Elevated Homocysteine Levels in Alcohol Withdrawal

Abstract

Ethanol exerts its behavioural effects largely by interacting with receptors for brain neurotransmitters. However, the molecular mechanisms involving these interactions and the pathogenesis of alcohol-withdrawal symptomatology are still not well understood. Until recently, no data were available about homocysteine (Hcy) levels in acute alcohol intoxication of chronic alcoholics and in patients undergoing withdrawal from alcohol. Hcy, blood-alcohol concentrations, vitamins B6, B12, and folate concentrations were assessed in 29 chronic alcoholics, who underwent withdrawal from alcohol. We observed increased Hcy levels in most patients. Hcy levels steadily decreased during the observation period. We postulate that hyperhomocysteinaemia and excitatory amino acid neurotransmitters, by their agonism at the N-methyl-D-aspartate receptor, may partly mediate alcohol-associated withdrawal symptomatology. The importance of assessing serum Hcy levels in order to detect methylation deficiency in patients with chronic alcoholism and for possible therapeutic strategies is discussed.

Reduced plasma homocysteine in obese red wine consumers: a potential contributor to reduced cardiovascular risk status

“…Hyperhomocysteinemia has been found in rats after ethanol feeding (Stickel et al, 2000). In addition, it has been shown that long-term ingestion of large quantities of ethanol causes inhibition of methionine synthase activity due to its breakdown product acetaldehyde (Kenyon et al, 1998) and it has been proposed that elevated blood levels of ethanol, rather than nutritional factors are responsible for changes in homocysteine metabolism (Bleich et al, 2000c). With high alcohol intake beer, rich in folate and vitamin B 6 , may reduce the risks of raised homocysteine concentrations (Cravo et al, 1996;van der Gaag et al, 2000).…”

Alcohol abuse and cigarette smoking are associated with global DNA hypermethylation: Results from the German Investigation on Neurobiology in Alcoholism (GINA)

“…Alcohol might induce changes in DNA methylation by altering homocysteine metabolism (Bleich et al, 2000;Bleich & Hillemacher, 2009;Bonsch et al, 2004;Varela-Rey, Woodhoo, Martinez-Chantar, Mato, & Lu, 2013).…”

Biomarkers to Predict Alcohol Withdrawal Seizures - A Review of Current Literature

“…Several investigations in recent years described that alcohol consumption, particularly in actively drinking alcoholics, is closely associated with elevated plasma homocysteine levels [1][2][3]. Also, homocysteine serum levels show a high positive correlation with the blood alcohol concentration.…”

“…Then, during detoxification, excitatory amino acids such as glutamate and homocysteine lead to an overstimulation of NMDA receptors, while the simultaneous removal of the inhibitory effect of ethanol intensifies this stimulation [1,24]. Course measurements during an alcohol withdrawal treatment showed a continuous reduction in plasma homocysteine levels, which return to normal range after several days of alcohol withdrawal [2,4,5,25].…”

“…Homocysteine, an excitatory amino acid, is evidentially elevated in non-abstinent alcoholics, with a steadily decrease during alcohol withdrawal [1][2][3]. Recent studies showed the impact of elevated homocysteine serum levels on alcohol withdrawal seizures: for first-onset [4] and for previous withdrawal seizures [5].…”