Biomolecules and Biomarkers Used in Diagnosis of Alcohol Drinking and in Monitoring Therapeutic Interventions

Abstract

Background: The quantitative, measurable detection of drinking is important for the successful treatment of alcohol misuse in transplantation of patients with alcohol disorders, people living with human immunodeficiency virus that need to adhere to medication, and special occupational hazard offenders, many of whom continually deny drinking. Their initial misconduct usually leads to medical problems associated with drinking, impulsive social behavior, and drunk driving. The accurate identification of alcohol consumption via biochemical tests contributes significantly to the monitoring of drinking behavior. Methods: A systematic review of the current methods used to measure biomarkers of alcohol consumption was conducted using PubMed and Google Scholar databases (2010–2015). The names of the tests have been identified. The methods and publications that correlate between the social instruments and the biochemical tests were further investigated. There is a clear need for assays standardization to ensure the use of these biochemical tests as routine biomarkers. Findings: Alcohol ingestion can be measured using a breath test. Because alcohol is rapidly eliminated from the circulation, the time for detection by this analysis is in the range of hours. Alcohol consumption can alternatively be detected by direct measurement of ethanol concentration in blood or urine. Several markers have been proposed to extend the interval and sensitivities of detection, including ethyl glucuronide and ethyl sulfate in urine, phosphatidylethanol in blood, and ethyl glucuronide and fatty acid ethyl esters in hair, among others. Moreover, there is a need to correlate the indirect biomarker carbohydrate deficient transferrin, which reflects longer lasting consumption of higher amounts of alcohol, with serum γ-glutamyl transpeptidase, another long term indirect biomarker that is routinely used and standardized in laboratory medicine.

Improved recovery of repeat intoxicated drivers using fingernails and blood spots to monitor alcohol and other substance abuse

“…Overall these detection rates are larger than previous reports using indirect alcohol biomarkers in Waukesha (20%; Bean et al,2009) and Dane Counties (28%; Bean et al, 2013) most likely a reflection of the longer window of detection described for the direct biomarkers (Nanau and Neuman, 2015;SAMSHA, 2012). These high detection rates are also an indication that the majority of repeat offenders continue to drink and drive after their OWI arrest until the time of their assessment interviews.…”

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

“…Alcohol ingestion can be measured using a breath test. Although ethanol is rapidly eliminated from the circulation, the time for detection by breath analysis is dependent on the amount of intake as ethanol depletes according to a linear reduction at about 0,15‰/1 h. Alcohol use can alternatively be detected by direct measurement of ethanol in blood or urine 27. The time course of the ethanol concentration in the blood after the ingestion of an alcoholic beverage is controlled by its pharmacokinetics that represents an interplay between the kinetics of absorption, distribution, and elimination and is thus important in determining the pharmacodynamic responses to alcohol.…”

Application of phosphatidylethanol (PEth) in whole blood in comparison to ethyl glucuronide in hair (hEtG) in driving aptitude assessment (DAA)

“…Due to an elimination half-life of about four days [17], accumulation of PEth is observed after repeated drinking. Therefore, PEth has been discussed as marker for detection of prolonged excessive alcohol consumption in several studies [16,[19][20][21][22][23].…”