New targets in the management of alcohol dependence : which role for gut microbiota, gut barrier and immunity ?

The prevalence of alcohol use disorders in Europe is 7.5%. Alcohol dependence is traditionally considered a brain disorder where ethanol interacts with several receptors for neurotransmitters. Pharmacological treatments of addiction currently target these receptors but demonstrated only limited therapeutic effect, and the relapse rate is still very high. This PhD work was dedicated to the study of alterations of the gut in alcohol-dependence. We observed important alterations of the gut microbiota in a large fraction of alcohol-dependent subjects, that was associated with a leaky gut barrier, which enabled the translocation of bacterial products from the gut lumen to the systemic circulation. These bacterial products induced an inflammatory response that correlated with psychological symptoms of alcohol dependence including depression, anxiety and craving. The results of this thesis open a new field of research for the treatment of alcohol dependence, targeting the gut microbiota.(BIFA - Sciences biomédicales et pharmaceutiques) -- UCL, 201