Fetal alcohol syndrome (FAS) is often called the number one preventable birth defect. Despite counselling of pregnant women to avoid alcohol, large numbers of babies are born with FAS. At present, no effective treatments exist that can prevent or reverse FAS after fetal exposure to alcohol. However, Alessandro Ieraci and Daniel Herrera now report encouraging results in mice that might one day change this situation.
The researchers tested whether nicotinamide, a drug that is commonly used in patients with some autoimmune diseases, could protect mice after alcohol exposure. They injected mouse pups shortly after birth with alcohol (mouse brain development happens a bit later in humans, and the time shortly after birth in mice corresponds to brain development in human babies during the third trimester of pregnancy). They found that this single exposure to alcohol (the levels were comparable to those of a human fetus after one-time excessive drinking by the pregnant mother) caused the death of brain cells in the mouse pups, as well as a range of behavioral abnormalities after the pups had grown into adult mice. When Ieraci and Herrera followed the injection of alcohol with a second injection of nicotinamide 2 hours later, the number of brain cells that died was no greater than during normal brain development, and the mice did not show behavioral abnormalities as adults. A weaker but noticeable protective effect against the cell death in the brain was also seen when nicotinamide was administered up to 8 hours after alcohol exposure.
These are early-stage experiments done in a mouse model of FAS, and much more work is needed before it will become clear whether this treatment would work in humans. That said, the results suggest that nicotinamide might be able to prevent some of the alcohol damage to the baby if the mother takes it soon after drinking alcohol. The emphasis in FAS prevention must obviously remain on helping pregnant women (and women who might become pregnant) to quit drinking alcohol. However, it is worth pursuing nicotinamide as a possible treatment for preventing FAS in situations where a pregnant woman is unable to stop drinking entirely.
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Citation: Ieraci A and Herrera DG (2006) Nicotinamide protects against ethanol-induced apoptotic neurodegeneration in the developing mouse brain. PLoS Med 3(4): e101.
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Caption: Fluoro-Jade-B staining of dying neurons after ethanol exposure
Daniel G. Herrera
Weill Medical College of Cornell University
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