Abstract
Once ingested, most of the alcohol is metabolized in the liver by alcohol dehydrogenase to acetaldehyde. Two additional pathways of acetaldehyde generation are by microsomal ethanol oxidizing system (cytochrome P450 2E1) and catalase. Acetaldehyde can form adducts which can interfere with cellular function, leading to alcohol-induced liver injury. The variants of alcohol metabolizing genes encode enzymes with varied kinetic properties and result in the different rate of alcohol elimination and acetaldehyde generation. Allelic variants of these genes with higher enzymatic activity are believed to be able to modify susceptibility to alcohol-induced liver injury; however, the human studies on the association of these variants and alcohol-associated liver disease are inconclusive. In addition to acetaldehyde, the shift in the redox state during alcohol elimination may also link to other pathways resulting in activation of downstream signaling leading to liver injury.
Highlights
Alcohol associated liver disease (ALD) is one of the major causes of chronic liver disease worldwide [1,2]
Many of the effects of ethanol are mediated by its byproduct acetaldehyde, which is mainly generated by alcohol dehydrogenase (ADH), cytochrome P450 2E1 (CYP2E1), and catalase (Figure 1)
The ability of acetaldehyde to alter cellular function will depend on the enzymatic activity and acetaldehyde formation
Summary
Alcohol associated liver disease (ALD) is one of the major causes of chronic liver disease worldwide [1,2]. The risk of ALD development is known to be associated with the quantity of alcohol (beverages containing ethanol) consumed [3,4]. 13,285 subjects were prospectively followed for 12 years to determine the association between the risk for development of future liver disease and self-reported alcohol consumption [7]. Most cases develop macrovesicular steatosis primarily in zone 3 or throughout the liver in severe cases [12] This condition is reversible upon abstinence [13]. Some of the enzymes involved in alcohol metabolism are genetically polymorphic leading to the alteration in enzymatic properties and varying amounts of acetaldehyde generation after alcohol consumption [23] The roles of these enzymes in association with ALD are the subject of this overview
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