoms may develop. Although studies support that alcohol addiction or craving is associated with systemic inflammation, causality is still unclear. However, the combination of alcohol cravings and negative emotions such as anxiety and depression is highly associated with drug-seeking behaviors and relapses, indicating that reducing systemic inflammation can improve psychological well-being and prevent relapses.


So, if it has been confirmed that this state of generalized inflammation of our body that is observed in several very diverse conditions such as generalized anxiety disorder, Covid 19 patients and in alcohol addiction, all associated with poor responses to treatment and a weak immune system response , it could be intuitive to hypothetically considered alcohol consumption as an important COVID-19 possible contagious facilitating factor, if it is true, the ways it happens needs to be study, and it may somehow be use in a preventive manner to decrease contagious rates.

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Wilfredo Santa Gomez