Now in its second year, the Yale Conference for Alcohol Research and Education (YCARE) was held on September 30, 2023. Offering a comprehensive agenda of talks, panel discussions, and poster presentations, the all-day event brought together Yale's researchers, clinicians, and other stakeholders under the banner of alcohol research. Bubu Banini, MD, PhD, assistant professor of medicine (digestive diseases), Yale School of Medicine (YSM), spearheaded the conference, along with co-directors David Fiellin, MD, professor of medicine (general medicine) and emergency medicine, YSM, and public health, Yale School of Public Health; Graeme Mason, PhD, professor of radiology and biomedical imaging and of psychiatry, YSM; and Sherry McKee, PhD, professor of psychiatry, YSM.
We sat down with Banini and Mason to discuss the conference and their own experiences in alcohol research.
Q: Can you provide an overview of the event and its goals?
Banini: The goal of the conference is to bring together researchers, clinicians, and others interested in alcohol research. Historically, people in these fields worked in silos with little interaction. This conference aims to foster collaboration. The event includes various talks and poster presentations on topics related to alcohol research, such as genetics of alcohol use disorder, its effects on driving, sleep, cognition, and drug development, among others.
Q: How has the event changed from last year’s inaugural conference?
Banini: Last year, we had around 11 posters, but this year, we had 32. The growth has come from increased awareness and interest in the field of alcohol research. It's a testament to the growing interest and need for a common platform for researchers and clinicians to meet, share ideas, and collaborate.
Q: Can you tell us about your background and how you came to focus on alcohol research?
Banini: After undergrad, I joined an MD-PhD program, which introduced me to both clinical work and research. During my residency, I had a significant experience with a patient with alcohol-related liver disease. This sparked my interest in the field. The stigma associated with alcohol use disorder and the lack of understanding about its causes and effects on patients motivated me to contribute to this area.
Afterward, I pursued postdoctoral training in liver diseases, including fatty liver disease, alcohol associated steatohepatitis, and liver cancer. These experiences deepened my interest in researching alcohol- and metabolic-associated fatty liver disease. My journey has involved a mix of basic science, translational, and clinical research.
Mason: I initially studied nuclear engineering in college and became interested in MRI technology when I came across a magazine article featuring MRI images of the human body. Later, during my PhD work at Yale, I began working with MR spectroscopy and later, as faculty, focused on alcohol metabolism. YCARE's mission aligns with my interests in teaching and dissemination of research. I saw it as an opportunity to contribute my expertise to a cause I'm passionate about.
Q: Could you share some of your current research related to alcohol use?
Banini: I've become increasingly interested in studying sex differences in alcohol use disorder and related diseases. Notably, females tend to have more severe alcohol-related liver disease compared to males, and I'm curious about the biological reasons behind this. Understanding these differences can help improve prevention and treatment strategies.
Mason: My research primarily focuses on how alcohol is metabolized in the body and especially in the brain. When you drink alcohol, your liver converts it into acetaldehyde, which is toxic. It then turns into acetate, which can be used by the body, including the brain, as an energy source. The brain can also make that conversion. I'm particularly interested in the brain's response to acetaldehyde and acetate, and how it might contribute to the desire to drink more.
Q: How do the multidisciplinary aspects of this field play into both patient care and research efforts?
Banini: The multidisciplinary nature of this field is crucial. For instance, alcohol-related hepatitis is a severe condition with no approved treatment. The biggest determinant of patient outcomes after discharge from hospitalization is whether they return to drinking. Mortality rates skyrocket for those who resume alcohol use — the disease carries a mortality as high as 40% within six months after discharge. This emphasizes the need for collaboration between gastroenterologists and mental health practitioners to ensure patients receive holistic care.
Mason: Alcohol use disorder is a complex, whole-body disease, not limited to the brain. Collaborations among researchers, clinicians, and experts from various fields are essential. We need to consider the gut-brain axis, liver interactions with the brain, and the impact on overall health to gain a comprehensive understanding and develop effective treatments.
Q: Could you elaborate on recent collaborations and interdisciplinary work?
Mason: Interdisciplinary collaboration is a cornerstone of our research. One interesting finding from our research involved people with alcohol dependence who were seeking treatment. We expected their brains to have high acetate consumption due to heavy drinking, but surprisingly, they had almost none. After just a month of sobriety, their acetate consumption was close to normal. This led us to investigate whether brain acetate metabolism could be a factor contributing to heavy drinking.
Q: Can you explain the need for better communication and integration between gastroenterologists and mental health practitioners?
Banini: Currently, we need integrated clinics that facilitate communication between hepatologists and mental health providers. Research is needed to identify ways to improve collaboration, as this will benefit patients in terms of clinical care and help us address important research questions. Collaborative efforts between medical professionals not only improve patient care by addressing the psychological aspects of alcohol use disorder but also generate research questions that can ultimately enhance patient outcomes.