Aldehyde dehydrogenase polymorphism and alcohol metabolism in alcoholics

Significant differences in the incidence of aldehyde dehydrogenase isozyme I deficiency were observed between healthy controls and alcoholics in Japan. Only about 5% of alcoholics were found deficient as compared to about 42% in the normal healthy population. Blood acetaldehyde level after alcohol drinking was also found significantly higher in deficient subjects than in individuals without deficiency. Among alcoholics, deficient subjects showed relatively less elevated blood acetaldehyde levels. When two districts in Japan were compared, per capita alcohol consumption correlated with the frequency of isozyme deficiency. Higher percentage of aldehyde dehydrogenase isozyme deficiency was associated with lower per capita alcohol consumption. Thus, individuals deficient in aldehyde dehydrogenase isozyme may consume less alcohol.     

The serum immunoglobulin levels in Down's syndrome and other diseases associated with mental disorder.

The serum levels of IgA, IgM, IgG and IgD were determined in patients with Down's syndrome (69 cases), Oligophrenia (101 cases) and Morbus Wilson (18 cases). In sera from Down's syndrome patients a significant increase in the levels of IgA, IgG and IgD were found. IgM levels were identical to those of healthy controls. The immunoglobulin levels in both the oligophrenia and Wilson's disease patients were not different from those of controls.     

Pharmacogenetics of alcohol metabolism and alcoholism.

The pharmacogenetic differences among individuals in their capacity to metabolize ingested alcohol are possibly responsible for the large inter-individual and inter-ethnic variations observed in the outcome of alcohol use and misuse. Based on results of adoption, twin, and family studies it is now widely accepted that the vulnerability to alcoholism is determined by genetic factors as well as by environment. There is a constant search for biological markers and specific genes which could identify individuals genetically predisposed to alcohol abuse and alcoholism. Numerous 'candidate genes' for alcoholism have been suggested including the alcohol metabolizing enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). Both ADH and ALDH exhibit genetic heterogeneity. An atypical form of ADH (ADH2), which contains a variant beta 2 subunit instead of the usual beta 1 subunit, differs substantially from the usual form in its kinetic properties and is found more frequently among the Japanese, Chinese and other Mongoloid populations than in Caucasoids and Negroids. A widely prevalent genetic polymorphism has been observed for ALDH; about 50% of Japanese and Chinese livers possess an inactive ALDH (ALDH2 isozyme) whereas none of the Caucasian or Negroid populations show this isozyme abnormality. These metabolic polymorphisms seem to contribute to differences in the in vivo elimination rate of ethanol and acetaldehyde, and may explain differences in alcohol-related behaviour and its disease outcome. Taken together, Orientals who possess an atypical ALDH2 gene are more sensitive to acute responses to alcohol, tend to be discouraged from drinking alcohol, and consequently are at lower risk of developing alcohol-related disorders. However, more work is needed to support these findings. Recent advances in molecular genetics have made it possible to analyze directly the human genome. This may help in a better understanding of the complex genetic and environmental factors in alcohol abuse by providing prospects for identification of gene loci which may be responsible for predisposition to, and protection from, alcoholism.     

Gastroduodenal polyps in familial adenomatous polyposis.

A retrospective review of the medical records of 30 patients with familial adenomatous polyposis who underwent oesophagogastroduodenoscopy was performed to evaluate the spectrum of gastroduodenal polyps. Twenty-five patients (83%) had gastroduodenal polyps. Eighteen patients (60%) had gastric polyps and 21 patients (70%) had duodenal polyps. Five patients (17%) had gastric and 20 patients (67%) had duodenal adenomatous polyps. Three patients (10%) died from an upper gastrointestinal tract adenocarcinoma. Three of nine patients with periampullary adenomas had a normal-appearing papilla of Vater. Since gastroduodenal polyps are common in familial adenomatous polyposis, oesophagogastroduodenoscopy should be performed at the time of diagnosis. Biopsy of polyps as well as biopsy of a normal-appearing papilla of Vater should be performed. Due to their malignant potential, if identified, gastroduodenal adenomatous polyps should be destroyed.     

Diurnal rhythm in the plasma level of total and free tryptophan and cortisol in rabbits

Plasma tryptophan level varied diurnally with highest concentrations at 12 noon (P less than 0.001); at that time free tryptophan level was lowest. The mean 8 h and 16 h cortisol levels were 70% higher compared to levels obtained at 24 h. Chronic administration of haloperidol and chlorpromazine led to significant increase in the plasma tryptophan (P less than 0.001 and P less than 0.1, respectively) compared to saline-treated rabbits. This change was associated with corresponding constant or reduced free tryptophan levels, and a diminution in plasma cortisol level (10 microgram/l) compared with controls (34 microgram/l). The results suggest that tryptophan in plasma is poorly transported in the brains of rabbits treated with chlorpromazine, and that treatment with haloperidol or chlorpromazine may lead to a reduced tryptophan flux into the kynurenine pathway.     

Heterogeneity in maple syrup urine disease: aspects of cofactor requirement and complementation in cultured fibroblasts.

Fibroblast strains derived from six patients with maple syrup urine disease have been investigated for their requirements of the cofactors NAD, CoASH, Mg++ and TPP in comparison with 10 normal control strains. The reconstitution of the decarboxylase function of branched chain alpha-keto acid (BCKA) dehydrogenase complex in lysed cells was studied with respect to the substrates alpha-keto-isocaproic acid, alpha-keto-isovaleric acid, and alpha-keto-beta-methylvaleric acid (KIC, KIVA, MEVA). The enzyme activity of all normal control strains for the substrates KIC and KIVA was not reconstituted by TPP + Mg++ alone, but CoASH + NAD could reconstitute the enzyme activity with KIC and KIVA in different degrees. Only two control strains were tested with MEVA as substrate, and these showed in contrast that TPP + Mg++ could partly reconstitute the enzyme activity. In contrast to the relative homogeneity in the reconstitution profiles of normal strains, the five classical and one intermittent MSUD strains showed heterogeneity in cofactor requirements. Complementation analysis using heterokaryons prepared from fibroblasts of four patients with classical MSUD and one patient with intermittent MSUD showed, in contrast to experiments with normal controls, a partial amelioration of the defect in two combinations; it is suggested that the defect in these strains is located at different functional subunits of the multienzyme complex.     

Human gastric alcohol dehydrogenase activity: effect of age,sex, and alcoholism.

As various isoenzymes of gastric alcohol dehydrogenase exist and as the effect of sex and age on these enzymes is unknown, this study measured the activity of gastric alcohol dehydrogenase at high and low ethanol concentrations in endoscopic biopsy specimens from a total of 290 patients of various ages and from 10 patients with chronic alcoholism. Gastric alcohol dehydrogenase was also detected by immunohistological tests in biopsy specimens from 40 patients by the use of a polyclonal rabbit antibody against class I alcohol dehydrogenase. A significant correlation was found between the immunohistological reaction assessed by the intensity of the colour reaction in the biopsy specimen and the activity of alcohol dehydrogenase measured at 580 mM ethanol. While alcohol dehydrogenase activity measured at 16 mM ethanol was not significantly affected by age and sex, both factors influenced alcohol dehydrogenase activity measured at 580 mM ethanol. Young women below 50 years of age had significantly lower alcohol dehydrogenase activities in the gastric corpus and antrum when compared with age matched controls (SEM) (6.4 (0.7) v 8.8 (0.6) nmol/min/mg protein; p < 0.001 and 6.0 (1.3) v 9.5 (1.3) nmol/min/mg protein; p < 0.001). Over 50 years of age this sex difference was no longer detectable, as high Km gastric alcohol dehydrogenase activity decreases with age only in men and not in women. In addition, extremely low alcohol dehydrogenase activities have been found in gastric biopsy specimens from young male alcoholics (2.2 (0.5) nmol/min/mg protein), which returned to normal after two to three weeks of abstinence. The activity of alcohol dehydrogenase in the human stomach measured at 580 mM ethanol is decreased in young women, in elderly men, and in the subject with alcoholism. This decrease in alcohol dehydrogenase activity may contribute to the reduced first pass metabolism of ethanol associated with raised ethanol blood concentrations seen in these people.     

Differenzierung von Pseudocholinesterase-Varianten im Diffusionstest

Zusammenfassung Es wird eine modifizierte Methode des Diffusionstestes¹⁵ zur Bestimmung von Pseudocholinesterase-Varianten speziell zur Erfassung des atypischen Allels Ch^S und als Schnelltest für Familienuntersuchungen mitgeteilt. Der Vergleich mit spektrophotometrischen Aktivitäts- und Inhibitortesten zeigt, daß diese neue Methode für Routinemessungen besonders geeignet ist.

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Summary A modified method of the screening test for the identification of the different pseudocholinesterase variants is reported, which is specially suitable to identificate the atypical allele Ch^S and as a quick test for the investigation of families. A comparison with the spectrophotometrical test for enzyme activity and inhibitor constants shows, that this novel procedure is especially suitable in routinetests.