Pulmonary consequences of alcoholism: A critical review

Alcohol use and abuse are prevailing practices in people throughout the world. Unfortunately, alcohol use disorders pose tremendous costs to both society and the individual. While alcoholism has many well-known medical consequences such as liver injury and pancreatitis, the effects of chronic alcohol exposure on the respiratory system are often overlooked. Specifically, studies have shown that alcohol abuse causes significant derangements in the lung and predisposes individuals to the development of pneumonia and acute lung injury. Several important processes are responsible for this increased susceptibility to pulmonary pathology, including alterations in nonimmunological defense systems, impairment of lung immunity, and alveolar epithelial barrier dysfunction. These crucial defects comprise what has been referred to as the "alcohol lung phenotype". Importantly, these abnormalities not only increase the risk of lung infections and injury, they cause worse morbidity and mortality in alcoholics compared to non-alcoholics. While there are no current therapies to combat these alcohol-induced pulmonary abnormalities, current research has revealed several important mechanisms that may be exploited to develop new treatment options for this vulnerable population.