Alcohol Use Disorder (AUD) is a major national health problem and the development of more effective treatments is required to offset the needs of this patient population. To this end, the following protocol utilizes two simple rodent drinking models to assess the preclinical efficacy of lead anti-alcohol compounds.
Alcohol Use Disorder (AUD) is a major problem with more than an estimated 76 million people worldwide meeting the diagnostic criteria. Current treatments are limited to three FDA-approved medications that are largely ineffective even when combined with psychosocial intervention, as is evident by the high relapse rate. As such, the search for more novel treatments represents an important public health goal. To this end, the following protocol utilizes two simple rodent drinking models to assess the preclinical efficacy of lead anti-alcohol compounds: two-bottle choice (TBC) and drinking in the dark (DID). The former allows mice to voluntary drink in moderation while the latter induces mice to voluntary consume a large amount of alcohol in a short period that mimics binge drinking. The simple and high throughput nature of both of these paradigms allow for rapid screening of pharmacological agents or for identifying strains of mice that exhibit certain voluntary drinking behavior.
For the past 25 plus years, significant effort has been put towards developing medications for the treatment of Alcohol Use Disorder (AUD)1.Although many advances have been made, AUD still remains a major public health problem, affecting over 18 million Americans, and costing over $220 billion annually2,3. Currently there are only three FDA-approved medications, disulfiram, naltrexone, and acamprosate, all of which have yielded inconsistent results in clinical trials and limited success even when combined with psychosocial intervention in the clinic settings4,5,6,7.
A primary reason for failures of current AUD therapy is linked to the heterogenous nature of AUD8. While both environmental and genetic factors contribute to the development of AUD, heritability accounts for an estimated 50 – 60% of the risk of onset9. Similar to the treatment of depression, it is widely accepted that patients suffering from AUD will need a variety of medications that are tailored to meet the needs of each patient10.
Clearly, there is an urgent need for more effective treatments that would be facilitated if the already arduous and time consuming process of drug discovery were streamlined3. To this end, the following protocol demonstrates the preclinical applicability of two rodent drinking models widely used to examine the neurobiological basis of AUD11. More specifically, the method introduced herein can assess the efficacy of candidate compounds at reducing alcohol consumption in both "moderate" and "binge drinking" scenarios utilizing the two-bottle choice (TBC) and drinking in the dark (DID) paradigms, respectively. Both paradigms examine non-operant ethanol self-administration, whereby mice ingest ethanol orally and at will, and therefore illustrate high face and construct validity as a model of human alcoholism11.
In TBC drinking, also known as free choice drinking, preference drinking, or social drinking, two bottles of solution are continuously available in the home cage. One bottle contains water, and the other contains a diluted solution of ethanol, whereby the concentration of ethanol can be varied (e.g., 5 – 30% v/v)11,12. The mice have constant access to both bottles, and therefore, can choose how much to drink from each bottle.
This model assesses the ethanol consumption of each mouse (g/kg), as well as the ethanol preference ratio (volume of ethanol consumed ÷ total volume liquid consumed). It is routinely used to compare drinking levels across different strains of mice, or after a specific genetic manipulation (e.g., gene knockout or knockdown) and results in blood ethanol concentrations (BECs) similar to what is found in humans when drinking in moderation13,14.
In the DID procedure, 3 h after the start of the dark cycle, the home cage bottle of water is exchanged with a bottle of 20% (v/v) ethanol solution for a limited access drinking session. The drinking sessions occur as a consecutive 4-day cycle, lasting 2 h on days 1 – 3 and 4 h on day 4. Days 1-3 serve as an alcohol-habituation period before the testing on day 4. Consequently, mice will reliably consume enough ethanol to attain BECs >100 mg/dL and as a result, exhibit the behavioral effects of intoxication found in humans that are binge drinking13,14,15. Water access is available at all times other than the drinking session.
There are several variations of limited access drinking. For example, in the intermittent access model, mice receive two bottles (one containing water and the other containing 20% (v/v) ethanol) only on Monday, Wednesday, and Friday with a 24 h and 48 h withdrawal period on weekdays and weekends, respectively16. After several weeks of intermittent access, the mice will gradually and voluntarily escalate drinking levels, eventually attaining BECS similar to what is observed in the DID model. The DID, however, appears to be the most commonly used model to assess binge-like drinking behavior. Other models of intermittent drinking exist, but they rely on restricting access to food or vapor chamber induced increases in voluntary self-administration, which makes them less representative of voluntary human alcohol consumption16.
All procedures described here have been approved by the Institutional Animal Care and Use Committees of the University of Southern California Health Sciences Campus.
1. Experimental Setup and Assembly
2. Animal Habituation
3. 24-Hour Two Bottle Choice (TBC)
Note: A schematic is prepared in Figure 1.
4. Drinking in the Dark (DID)
NOTE: A schematic is prepared in Figure 3.
In the following representative investigations, social drinking was modeled using the two-bottle choice (TBC) paradigm. Briefly, mice had access to two bottles of solution, one of which contained water, and the other a 10% (v/v) ethanol solution. Subjects were subsequently split and evenly assigned to drug treatment groups, moxidectin (MOX) vs. saline control, so that each group would have averaged ethanol intake levels with the least amount of variation.
Initial baseline 10E intake during the 24-h period stabilized at 14.46 ± 1.85 g/kg (n = 8) before injections began, and subsequently re-stabilized at 14.14 g/kg post saline injections. To assess the effects of an acute dose (5 mg/kg) of MOX on ethanol intake and preference, drinking activity was assessed pre MOX, MOX, and post MOX. We found that a single dose of MOX significantly reduced alcohol intake in excess of 45%, compared with pre MOX injections [F (2, 22) = 26.33, p <0.0001] (Figure 2A), and preference [F (2, 14) = 17.35, p <0.0001] (Figure 2B) in excess of 30%. 10E intake and preference both remained significantly lower than saline on the day immediately following MOX treatment (by more than 25%, and 15% respectively) shown as post MOX injections in Figure 2).
In an unpublished pilot study, binge drinking was modeled using the drinking in the dark (DID) procedure whereby mice had daily limited access (2 h) to one bottle containing 20E beginning 3-h into the circadian dark phase, for 3 consecutive days, with a longer access period (4 h) on day 4 (Figure 4). Female mice (n = 12, 6 mice/group) were administered saline injections (i.p.) on days 1 – 4 with baseline 20E established on day 4 (Pre-Drug). On Days 1 – 3 of the 2nd weekly cycle, all mice received yet another daily saline injection. The ethanol intake values from day 3 were then used to split the mice into two groups (n = 6/ group) that subsequently received either one injection (i.p.) of MOX (5 mg/kg) or saline on Day 4 (Drug). The following week all mice received daily saline injections on days 1 – 4 and ethanol intake was measured yet again on Day 4 (post Drug). Acute administration of 5 mg/kg MOX was analyzed and found to significantly reduced alcohol intake in excess of 54%, compared with pre-Drug injections (t = 7.635, p < 0.0001)
Figure 1. Two-Bottle Choice Schematic Please click here to view a larger version of this figure.
Figure 2. Two Bottle Choice (TBC). MOX (5 mg/kg) reduces 10% v/v ethanol (10E) intake (A) and preference (B) in female C57BL/6J mice using a 24-h access two-bottle choice paradigm. After attaining stable drinking levels for 3 consecutive days, MOX was administered. Bars represent average 10E intake levels from the day prior to the MOX injection (white; Pre MOX), the day of the MOX injection (black; MOX) and the day after the MOX injection (gray; Post MOX). Values represent the mean ± SEM for 12 mice. *P <0.05, **P <0.01, ***P <0.001, and ****P <0.0001 versus Pre MOX (leftmost horizontal line) or Post MOX (rightmost horizontal line), Tukey's multiple comparison post-hoc test. Modified from Huynh N. et al.19 Please click here to view a larger version of this figure.
Figure 3. Drinking in the Dark Schematic Please click here to view a larger version of this figure.
Figure 4. Drinking in the Dark (DID). MOX (5 mg/kg) reduces 20% v/v ethanol (20E) intake in female C57BL/6J mice using a drinking in the dark paradigm. Bars represent average 20E intake levels on the week prior to the MOX injection (Pre-Drug), the week of the MOX injection (Drug) and the week after the MOX injection (Post-Drug). Values represent the mean ± SEM for 12 mice (6/group) between saline and MOX groups. ****P <0.0001 versus Pre-Drug (leftmost horizontal line) or Post-Drug (rightmost horizontal line), Tukey's multiple comparison post-hoc test. Please click here to view a larger version of this figure.
Worldwide estimates indicate that as many as 76 million people meet the criteria to warrant a diagnosis for Alcohol Use Disorder (AUD). Unfortunately, pharmaceutical treatments currently available are largely ineffective and further development is necessary to offset the needs of this clinical population20. To this end, the following protocol aims to facilitate this endeavor by exemplifying two of the most basic rodent drinking paradigms: two-bottle-choice (TBC) and drinking in the dark (DID). Both models measure non-operant self-administration of ethanol, whereby mice ingest ethanol orally. In the TBC paradigm, ethanol (10% v/v) and water are both available continuously, resulting in comparably low blood ethanol levels that are a consequence of an episodic and gradual ethanol consumption pattern. This model is best for assessing lower levels of ethanol intake as a preference tastant and therefore, is said to be similar to human "moderate" drinking. Figure 2 above shows representative results for the TBC paradigm.
On the other hand, in the DID model ethanol (20% v/v) is only available for a limited amount of time. Unlike TBC, this model assesses the effects of a compound on behaviorally relevant concentrations of ethanol, taking advantage of the fact that C57BL/6J mice will consume large amounts of ethanol very quickly during the most active phase of their circadian cycle. These drinking sessions occur for 4 consecutive days, beginning at the 3rd h into the dark cycle, with a duration of 2 h on days 1 – 3 and 4 h on day 4. Using this procedure, mice typically consume enough ethanol to achieve BECs >100 mg/dL and to exhibit behavioral evidence of intoxication. Our representative results for the DID paradigm are shown in Figure 4. Although we did not measure BECs for these mice, their drinking levels are similar to those reported in the literature that achieved BECs over 100 mg/dL13,14,15.
Both paradigms have limitations. During instances when oral gavages are the preferred method of administration for pharmacological testing of lead compounds, esophogeal trauma caused by the procedure may hinder ethanol self-administration in both paradigms. This is especially true for the DID model, which uses a higher concentration of ethanol (20%) and which may present instances where the pharmacokinetics of the drug require the drinking session to begin before the animals have had adequate time to recover from the procedure. This would be evident in a control group drinking at levels that correspond to BECs well below the expected 0.08. In our lab, we have experienced difficulty with force feedings both with the DID and TBC. We were able to work around these issues by formulating our compounds so that they could be delivered using an orally dissolving thin strip (ODS)19.
Moreover, in the DID model specifically, given the fact that the ethanol access period is so short in duration, drug dosing must be done during a preselected time during the light cycle that is chosen in accordance with the pharmacokinetics of the drug so that the compound is at/or approaching the maximum brain concentration during the drinking period. If a pharmacokinetic analysis cannot be performed, an alternative approach would be to conduct a time course assessment of the behavioral effects of the drug using TBC. Following this logic, by monitoring drinking activity on an hourly basis, and determining peak anti-alcohol effects, one could reasonably strategize when drugs should be administered19.
While the field of alcoholism has various animal models to investigate the different physiological and behavioral aspects of AUD8, the following protocol describes two commonly used paradigms, which allows for comparisons of results across laboratories. A second benefit is that these methods are straightforward, making their use convenient during acute and chronic studies similar to the examples provided above. Additionally, unlike other commonly used alcohol paradigms, such as operant conditioning and vapor chamber paradigms, the methodology we have described here can be carried out without the need for specialty equipment. Anecdotally, it is likely that nearly all components of the drinking apparatus can be found in a prototypical institutional vivarium. There are also various ways to alter the protocols described here so that they can best fit the goals of each experiment. For instance, our DID procedure is best for testing the acute effects of a drug on a single drinking session (during day Day 4). However, we have shown that multi-day drug dosing can be assessed by augmenting the drinking sessions to 4 consecutive days of 2 hour access, as opposed to the current 2 hours of access on days 1 – 3 and 4 hours on day 419. Mice can also be transferred from one paradigm to another, or re-tested for additional doses / different compounds, with a simple 1 – 2 week washout period in between.
It should be mentioned that any drug-induced change in drinking observed through these methods must be thoroughly investigated to determine whether the effects are selective for alcohol or if they might be the result of toxicity. For more information on controls the reader should refer to Yardley et al.20 No single paradigm can model all aspects of this condition. Instead, each paradigm typically examines a few of the key attributes associated with AUD. The TBC and DID models described here, have been linked to the binge/intoxication stage of the addiction cycle. For a more thorough understanding of the utility of the compound, multiple preclinical drinking models should be utilized.
The authors have nothing to disclose.
This work was supported, in part, by Research grants SC CTSI NIH/NCRR/ NCATS — UL1TR000130 (D.L.D.), AA022448 (D.L.D.), and the USC School of Pharmacy.
1 L graduated cylinder | VWR | https://us.vwr.com/store/product/20935285/marisco-single-scale-cylinder-graduates-john-m-maris-co | To prepare ethanol solution. |
1 L glass bottle | Pyrex (Fisher Scientific) | https://www.fishersci.com/shop/products/pyrex-reusable-media-storage-bottles-12/p-42752 | To prepare ethanol solution. |
100 mL graduated cylinder | Fisher Scientific | https://www.fishersci.com/shop/products/kimble-chase-kimax-class-a-to-contain-graduated-cylinders-8/p-4369311 | To prepare ethanol solution. |
Analox | One potential method of analyzing DID blood samples is by using the analox machine | ||
ball-bearing sipper tubes | Ancare Corp. | http://www.ancare.com/products/watering-equipment/open-drinking-tubes/straight-tubes-ball-point | Length: 2.5 inches, Diameter: 5/16 inches, Model: TD100 |
C57BL/6J Mice | Jackson lab | https://www.jax.org/strain/000664 | May also come from internal breeding colony |
disposable serological pipets | VWR International (VWR) | https://us.vwr.com/store/product/4760455/vwr-disposable-serological-pipets-polystyrene-sterile-plugged | 10 mL, 18 mL, or 25 mL |
ethanol, pure, 190 proof (95%), USP, KOPTEC | Decon Labs (VWR) | https://us.vwr.com/store/product/4542412/ethanol-pure-190-proof-95-usp-koptec | — |
heat gun | Master Appliances Corp. | http://www.masterappliance.com/master-heat-guns-kits/ | |
heat shrink tubing | — | — | Diameter: 3/8 inches |
industrial knife/blade | — | — | — |
metal cage plate | — | — | Should be available through the university/institutional vivarium |
mouse RO water | — | — | Should be available through the university/institutional vivarium |
portable electronic scale | Ohaus (VWR) | https://us.vwr.com/store/product/4789377/portable-electronic-cs-series-scales-ohaus | — |
red light headlamp | nyteBright (Amazon) | https://www.amazon.com/LED-Headlamp-Flashlight-Red-Light/dp/B00R0LMMF8/ref=sr_1_1?ie=UTF8&qid=1499591137&sr=8-1-spons&keywords=red+lamp+headlamp&psc=1 | — |
silicone stoppers | Fisher | — | — |
thermometer | Fisher Scientific | https://www.fishersci.com/shop/products/fisher-scientific-hygro-thermometer-clock-large-display-2/p-4077232 | — |
weigh boat | VWR International (VWR) | https://us.vwr.com/store/product/16773534/vwr-pour-boat-weighing-dishes | The lid from a pipete tip box is an appropriate alternative |