Emerging Biomarkers of Alcohol Consumption: Clinical and Forensic Applications

Abstract

Alcohol-related problems are typically associated with medical, economic and social issues. The reduction of the problem can only occur if effective strategies to prevent, diagnose and treat alcohol abuse are developed. Real help could come from laboratory tests that represent objective evidence of alcohol problems. Authors present new biomarkers as Carbohydrate-deficient transferrin (CDT), Ethyl Glucuronide and Ethyl Sulfate (EtG and EtS)), Fatty Acids Ethyl Esters (FAEE) anf Phosphatidy ethanol (PEth) in differents biological samples.

Alcohol Biomarkers and their Relevance in Detection of Alcohol Consumption in Clinical Settings

“…Phosphatidyl choline is hydrolysed by phospholipase-D to form phosphatidic acid. In the presence of alcohol, PEth is formed at the expense of phosphatidic acid through transphosphatidylation of phospholipase-D [39].…”

“…ALT is more specific to alcohol induced liver cell injury compared to AST which is also found in heart, muscle, kidney and brain cells [39]. Any injury or disease that can increase the level of cellular injury or death in these organs will cause an elevation of AST [8].…”

Sustained heavy ethanol drinking affects CD4<sup>+</sup> cell counts in HIV-infected patients on stavudine (d4T), lamivudine (3TC) and nevirapine (NVP) treatment regimen during 9 months follow-up period

“…However, because the WHO AUDIT was not sensitive enough to actually detect some of the patients in the control group who were consuming alcohol chronically, chronic alcohol-use biomarkers (GGT, MCV and AST/ALT ratio) were used to further sort out the patients in the control group. The simultaneous elevation of GGT values above 55.0 UI, MCV values above 96 fL and AST/ALT ratio above 2.0 were indicators of chronic alcohol use [44][45][46] and these were monitored throughout the 9 months of the study period to ensure that there were no reverts and converts. The baseline serum enzyme concentrations (GGT, ALT and AST) at time 0 month just before they were initiated on the d4T/ 3TC/NVP drug regimen of all the patients that participated in the study were collected retrospectively from the patients' records.…”

“…The CD4 + T-lymphocyte counts are the most widely used surrogate markers for determining HIV disease progression since they are the targets of HIV and patient staging as well as the therapeutic monitoring of these patients [41,42]. The study therefore determined the effect of chronic alcohol use on the CD4 + cell count in the HIV-infected patients on d4T/3TC/NVP drug regimen using the chronic alcohol-use self reporting WHO alcohol-use disorders identification test (AUDIT) tool [43] and the increased levels of chronic alcohol-use biomarkers (liver enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT) (AST/ALT ≥ 2.0) and mean corpuscular volume (MCV)) [44][45][46] during the 9 months follow-up period.…”