title: Thiamine deficiency, oxidative metabolic pathways and ethanol-induced neurotoxicity: how poor nutrition contributes to the alcoholic syndrome, as Marchiafava-Bignami disease.
abstract: Ethanol is an important risk factor for the occurrence of several brain disorders that depend on the amount, period and frequency of its consumption. Chronic use of ethanol often leads to the development of neurodegenerative syndromes, which cause morphological and functional impairments such as foetal alcohol syndrome in newborns exposed to ethanol during pregnancy, Wernicke-Korsakoff Syndrome and, more rarely, Marchiafava-Bignami disease (MBD). MBD is characterized by primary degeneration of the corpus callosum, without inflammation and is associated with oxidative stress and hypovitaminosis, as well as altered mental status, to mention dementia, seizures, depression and so on. This review discusses MBD and poor nutrition as a risk factor for the development of such alcoholic syndrome, with focus on diagnosis, pathogenic aspects, signs and symptoms, as well as therapeutic perspectives. On the basis of the inclusion/exclusion criteria adopted, the performed search in scientific databases (Pubmed, Scielo and Google Scholar) resulted in 100 studies that are being presented and discussed in the present work. Review, case-control and cohort studies on alcoholism-associated hypovitaminosis, oxidative stress, MBD and ethanol metabolism pathways were admitted as relevant. We highlight that MBD is a poorly described, diagnosed, insidious and progressive condition, for which evidence suggests a synergism between ethanol-induced neurotoxic effects and hypovitaminosis B. Present treatment consists of vitamin B1(thiamine) supplementation. Nonetheless, other strategies such as the inclusion of antidepressants or steroidal anti-inflammatories as add-on therapies have been employed as an attempt to improve the damage. Indeed, both the diagnosis and treatment are difficult, and death occurs within few years.
authors.affiliation: Programa de Pós-Graduação em Ciências Farmacêuticas, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.|Programa de Pós-graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil.|Laboratório de Farmacologia da Inflamação e do Comportamento, Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: L M P
authors.initials: LMP
authors.lastname: Fernandes
authors.affiliation: Programa de Pós-Graduação em Ciências Farmacêuticas, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: F R
authors.initials: FR
authors.lastname: Bezerra
authors.affiliation: Programa de Pós-Graduação em Ciências Farmacêuticas, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.|Programa de Pós-graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil.|Laboratório de Ensaios in vitro, Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: M C
authors.initials: MC
authors.lastname: Monteiro
authors.affiliation: Laboratório de Farmacologia da Inflamação e do Comportamento, Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: M L
authors.initials: ML
authors.lastname: Silva
authors.affiliation: Programa de Pós-graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil.|Curso de Ciências Farmacêuticas, Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá, Amapá, Brazil.
authors.forename: F R
authors.initials: FR
authors.lastname: de Oliveira
authors.affiliation: Programa de Pós-graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: R R
authors.initials: RR
authors.lastname: Lima
authors.affiliation: Programa de Pós-Graduação em Ciências Farmacêuticas, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.|Laboratório de Farmacologia da Inflamação e do Comportamento, Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: E A
authors.initials: EA
authors.lastname: Fontes-Júnior
authors.affiliation: Programa de Pós-Graduação em Ciências Farmacêuticas, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.|Programa de Pós-graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil.|Laboratório de Farmacologia da Inflamação e do Comportamento, Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: C S F
authors.initials: CSF
authors.lastname: Maia
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects* / Q000097:blood; D000437:Alcoholism / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D000431:Ethanol / Q000009:adverse effects*; D054319:Marchiafava-Bignami Disease / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D020258:Neurotoxicity Syndromes / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D018384:Oxidative Stress; D013831:Thiamine / Q000494:pharmacology; D013832:Thiamine Deficiency / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D014803:Vitamin B Complex / Q000494:pharmacology
chemical_list: D014803:Vitamin B Complex; D000431:Ethanol; D013831:Thiamine