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Alcohol-associated bowel disease: new insights into pathogenesis
Luca Maccioni1,2, Yaojie Fu1, Yves Horsmans3
1Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA.
Excessive alcohol intake causes alcohol-associated bowel disease (ABD) through gut barrier dysfunction. Ethanol metabolism to acetaldehyde and acetate may drive these changes and contribute to digestive tract cancers.
Area of Science:
- Gastroenterology and Hepatology
- Toxicology
- Oncology
Background:
- Excessive alcohol consumption leads to pathological changes in the digestive tract, including cancer.
- Mechanisms underlying alcohol-associated bowel disease (ABD) remain incompletely understood.
- Alcohol's impact on small and large intestinal functions, such as leaky gut and dysbiosis, contributes to ABD.
Purpose of the Study:
- To review the effects of alcohol on intestinal functions and immune system.
- To discuss the potential role of ethanol metabolism products, acetaldehyde and acetate, in ABD pathogenesis.
- To identify knowledge gaps and suggest future research directions in ABD.
Main Methods:
- Literature review focusing on alcohol's effects on the gastrointestinal tract.
- Analysis of mechanisms involving ethanol metabolism (acetaldehyde and acetate).
- Discussion of evidence linking ABD to carcinogenesis.
Main Results:
- Alcohol intake disrupts intestinal barrier integrity, leading to leaky gut, dysbiosis, and immune dysfunction (ABD).
- Ethanol metabolism generates acetaldehyde and acetate, implicated in functional disruptions of the intestinal barrier.
- These metabolites may play a pathogenic role in ABD and associated cancers.
Conclusions:
- Alcohol-associated bowel disease involves complex disruptions of the intestinal tract.
- Acetaldehyde and acetate from ethanol metabolism are potential key players in ABD pathogenesis.
- Further research is needed to elucidate the precise roles of these metabolites in alcohol-induced intestinal pathologies and cancer.
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