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The effect of chronic
alcohol abuse on pulmonary glutathione homeostasis
Moss, Marc; Guidot, David; Wong-Lambertina, Monique; Hoor, Terri; Perez,
Rafael; Brown, Lou Ann
Am J Respir Crit Care Med 2000;161:414-419.
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ABSTRACT
The incidence and severity of
the acute respiratory distress syndrome (ARDS) is increased in
critically ill patients with a prior history of chronic alcohol abuse;
however, the specific mechanisms responsible for this association are
unknown. Recently, we determined that chronic ethanol ingestion in rats
decreased the alveolar epithelial lining fluid (ELF) concentration of
the antioxidant glutathione (GSH), which is a characteristic finding in
patients with ARDS. However, the effects of chronic alcohol abuse on the
human alveolar epithelium are essentially unknown. Therefore, as a first
step we asked if chronic alcohol abuse, independent of other comorbid
conditions, decreases the concentration of GSH in the human lung. We
determined that otherwise healthy chronic alcoholics had significantly
decreased ELF concentrations of GSH compared with nonalcoholic control
subjects (79
mmol [48 to 118 mmol]
versus 576mmol
[493 to 728 mol], p <0.001). Furthermore, the percentage of GSH in the
oxidized form was higher in the chronic alcoholics (9.8% [2.2 to 14.8%]
versus 2.8% [0.4 to 4.0%] p=0.05),indicative of increased utilization of
GSH. This is the first report that chronic alcohol abuse alters GSH
homeostasis in the human lung, and suggests a potential mechanism by
which chronic alcohol abuse predisposes susceptible patients to develop
ARDS.
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