Amore practical alternative could be ketone bodies, which enter thebrain via the same MCTs as acetate, raising their possible use astherapy for AUD [67–69]. A ketogenic diet raises ketone bodies inblood for subsequent use by the brain to replace glucose partially[70]. Previous studies [17, 65] tested this idea with the introductionof a ketogenic diet to AUD patients [65], and that work showedthat the diet reduced withdrawal symptoms in AUD patientsrelative to those on a standard diet.

Chronically, plasma acetate (daily, not sporadic) could leadthe brain to protect against importing acetate, possibly byreduced MCT across the blood-brain barrier. Mews et al.reported histone acetylation with alcohol exposure in themouse brain [56], which may be harmful when it occurschronically [57, 58].

In brain, acetateis selectively utilized by astrocytes [30], so isotopically labeledacetate can be used to trace glial metabolism and the glutamate-glutamine neurotransmitter cycle [31–33], which relates directly tothe rate of synaptic glutamate release.