What is Alcohol Intolerance?
Alcohol intolerance is a disease that results from a interruption in the metabolism of alcohol. Alcohol intolerance is commonly caused by a missense mutation in the aldehyde dehydrogenase (ALDH) pathway. Specifically, ALDH2 typically has a missense mutation that interrupts the degeneration of ethanol. There can be many different interruptions in the alcohol metabolism pathway, but the most commonly possessed mutation is in the ALDH2 allele.
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How does alcohol effect people with this disease?
When people with this disease ingest alcohol they feel more severe effects. Acetaldehyde levels can rise to lethal levels at a rapid rate in individuals with the disease. This accumulation can cause a person's skin to turn to a flush red color. The accumulation of acetaldehyde is associated with multiple types of gastric cancer(2). Antihistamines are known to reduce the effect of the flush reaction, but some research shows there may be long term issues with this response. Other possible remedies for the flush reaction recommend eating before consuming alcohol.
Whose effected?
Treatments
There are currently no known treatments for this disease, but there are some studies that show different diets can reduce the flush reaction (5). Altered diets are the only treatment to reduce the flush reaction and does not have potential for issues later in life.
Gap in knowledge
Alcohol intolerance is associated with a higher incidence of cancer in multiple different tissue types (6). The cause of this proliferation affect is unknown.
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References:
1)Xiao, Q., Weiner, H., & Crabb, D. W. (1996). The mutation in the mitochondrial aldehyde dehydrogenase (ALDH2) gene responsible for alcohol-induced flushing increases turnover of the enzyme tetramers in a dominant fashion. The Journal of clinical investigation, 98(9), 2027–2032. doi:10.1172/JCI119007
2)Brooks, P. J., Enoch, M. A., Goldman, D., Li, T. K., & Yokoyama, A. (2009). The alcohol flushing response: an unrecognized risk factor for esophageal cancer from alcohol consumption. PLoS medicine, 6(3), e50. doi:10.1371/journal.pmed.1000050
3)Wang X, Sheikh S, Saigal D, Robinson L, Weiner H. Heterotetramers of human liver mitochondrial (class 2) aldehyde dehydrogenase expressed in Escherichia coli. A model to study the heterotetramers expected to be found in Oriental people. J Biol Chem 1996;271: 31172–8.
4)Kim, Y., Park, J., Nam, B. H., & Ki, M. (2015). Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011. Epidemiology and health, 37, e2015006. doi:10.4178/epih/e2015006
5) Fujioka K., Gordon S. Effects of “Essential AD2” Supplement on Blood Acetaldehyde Levels in Individuals Who Have Aldehyde Dehydrogenase (ALDH2) Deficiency. Am. J. Ther. 2018 Published online February 21, 2018.
6)Chang, J.S., Hsiao, J. & Chen, C. ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective. J Biomed Sci 24, 19 (2017). https://doi.org/10.1186/s12929-017-0327-y
1)Xiao, Q., Weiner, H., & Crabb, D. W. (1996). The mutation in the mitochondrial aldehyde dehydrogenase (ALDH2) gene responsible for alcohol-induced flushing increases turnover of the enzyme tetramers in a dominant fashion. The Journal of clinical investigation, 98(9), 2027–2032. doi:10.1172/JCI119007
2)Brooks, P. J., Enoch, M. A., Goldman, D., Li, T. K., & Yokoyama, A. (2009). The alcohol flushing response: an unrecognized risk factor for esophageal cancer from alcohol consumption. PLoS medicine, 6(3), e50. doi:10.1371/journal.pmed.1000050
3)Wang X, Sheikh S, Saigal D, Robinson L, Weiner H. Heterotetramers of human liver mitochondrial (class 2) aldehyde dehydrogenase expressed in Escherichia coli. A model to study the heterotetramers expected to be found in Oriental people. J Biol Chem 1996;271: 31172–8.
4)Kim, Y., Park, J., Nam, B. H., & Ki, M. (2015). Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011. Epidemiology and health, 37, e2015006. doi:10.4178/epih/e2015006
5) Fujioka K., Gordon S. Effects of “Essential AD2” Supplement on Blood Acetaldehyde Levels in Individuals Who Have Aldehyde Dehydrogenase (ALDH2) Deficiency. Am. J. Ther. 2018 Published online February 21, 2018.
6)Chang, J.S., Hsiao, J. & Chen, C. ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective. J Biomed Sci 24, 19 (2017). https://doi.org/10.1186/s12929-017-0327-y
Images:
Header:https://www.alcohol.org.nz/alcohol-its-effects/about-alcohol/what-is-alcohol
How does alcohol effect people with this disease background: https://uproxx.com/life/what-is-fake-alcohol-how-to-avoid/
Alcohol flush map: https://www.23andme.com/en-ca/topics/wellness/alcohol-flush-reaction/
Header:https://www.alcohol.org.nz/alcohol-its-effects/about-alcohol/what-is-alcohol
How does alcohol effect people with this disease background: https://uproxx.com/life/what-is-fake-alcohol-how-to-avoid/
Alcohol flush map: https://www.23andme.com/en-ca/topics/wellness/alcohol-flush-reaction/