Alcohol-Mediated Organ Damages: Heart and Brain

Abstract

Alcohol is one of the most commonly abused substances in the United States. Chronic consumption of ethanol has been responsible for numerous chronic diseases and conditions globally. The underlying mechanism of liver injury has been studied in depth, however, far fewer studies have examined other organs especially the heart and the central nervous system (CNS). The authors conducted a narrative review on the relationship of alcohol with heart disease and dementia. With that in mind, a complex relationship between inflammation and cardiovascular disease and dementia has been long proposed but inflammatory biomarkers have gained more attention lately. In this review we examine some of the consequences of the altered cytokine regulation that occurs in alcoholics in organs other than the liver. The article reviews the potential role of inflammatory markers such as TNF-α in predicting dementia and/or cardiovascular disease. It was found that TNF-α could promote and accelerate local inflammation and damage through autocrine/paracrine mechanisms. Unraveling the mechanisms linking chronic alcohol consumption with proinflammatory cytokine production and subsequent inflammatory signaling pathways activation in the heart and CNS, is essential to improve our understanding of the disease and hopefully facilitate the development of new remedies.

The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy

“…However, genetic polymorphisms, the use of other concomitant drugs (tobacco, cocaine), and the presence of other cardiac risk factors (hypertension, diabetes) may influence and worsen the natural course of ACM in each specific individual [27,72,98]. The multiple sites of myocyte damage from alcohol [11,19,23] and the genetically mediated individual predisposition [32,153] create a large individual clinical variability and make it difficult to establish a simple effective treatment for ACM [27,30,52]. Heart remodeling is an adaptive mechanism, susceptible to being modified in ACM by the use of cardiomyokines (FGF21, Metrnl) and growth factors (IGF-1, Myostatin) [112,119].…”

“…Therefore, physicians should be aware of the risk of new cardiomyopathy in patients with these overlapping diagnoses [144]. Control of these alcohol-related systemic diseases, as well as the strict control of the presence of other heart risk factors (tobacco, cocaine, arterial hypertension, diabetes mellitus, or anemia) contributes to ACM improvement [10,20,23,37,52]. Atrial fibrillation should be controlled with chronotropic drugs such as digoxin or diltiazem and anticoagulant treatment to avoid arterial embolisms [60,145].…”

“…One is the physical characteristics of ethanol itself, with a low molecular size, high distribution capacity, and high tissue reactivity. Ethanol has active metabolites (acetaldehyde-acetate, fatty-acid ethyl esters), is a potent enzymatic inductor [20,21], and interacts with other drugs [22], but its effect also depends on the characteristics of the target organ, with excitable (brain, heart) [23] and metabolic (liver, pancreas) organs [24] being more susceptible to ethanol-induced organ damage. In addition, there is a relevant role on each organ, particularly on defense and adaptive mechanisms, with a clear induction of anti-oxidant, metabolic, and anti-inflammatory protective responses as a result of ethanol aggression [18,25,26].…”

The burden of alcohol use: an update on the local and global picture

“…Use of alcohol as a psychoactive substance and a cultural and culinary implement has a long history (2). While alcohol has had a significant impact on human civilisation, the chemical alcohol also has various shortand long-term effects on different organs of the body (3). The acute effect on the function of brain is the so-called psychoactive effect.…”

Relation between alcohol consumption in midlife and dementia in late life

“…Only a few studies had longer follow-up or assessed the role of ethnicity or sex or types of alcohol consumed, and none evaluated the effects of change in consumption behaviour. Light to moderate alcohol use has also been associated with a cardioprotective effect through anti-inflammatory or antioxidant pathways, or both,5 and a reduction in mortality 6…”