IT is generally accepted that the rate-limiting step in the metabolism of alcohol (ethanol) in man is the conversion of alcohol into acetaldehyde1–3. This reaction is believed to occur chiefly in the soluble cytoplasm of liver cells4,5, and is catalysed by alcohol dehydrogenase (ADH)6, NAD acting as hydrogen acceptor7,8. The part played by the interesting ethanol-oxidizing system recently discovered9 in the microsomes of liver cells may be significant, but requires further evaluation. The availability of unreduced NAD in the cell sap seems to be important10,11, because NADH competes with NAD for binding sites on the enzyme ADH and, in sufficient concentration, may inhibit the rate of ethanol dehydrogenation12. The NADH produced in the initial oxidative step in ethanol metabolism must therefore be continually reoxidized by various oxidation-reduction systems for the reaction to proceed13. In the cell sap of liver cells the reoxidation of NADH may be coupled to the reduction of pyruvate to lactate3,8, and to the reductive synthesis14, elongation and saturation of fatty acids; but perhaps the most important route for reoxidation of the NADH involves the mitochondrial flavoprotei–cytochrome electron transfer system coupled with phosphorylating oxidation15–17. The “carrier” of the hydrogen equivalents from NADH across the relatively impermeable mitochondrial membranes may be substances like alpha-glycero-phosphate17, beta-hydroxybutyrate18,19, malate and glutamate20, which serve to “shuttle” hydrogen from the extramitochondrial NADH, across the mitochondrial membranes, for oxidation in the intra-mitochondrial compartment.
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