Blood Ethanol Research Articles

Development of a Novel and Rapid LC-MS/MS Method for Measuring Phosphatidylethanol in Whole Blood

Abstract Alcohol consumption can lead to serious health repercussions, including motor impairments and organ failure. Testing for short-term alcohol use is routinely conducted using blood ethanol tests in clinical laboratories. However, there is an emergent need to identify heavy alcohol users, especially crucial for patients undergoing organ transplant evaluations. With the advent of various biomarkers to detect heavy alcohol use, phosphatidyl ethanol (PEth), a group of abnormal phospholipids formed in cell membranes due to alcohol consumption, has gained prominence. PEth has been analyzed in whole blood with liquid chromatography-tandem mass spectrometry (LC-MS/MS) as two isomers: 18:1 (fatty acid:double bond) and 18:2 (fatty acid:double bond). We have developed an LC-MS/MS method that can detect these isomers in 4.5 minutes at concentrations of 10-500 ng/mL with excellent linearity and precision. In contrast to most LC-MS/MS methods where phospholipids are removed to minimize ion suppression, this method requires retaining phospholipids because the analyte, PEth, is a type of phospholipid. This was achieved through a ‘reverse extraction’ approach using phospholipid removal cartridges. Subsequently, the extracted samples were separated in an Agilent Protoshell 120 HPLC column on a Vanquish UHPLC instrument using 1 mM ammonium formate with 0.2% formic acid in water as Solution A and 50/50 isopropanol/acetonitrile as Solution B. The separation is performed starting at 80% Solution B (rest is Solution A) followed by a gradient elution where Solution B was increased to 95% over 2.3 minutes. Ions were analyzed using a ThermoFisher TSQ Endura MS/MS instrument in the negative mode. Additionally, commercially available whole blood was found to contain detectable levels of PEth in random lots, rendering them unsuitable for use as blank blood in the preparation of calibrators and quality controls. Instead, synthetic was used for this purpose. Ion suppression was observed, and various strategies were attempted to minimize it, including adjusting additives in the mobile phase, extending LC separation times, among others. More details on the impact of these adjustments and their effectiveness in improving the method’s performance will be presented.

Neuroinflammatory responses and blood–brain barrier injury in chronic alcohol exposure: role of purinergic P2 × 7 Receptor signaling

Alcohol consumption leads to neuroinflammation and blood‒brain barrier (BBB) damage, resulting in neurological impairment. We previously demonstrated that ethanol-induced disruption of barrier function in human brain endothelial cells was associated with mitochondrial injury, increased ATP and extracellular vesicle (EV) release, and purinergic receptor P2 × 7R activation. Therefore, we aimed to evaluate the effect of P2 × 7R blockade on peripheral and neuro-inflammation in ethanol-exposed mice. In a chronic intermittent ethanol (CIE)-exposed mouse model, P2 × 7R was inhibited by two different methods: Brilliant Blue G (BBG) or gene knockout. We assessed blood ethanol concentration (BEC), brain microvessel gene expression by using RT2 PCR array, plasma P2 × 7R and P-gp, serum ATP, EV-ATP, number of EVs, and EV mtDNA copy numbers. An RT2 PCR array of brain microvessels revealed significant upregulation of proinflammatory genes involved in apoptosis, vasodilation, and platelet activation in CIE-exposed wild-type animals, which were decreased 15–50-fold in BBG-treated–CIE-exposed animals. Plasma P-gp levels and serum P2 × 7R shedding were significantly increased in CIE-exposed animals. Pharmacological or genetic suppression of P2 × 7R decreased receptor shedding to levels equivalent to those in control group. The increase in EV number and EV-ATP content in the CIE-exposed mice was significantly reduced by P2 × 7R inhibition. CIE mice showed augmented EV-mtDNA copy numbers which were reduced in EVs after P2 × 7R inhibition or receptor knockout. These observations suggested that P2 × 7R signaling plays a critical role in ethanol-induced brain injury. Increased extracellular ATP, EV-ATP, EV numbers, and EV-mtDNA copy numbers highlight a new mechanism of brain injury during alcohol exposure via P2 × 7R and biomarkers of such damage. In this study, for the first time, we report the in vivo involvement of P2 × 7R signaling in CIE-induced brain injury.

A headspace injection double-column dual-detector gas chromatography system for the analysis of 12 volatile compounds such as ethanol in human blood

Based on the technical methods of GB/T 42430-2023 and GA/T 204-2019, this study established an analytical method for headspace injection double-column dual-detector (hydrogen flame ion detector) gas chromatography for the simultaneous analysis of at least 12 volatile compounds, including ethanol, in human blood using two different equipment platforms and chromatographic columns. A 100 μL blood or urine sample and a 0.04 g/L tert-butanol working solution prepared as an internal standard are introduced into the headspace sample bottle and then sealed, mixed, and placed on the headspace sampler rack. Using different equipment platforms and columns, methodological parameters such as the limit of detection (LOD), limit of quantification (LOQ), precision, and accuracy of the method were systematically evaluated. The chromatographic separation of acetone, alcohols and benzenes using the established method was satisfactory. The linear ranges, linear correlation coefficients (r), and LODs of acetone and six alcohols, including ethanol, were 0.10-3.00 g/L, >0.997, and 0.05 g/L, respectively. The LOQs were 0.10 g/L for all other compounds, excluding n-propanol (0.005 g/L). Additionally, the linear ranges, r values, LODs, and LOQs of benzene and four benzene derivatives were 0.05-50 mg/L, >0.995, 0.02 mg/L, and 0.05 mg/L, respectively (Column J&W DB-BAC1 UI and Column Rtx-BAC-PLUS 2). The average recoveries of compounds on J&W DB-BAC1 UI and Rtx-BAC-PLUS 2 columns ranged from 92.2% to 111.6%, and the relative standard deviations (RSDs, n=6) ranged from 0.4% to 7.4%. The LOD, LOQ, precision, accuracy, and linearity of the established method met the requirements of relevant standards, and no significant differences arose between the methodological parameters of the two platforms. CNAS-GL006 (2019) and JJF 1059.1-2012 were used as guides to evaluate the uncertainty of ethanol on two different sets of equipment platforms and chromatographic columns. The ethanol uncertainty was mainly derived from the calibration curve; however, the confidence probability was 95% (k=2). According to the analysis of the verification samples and real samples, the established method is suitable for the high-precision quantitative analysis of acetone and six alcohols and five benzene derivatives in human blood and other body fluids. It can be used in practical scenarios such as judicial identification and the detection of poisons.

Preclinical Evaluation of Sodium Butyrate's Potential to Reduce Alcohol Consumption: A Dose-Escalation Study in C57BL/6J Mice in Antibiotic-Enhanced Binge-Like Drinking Model.

In our earlier efforts to establish gut-brain axis during alcohol use disorder (AUD), we have demonstrated that supplementation of C57BL/6J male mice with 8 mg/mL sodium butyrate, a major short-chain fatty acid, in drinking water reduced ethanol intake and neuroinflammatory response in antibiotic (ABX)-enhanced voluntary binge-like alcohol consumption model, drinking in the dark (DID). To further evaluate the preclinical potential of SB, we have set a dose-escalation study in C57BL/6J male mice to test effects of ad libitum 20 mg/mL SB and 50 mg/mL SB and their combinations with ABX in the DID procedure for 4 weeks. Effects of these SB concentrations on ethanol consumption and bodily parameters were determined for the duration of the treatments. At the end of study, blood, liver, and intestinal tissues were collected to study any potential adverse effects ad to measure blood ethanol concentrations. Increasing SB concentrations in the drinking water caused a loss in the protective effect against ethanol consumption and produced adverse effects on body and liver weights, reduced overall liquid intake. The hypothesis that these effects were due to aversion to SB smell/taste at these high concentrations were further tested in a follow up proof-of-concept study with intragastric gavage administration of SB. The higher gavage dose (320 mg/kg) caused reduction in ethanol consumption without any adverse effects. Overall, these findings added more support for the therapeutic potential of SB in management of AUD, given a proper form of administration.

N-Acetylcysteine Ineffective in Alleviating Hangover from Binge Drinking: A Clinical Study.

Alcohol hangover (veisalgia) is a fairly common phenomenon. The pathogenesis of veisalgia is not understood and treatment has not yet been established. Occasionally, students take N-acetylcysteine (NAC) before binge drinking to alleviate hangover. The aim of this study was to evaluate the effect of NAC on serum levels of electrolytes, enzymes, oxidative stress biomarkers and symptoms of veisalgia in binge drinking. In this randomized, double-blind, placebo-controlled study, healthy students were randomly assigned into two groups: one receiving NAC and the other receiving a placebo. Blood samples were taken before drinking, 30 min after a 1.5 h long drinking session, and the subsequent morning. Serum levels of electrolytes, urea, enzymes, ethanol, 8-Hydroxydeoxyguanosine (8-OHdG) and N-epsilon-hexanoyl-lysine were measured. The participants completed the Acute Hangover Severity Scale (AHSS) assessment based on symptoms, and 40 students (20 male), aged 23 ± 2 years, were included in the study. Their mean blood ethanol concentration was 1.4 g/kg. Serum sodium levels were increased after drinking, and urea decreased the following morning compared to their levels before drinking in both groups. Serum 8-OHdG levels were increased after drinking and remained elevated until the following morning, compared to the levels before drinking, in both groups. NAC had no effect on sodium, urea and 8-OHdG levels or the symptoms of veisalgia. In conclusion, binge drinking causes a transient increase in serum sodium and as a prolonged increase in oxidative marker 8-OHdG levels. NAC had no effect on the sodium and 8-OHdG levels.

Facial changes in individuals deceased from ethanol poisoning

BACKGROUND: Changes in the facial area (facial edema, its purplish or bluish color, drooling, tearing, and a sign described by A.P. Kurdyumov) are among the most commonly observed signs of ethanol poisoning. However, their diagnostic capabilities are not investigated, and the mechanisms of development are not described. AIM: To study the occurrence of changes in the facial area in individuals who died from ethanol poisoning. From a modern perspective, the mechanism of their development, characteristics, and specificity were assessed. MATERIALS AND METHODS: A single-center retrospective observational cross-sectional study was conducted based on the archive of the State Budgetary Healthcare Institution of Moscow Region “Bureau of Forensic Medical Examination,” including cases of death from January 1, 2020, to December 31, 2020. Cases were grouped into five categories: ethanol poisoning, poisoning with other alcohols, asphyxia, other violent causes of death, and natural death. RESULTS: The study included 1,181 cases, with a median age of 52 (range, 19–95) years. Women were older, with no significant difference in blood ethanol concentration. Facial puffiness was observed in 53.1% of ethanol poisoning cases and bluish discoloration in 59.5%. The sign described by A.P. Kurdyumov was less frequently observed. Facial puffiness (p=0.002) and the sign described by A.P. Kurdyumov (p=0.014) were more common in poisoning with other alcohols than in deaths from asphyxia. However, no such differences were observed for facial bluish discoloration (p=0.176). Facial bluish discoloration had the highest sensitivity in both alcohol and other alcohol poisoning cases (59.53% and 40.74%, respectively) but had the lowest specificity in the same groups among the examined signs. The sign described by A.P. Kurdyumov had the highest specificity among those examined for both ethanol poisoning and poisoning with other alcohols. CONCLUSION: In ethanol poisoning, facial bluish discoloration was the most sensitive sign, and the sign described by A.P. Kurdyumov was the most specific among the analyzed signs. The examined signs were observed in both ethanol and other alcohol poisoning but less frequently. The forensic medical signs considered are largely similar to the clinical signs observed in flush syndrome.

Food from Equids-Commercial Fermented Mare's Milk (Koumiss) Products: Protective Effects against Alcohol Intoxication.

Fermented mare's milk (koumiss), a traditional Central Asian dairy product derived from fermented mare's milk, is renowned for its unique sour taste and texture. It has long been consumed by nomadic tribes for its nutritional and medicinal benefits. This study aimed to comprehensively analyze the protective effects of koumiss against alcohol-induced harm across behavioral, hematological, gastrointestinal, hepatic, and reproductive dimensions using a mouse model. Optimal intoxicating doses of alcohol and koumiss doses were determined, and their effects were explored through sleep tests and blood indicator measurements. Pretreatment with koumiss delayed inebriation, accelerated sobering, and reduced mortality in mice, mitigating alcohol's impact on blood ethanol levels and various physiological parameters. Histopathological and molecular analyses further confirmed koumiss's protective role against alcohol-induced damage in the liver, stomach, small intestine, and reproductive system. Transcriptomic studies on reproductive damage indicated that koumiss exerts its benefits by influencing mitochondrial and ribosomal functions and also shows promise in mitigating alcohol's effects on the reproductive system. In summary, koumiss emerges as a potential natural agent for protection against alcohol-induced harm, opening avenues for future research in this field.

Abstracts of the Toxicology and Poisons Network Australasia (TAPNA) 2024 Annual Scientific Meeting (Melbourne, Victoria).

Background Toxic alcohol poisoning is uncommon in New South Wales (NSW). Inadequate treatment causes significant morbidity and mortality. Management priorities are diagnosis, and early treatment with alcohol dehydrogenase (ADH) blockade and extracorporeal treatments (ECTRs). Fomepizole is a potent ADH inhibitor available in Australia but its use and role, compared to ethanol, is uncertain. We describe the epidemiology, management and outcomes of suspected significant toxic alcohol poisonings in NSW. Methods We searched databases of the NSW Poisons Information Centre, five tertiary clinical toxicology services and Statewide retrieval services. We included all patients with known or suspected toxic alcohol poisoning referred to a clinical toxicologist and included all patients who received treatment with ADH blockade. Patients were subdivided on the basis of whether toxic alcohol poisoning was confirmed or excluded. Data extracted included demographics, details of the exposure, management (including treatment delays and monitoring of ethanol therapy (if received), outcomes and complications). Categorical data were described as frequencies and percentages, and continuous data were described as median and interquartile ranges. Results Among 198 patients between 2015 and 2023, 36 fulfilled inclusion criteria. Toxic alcohols ingested included ethylene glycol (29), diethylene glycol (5), and methanol (1); 12 co-ingested ethanol. Toxic alcohol poisoning was confirmed by history or specific assays in 35 cases. Delay to presentation was median 3 h (IQR 2–9; 20). Delay from hospital presentation to initiating ADH blockade was median 3 h (IQR 2–7; 27). Three were diagnosed after developing unexplained AKI. Four patients received fomepizole and 27 received ethanol therapy. In the 20 patients who received ethanol for ≥24 h, blood ethanol concentrations were measured median 5.5 times (IQR 4-11) in the first 24 h, and 9 had at least 2 subtherapeutic levels. 21 patients received ECTR, which was initiated within median 7 h (IQR 4-11). Excluding 3 patients who did not receive treatment due to delayed diagnosis, 18 developed complications (acute kidney injury 16, neurotoxicity 8, death 3). In 18 ethanol-treated patients, fomepizole would have offered key advantages, including avoiding ICU (9), facilitating transport (7), and delaying and/or foregoing ECTR (6). Discussion There are potential benefits of fomepizole use in NSW.

Drugs in blood and urine samples from victims of suspected exposure to drink spiking: A prospective observational study from Oslo, Norway.

People regularly contact emergency medicine services concerned that they have been exposed to drink spiking, i.e., exposure to drugs without their knowledge or permission. We identified drugs in blood and urine samples from patients suspecting exposure to drink spiking, with special consideration for drugs not reported taken by the patient (unreported drugs). From September 2018 to May 2019, we collected blood and urine samples from patients 16 years or older presenting at an emergency clinic in Oslo, Norway, within 48 hours of suspected exposure to drink spiking. We also collected information on ethanol ingestion and drugs taken. Blood samples were analyzed for 20 classical recreational drugs using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) and an automated enzymatic method for ethanol. Urine samples were analyzed using immunoassay methods and a specific gas chromatography mass spectrometry (GCMS) method for gammahydroxybutyrate (GHB). From 100 included patients (median age 24 years, 62 females), we collected 100 blood samples and 72 urine samples. Median time since exposure was 5 hours. Unreported drugs were found in 15 patients. Unreported drugs in the blood samples were clonazepam in 3, methylenedioxymethamphetamine (MDMA) in 3, amphetamine in 2, tetrahydrocannabinol (THC) in 2, tramadol in 1, cocaine in 1, and methamphetamine in 1. Unreported drugs in the urine samples were cocaine in 5, amphetamine in 4, ecstasy in 3, and cannabis in 2. Ethanol was found in 69 patients, all reporting ethanol ingestion. Median blood ethanol concentration was higher in patients with no unreported drugs detected, 1.00‰ (interquartile range (IQR) 0-1.52) vs. 0‰ (IQR 0-0.46) (p<0.001). GHB was not detected. Unreported drugs, possibly used for drink spiking, were found in 15% of patients. Blood ethanol concentration was higher when no unreported drugs were found. GHB was not detected in any patient.

Exploratory studies of ethanol drinking in the white-tufted marmoset (Callithrix jacchus)

The white-tufted marmoset is a small, nonhuman primate that is rapidly gaining popularity as a model organism, especially for neuroscience research. To date, little work in the alcohol research field has utilized the marmoset. As a step toward establishing the marmoset as a research model for alcohol experimentation, a series of exploratory studies were undertaken to characterize ethanol drinking behavior. A voluntary drinking paradigm was established whereby the common marmoset would consume pharmacologically relevant amounts of ethanol. To facilitate ethanol consumption, ethanol was mixed with a marshmallow flavored solution (hereafter called marshmallow juice) to mask the presumed adverse taste of ethanol. Using marshmallow juice flavored solutions, marmosets readily consumed ethanol up to 1 g/kg during 10 min binge-like drinking sessions or up to 5 g/kg during ∼4 h drinking sessions. Consumption of 1.0–1.5 g/kg during a 30 min session resulted in blood ethanol concentrations of 49–73 mg/dl, which are predicted to be pharmacologically relevant. In animals that were stably consuming ethanol in marshmallow juice, gradually reducing the concentration of the marshmallow juice flavoring resulted in markedly reduced ethanol consumption. Lastly, when offered a choice between ethanol in marshmallow juice and marshmallow juice alone, marmosets displayed a very strong preference for the marshmallow juice solution without ethanol. From these studies, it is concluded that marmosets will voluntarily consume ethanol if the taste is masked with a sweet solution such as marshmallow juice. These studies represent the first report of alcohol consumption and preference in the white-tufted marmoset.

A Novel and Simple Method for a Differentiation of Alcohol Types.

Alcohol poisoning is a significant global problem that has become an epidemic. The determination of the alcohol type is hereby essential as it may affect the course of the treatment; however, there is no routine laboratory diagnostic method for alcohol types other than for ethanol. In this study, we aimed to define a simple method for alcohol type differentiation by utilizing a combination of breathalyzer and spectrophotometrically measured serum ethanol results. A breathalyzer and spectrophotometry were used to measure four different types of alcohol: ethanol, isopropanol, methanol, and ethylene glycol. To conduct serum alcohol analysis, four serum pools were created, each containing a different type of alcohol. The pools were analyzed using the spectrophotometric method with an enzymatic ethanol test kit. An experiment was conducted to measure the different types of alcohol using impreg-nated cotton and a balloon, simulating a breathalyzer test. An algorithm was created based on the measurements. Based on the results, the substance consumed could be methanol or isopropanol if the breathalyzer test indicates a positive reading and if the blood ethanol measurement is negative. If both the breathalyzer and the blood measurements are negative, the substance in question may be ethylene glycol. This simple method may determine methanol or isopropanol intake. This straightforward and innovative approach could assist healthcare professionals in different fields with diagnosing alcohol intoxication and, more precisely, help reducing related morbidity and mortality.

Short-chain fatty acid valerate reduces voluntary alcohol intake in male mice

BackgroundDespite serious health and social consequences, effective intervention strategies for habitual alcohol binge drinking are lacking. The development of novel therapeutic and preventative approaches is highly desirable. Accumulating evidence in the past several years has established associations between the gut microbiome and microbial metabolites with drinking behavior, but druggable targets and their underlying mechanism of action are understudied.ResultsHere, using a drink-in-the-dark mouse model, we identified a microbiome metabolite-based novel treatment (sodium valerate) that can reduce excessive alcohol drinking. Sodium valerate is a sodium salt of valeric acid short-chain fatty acid with a similar structure as γ-aminobutyric acid (GABA). Ten days of oral sodium valerate supplementation attenuates excessive alcohol drinking by 40%, reduces blood ethanol concentration by 53%, and improves anxiety-like or approach-avoidance behavior in male mice, without affecting overall food and water intake. Mechanistically, sodium valerate supplementation increases GABA levels across stool, blood, and amygdala. It also significantly increases H4 acetylation in the amygdala of mice. Transcriptomics analysis of the amygdala revealed that sodium valerate supplementation led to changes in gene expression associated with functional pathways including potassium voltage-gated channels, inflammation, glutamate degradation, L-DOPA degradation, and psychological behaviors. 16S microbiome profiling showed that sodium valerate supplementation shifts the gut microbiome composition and decreases microbiome-derived neuroactive compounds through GABA degradation in the gut microbiome.ConclusionOur findings suggest that sodium valerate holds promise as an innovative therapeutic avenue for the reduction of habitual binge drinking, potentially through multifaceted mechanisms.4EUMY4VU8ayPcKT8VYWNUCVideo

HISTOSTRUCTURAL ALTERATIONS IN THE CEREBRAL ARCHITECTURE ASSOCIATED WITH THE PROGRESSION OF ALCOHOL INTOXICATION: AN EXPERIMENTAL ANALYSIS

The aim of this study is to evaluate the histological changes in the cerebellum of rat brains following chronic alcohol intoxication. Materials and Methods. We employed a classical approach for modeling chronic alcohol intoxication by administering 40% ethanol to rats (n=55) in a dosage of 2 ml per 100 g of body weight daily for three months. The cerebellar structure was then analyzed. Results. This study investigates the impact of chronic alcohol intoxication on the histological structures of the cerebellar cortex. The cerebellum, like the nervous system overall, possesses a significant cellular and functional reserve. However, teratogenic factors, including ethanol, notably influence the activity of cerebellar neurons, increasing it. Ethanol exposure during early pregnancy can lead to prenatal growth retardation, stillbirth, cleft palate, hydrocephaly, and reductions in fetal body size. There is evidence suggesting a correlation between blood ethanol levels and a reduction in the number of Purkinje cells. Chronic alcohol consumption results in cerebellar ataxia, alterations in upper limb movements, decreased reaction speeds, reduced attention concentration, impaired coordination accuracy, and disturbances in postural stability and balance. Conclusion. The cerebellum, especially during development, is particularly vulnerable to the toxic effects of alcohol. Recent research suggests that changes in the neurotransmission of gamma-aminobutyric acid (GABA)-dependent receptors may contribute to cerebellar dysfunction induced by ethanol. Ethanol exposure increases the release of GABA not only in Purkinje cells but also in the interneurons of the molecular layer and granule cells.

Proposal of a New Predictive Score for the Requirement of Intensive Care Unit Admission Among Ethanol-Intoxicated Patients

ABSTRACT The correct selection of ethanol-intoxicated patients that require ICU admission is crucial for reducing morbidity and mortality. This study included 165 patients intoxicated with ethanol, confirmed by blood analysis. The patients were divided into ICU group = 46 and inward group = 119. We created a new predictive score based on seven parameters of APACHE II score and seven laboratory parameters that were significant in ICU-admitted patients by giving each parameter one point. The new predictive score achieved a sensitivity of 87, a specificity of 93.3, and an area under the curve of 0.967 with a cutoff >6. On the other hand, blood ethanol level (BEL) exhibited a weak correlation with both APACHE II and new predictive scores and a weak correlation with the parameters of the new predictive score. The new predictive score included 14 parameters. This score can be used in predicting whether patients need ICU admission during assessment for ethanol intoxication in emergency rooms, independent of BEL analysis. It could potentially reduce morbidity and mortality.

Loss of glycine receptors in the nucleus accumbens and ethanol reward in an Alzheimer´s Disease mouse model

Alterations in cognitive and non-cognitive cerebral functions characterize Alzheimer's disease (AD). Cortical and hippocampal impairments related to extracellular accumulation of Aβ in AD animal models have been extensively investigated. However, recent reports have also implicated intracellular Aβ in limbic regions, such as the nucleus accumbens (nAc). Accumbal neurons express high levels of inhibitory glycine receptors (GlyRs) that are allosterically modulated by ethanol and have a role in controlling its intake. In the present study, we investigated how GlyRs in the 2xTg mice (AD model) affect nAc functions and ethanol intake behavior. Using transgenic and control aged-matched litter mates, we found that the GlyRα2 subunit was significantly decreased in AD mice (6-month-old). We also examined intracellular calcium dynamics using the fluorescent calcium protein reporter GCaMP in slice photometry. We also found that the calcium signal mediated by GlyRs, but not GABAAR, was also reduced in AD neurons. Additionally, ethanol potentiation was significantly decreased in accumbal neurons in the AD mice. Finally, we performed drinking in the dark (DID) experiments and found that 2xTg mice consumed less ethanol on the last day of DID, in agreement with a lower blood ethanol concentration. 2xTg mice also showed lower sucrose consumption, indicating that overall food reward was altered. In conclusion, the data support the role of GlyRs in nAc neuron excitability and a decreased glycinergic activity in the 2xTg mice that might lead to impairment in reward processing at an early stage of the disease.

Does cleaning of venipuncture site with alcohol affect blood ethanol concentration?

BackgroundIt is important to accurately determine the blood ethanol concentration (BEC) to ensure appropriate diagnosis and treatment of patients in the emergency department (ED) and protect their legal rights. This study aimed to determine whether sterilization of venipuncture site with ethanol, which is frequently used in practice in the ED would affect BEC. MethodsVenous blood samples were collected by two consecutive techniques from 94 individuals who were admitted to the ED, had an indication for BEC measurement, and volunteered to participate in the study. The reference technique involved applying 3 cc of 10 % povidone-iodine solution to a gauze pad, cleaning the right arm antecubital region, and performing phlebotomy. The index technique used 3 cc of alcohol-based antiseptic (89 % ethanol) on another gauze for cleaning the left arm antecubital region. Both techniques allowed the antiseptic to air-dry for 30 s before phlebotomy. Two blood sample tubes per patient were sent to the laboratory, and BEC were measured using the alcohol dehydrogenase enzymatic method. Results94 patients were included in the study. The mean age was 37.8 years (±15.7), with 77 % (n = 72) of them were male. The median BEC levels measured by both the reference and index techniques were 2 mg/dL (IQR: 0.97–16.25) and 2 mg/dL (IQR: 0.90–15.22), respectively, with no significant statistical difference (p = 0.536). 72 (77 %) of the patients had a BEC level below the legal driving limit of 20 mg/dL. Bland-Altman analysis, performed on these patients, revealed a small negative bias, −0.116 mg/dL with a standard deviation of 1.13 mg/dL. The upper and lower limit of the agreement was 2.092 and −2.323 respectively. ConclusionIn patients with a BEC level of less than 20 mg/dL, using ethanol-containing antiseptics before blood sampling does not lead to erroneously elevated BEC levels.

Melatonin reduces brain injury following inflammation-amplified hypoxia-ischemia in a translational newborn piglet study of neonatal encephalopathy.

There is a need to develop therapies for neonatal encephalopathy (NE) in low- and middle-income countries (LMICs) where the burden of disease is greatest and therapeutic hypothermia (HT) is not effective. We aimed to assess the efficacy of melatonin following inflammation-amplified hypoxia-ischaemia (IA-HI) in the newborn piglet. The IA-HI model accounts for the contribution of infection/inflammation in this setting and HT is not cytoprotective. We hypothesised that intravenous melatonin (5% ethanol, at 20 mg/kg over 2 h at 1 h after HI + 10 mg/kg/12 h between 24 and 60 h) is safe and associated with: (i) reduction in magnetic resonance spectroscopy lactate/N-acetylaspartate (MRS Lac/sNAA); (ii) preservation of phosphorus MRS phosphocreatine/phosphate exchange pool (PCr/Epp); (iii) improved aEEG/EEG recovery and (iv) cytoprotection on immunohistochemistry. Male and female piglets underwent IA-HI by carotid artery occlusion and reduction in FiO2 to 6% at 4 h into Escherichia coli lipopolysaccharide sensitisation (2 μg/kg bolus + 1 μg/kg/h over 12 h). At 1 h after IA-HI, piglets were randomised to HI-saline (n = 12) or melatonin (n = 11). There were no differences in insult severity between groups. Target melatonin levels (15-30 mg/L) were achieved within 3 h and blood ethanol levels were <0.25 g/L. At 60 h, compared to HI-saline, melatonin was associated with a reduction of 0.197 log10 units (95% CrI [-0.366, -0.028], Pr(sup) 98.8%) in basal-ganglia and thalamic Lac/NAA, and 0.257 (95% CrI [-0.676, 0.164], Pr(sup) 89.3%) in white matter Lac/NAA. PCr/Epp was higher in melatonin versus HI-saline (Pr(sup) 97.6%). Melatonin was associated with earlier aEEG/EEG recovery from 19 to 24 h (Pr(sup) 95.4%). Compared to HI-saline, melatonin was associated with increased NeuN+ cell density (Pr(sup) 99.3%) across five of eight regions and reduction in TUNEL-positive cell death (Pr(sup) 89.7%). This study supports the translation of melatonin to early-phase clinical trials. Melatonin is protective following IA-HI where HT is not effective. These data guide the design of future dose-escalation studies in the next phase of the translational pipeline.

Six months of voluntary alcohol consumption in male cynomolgus macaques reduces intracortical bone porosity without altering mineralization or mechanical properties

Chronic heavy alcohol consumption is a risk factor for low trauma bone fracture. Using a non-human primate model of voluntary alcohol consumption, we investigated the effects of 6 months of ethanol intake on cortical bone in cynomolgus macaques (Macaca fascicularis). Young adult (6.4 ± 0.1 years old, mean ± SE) male cynomolgus macaques (n = 17) were subjected to a 4-month graded ethanol induction period, followed by voluntary self-administration of water or ethanol (4 % w/v) for 22 h/d, 7 d/wk. for 6 months. Control animals (n = 6) consumed an isocaloric maltose-dextrin solution. Tibial response was evaluated using densitometry, microcomputed tomography, histomorphometry, biomechanical testing, and Raman spectroscopy. Global bone response was evaluated using biochemical markers of bone turnover. Monkeys in the ethanol group consumed an average of 2.3 ± 0.2 g/kg/d ethanol resulting in a blood ethanol concentration of 90 ± 12 mg/dl in longitudinal samples taken 7 h after the daily session began. Ethanol consumption had no effect on tibia length, mass, density, mechanical properties, or mineralization (p > 0.642). However, compared to controls, ethanol intake resulted in a dose-dependent reduction in intracortical bone porosity (Spearman rank correlation = −0.770; p < 0.0001) and compared to baseline, a strong tendency (p = 0.058) for lower plasma CTX, a biochemical marker of global bone resorption. These findings are important because suppressed cortical bone remodeling can result in a decrease in bone quality. In conclusion, intracortical bone porosity was reduced to subnormal values 6 months following initiation of voluntary ethanol consumption but other measures of tibia architecture, mineralization, or mechanics were not altered.

Determination of Ethanol and Aromatics in Blood by Headspace Portable Gas Chromatography-Mass Spectrometry (HS-PGC-MS)

Ethanol abuse is increasingly becoming a global issue, adversely affecting both society and families. In blood alcohol concentration (BAC) detection, traditional techniques have long experimental cycles and harsh experimental conditions and often fail to produce timely results. Consequently, achieving swift and precise on-site detection of ethanol poisoning in humans poses a formidable challenge in analytical science. We designed a novel assay for swift on-site analysis of ethanol and BTEX (benzene, toluene, ethylbenzene, and xylene) poisoning in humans using a custom portable headspace injector (portable HS) and portable gas chromatography-mass spectrometry (portable GC-MS). This setup, known for its lightweight design and speed, allows on-site sampling and delivers rapid results. We established a calibration curve (R2 > 0.99) for ethanol in blood using portable gas chromatography-mass spectrometry (portable GC-MS). This on-site blood alcohol concentration (BAC) assay proves simpler than traditional methods, enabling rapid analysis of each sample within a short timeframe and requiring only a small blood volume (0.1 ml). In addition to our investigation on ethanol, we developed a portable method for detecting BTEX in blood. This method provides a favorable coefficient of determination (R2 > 0.99) for various substances, thereby broadening the utility of portable mass spectrometry in areas such as traffic inspection and forensic identification.

MASLD is related to impaired alcohol dehydrogenase (ADH) activity and elevated blood ethanol levels: Role of TNFα and JNK

Elevated fasting ethanol levels in peripheral blood frequently found in metabolic dysfunction-associated steatohepatitis (MASLD) patients even in the absence of alcohol consumption are discussed to contribute to disease development. To test the hypothesis that besides an enhanced gastrointestinal synthesis a diminished alcohol elimination through alcohol dehydrogenase (ADH) may also be critical herein, we determined fasting ethanol levels and ADH activity in livers and blood of MASLD patients and in wild-type ± anti-TNFα antibody (infliximab) treated and TNFα-/- mice fed a MASLD-inducing diet. Blood ethanol levels were significantly higher in patients and wild-type mice with MASLD while relative ADH activity in blood and liver tissue was significantly lower compared to controls. Both alterations were significantly attenuated in MASLD diet-fed TNFα-/- mice and wild-type mice treated with infliximab. Moreover, alcohol elimination was significantly impaired in mice with MASLD. In in vitro models, TNFα but not IL-1β or IL-6 significantly decreased ADH activity. Our data suggest that elevated ethanol levels in MASLD patients are related to TNFα-dependent impairments of ADH activity.