The influence of alcohol on porphyrin metabolism was investigated in 6 healthy non-alcoholics and 19 patients with chronic alcohol abuse. In the healthy subjects, blood and urine samples were obtained before and after acute alcohol exposure, whereas in the chronic alcoholics only one examination was performed. In both groups a significant inhibition of δ-aminolevulinic acid dehydratase was demonstrated. The activity was partially restored in vitro by addition of zinc ions or dithiothreitol. A combination of both activators produced reactivation to normal levels. Coproporphyrinuria was more prominent in chronic alcoholics (373 nmol/24 h on average, upper norm 119 nmol/24 h) compared to non-alcoholics (140 nmol/24 h). Urinary porphobilinogen and δ-amino-levulinic acid were normal except for a moderately increased δ-aminolevulinic acid in four healthy individuals. In conclusion, alcohol causes reversible inhibition of δ-aminolevulinic acid dehydratase. The metabolic changes reflect both an inhibition of δ-aminolevulinic acid dehydratase and coproporphyrinogen oxidase; a simultaneous, moderate induction of hepatic δ-aminolevulinic acid synthase is suggested. Erythrocyte δ-aminolevulinic acid dehydratase activity could serve as a sensitive indicator for both acute and chronic alcohol consumption even better than Coproporphyrinuria.
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