Alcohol and lung injury and immunity

Abstract

Annually, excessive alcohol use accounts for more than $220 billion in economic costs and 80,000 deaths, making excessive alcohol use the third leading lifestyle-related cause of death in the US. Patients with an alcohol-use disorder (AUD) also have an increased susceptibility to respiratory pathogens and lung injury, including a 2–4-fold increased risk of acute respiratory distress syndrome (ARDS). This review investigates some of the potential mechanisms by which alcohol causes lung injury and impairs lung immunity. In intoxicated individuals with burn injuries, activation of the gut-liver axis drives pulmonary inflammation, thereby negatively impacting morbidity and mortality. In the lung, the upper airway is the first checkpoint to fail in microbe clearance during alcohol-induced lung immune dysfunction. Brief and prolonged alcohol exposure drive different post-translational modifications of novel proteins that control cilia function. Proteomic approaches are needed to identify novel alcohol targets and post-translational modifications in airway cilia that are involved in alcohol-dependent signal transduction pathways. When the upper airway fails to clear inhaled pathogens, they enter the alveolar space where they are primarily cleared by alveolar macrophages (AM). With chronic alcohol ingestion, oxidative stress pathways in the AMs are stimulated, thereby impairing AM immune capacity and pathogen clearance. The epidemiology of pneumococcal pneumonia and AUDs is well established, as both increased predisposition and illness severity have been reported. AUD subjects have increased susceptibility to pneumococcal pneumonia infections, which may be due to the pro-inflammatory response of AMs, leading to increased oxidative stress.

Definition and epidemiology of acute respiratory distress syndrome

“…On the other side, instead, diabetes might be protective by means of a depressed immune response of the organism against an inflammatory insult (44). Among the modifiable risk factors for ARDS, alcohol abuse emerges (48,49) and impaired immune response involving alveolar macrophages is reported (50,51). Since the observation that positive cumulative fluid balance is independently associated to higher mortality rate in patients with lung injury (52), a number of study raised in order to assess the impact of conservative fluid management or active fluid removal on mortality in ARDS patients, but results are yet not conclusive (53,54).…”

Unhealthy alcohol use is associated with postoperative complications in veterans undergoing lung resection

“…This is consistent with a speculated role for its attenuating pulmonary immunity and pathogen clearance (38). Pneumonia is the most common major complication following lung resection, and is particularly prevalent in cases of lung resection in VA centers (39).…”

Effects of Maalox Plus® Antacid and PureCal® Calcium Supplements on Haematological and Biochemical Parameters of Rats Subjected to Alcohol Intoxication

“…Abuse of alcohol is also known to cause fetal abnormalities, cardiovascular disease and inhibition of CNS activity [10]. Excessive consumption of this xenobiotic has also been implicated in increase of susceptibility to lung and respiratory infections [11]. Malnutrition is also a common feature of excessive indulges and includes deficiencies of proteins, vitamins and minerals [12].…”