Phosphatidylethanol is Superior to Carbohydrate‐Deficient Transferrin and <i>γ</i>‐Glutamyltransferase as an Alcohol Marker and is a Reliable Estimate of Alcohol Consumption Level

Walther, Lisa; Bejczy, Andrea de; Löf, Elin; Hansson, Therése; Andersson, Anders; Guterstam, Joar; Hammarberg, Anders; Asanovska, Gulber; Franck, Johan; Söderpalm, Bo; Isaksson, Anders

doi:10.1111/acer.12883

Cited by 91 publications

(94 citation statements)

References 50 publications

(65 reference statements)

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“…The highest sensitivity of up to 99% was observed for Peth 31, 41 that showed a rapid decrease at the beginning of withdrawal, a slow decline after the first few days, and persistence at low levels beyond 19d of abstinence 42. Apart from biomarkers detected in blood and urine samples, saliva is a promising and easy accessible material to detect glycomarkers of oxidative stress,43, 44 but the reproducibility and validity in Peth has to be proven for clinical routine application 45. As an antibody based flash test is available for detection of EtG in urine with good sensitivity and specificity, this parameter is the most promising one to be integrated in routine laboratory settings and in screening of patients at risk to develop AWS 46…”

Section: Biomarkersmentioning

confidence: 99%

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

et al. 2016

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The alcohol withdrawal syndrome is a well‐known condition occurring after intentional or unintentional abrupt cessation of heavy/constant drinking in patients suffering from alcohol use disorders (AUDs). AUDs are common in neurological departments with patients admitted for coma, epileptic seizures, dementia, polyneuropathy, and gait disturbances. Nonetheless, diagnosis and treatment are often delayed until dramatic symptoms occur. The purpose of this review is to increase the awareness of the early clinical manifestations of AWS and the appropriate identification and management of this important condition in a neurological setting.

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Section: Biomarkersmentioning

confidence: 99%

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

et al. 2016

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“…There is a correlation between PEth and alcohol consumption level, PEth likely reflecting the exposition to alcohol over time, i.e., average blood alcohol concentration during several weeks before sampling [13,14]. However, in addition to the Fig.…”

Section: Discussionmentioning

confidence: 97%

“…PEth is an alcohol marker with high sensitivity in groups with excessive alcohol consumption (96-100%) [13,14,25]. The clinical sensitivity has been more varied in groups with low or moderate alcohol consumption, largely due to differences in sensitivity between analytical methods [14,16,26,27]. Hence, it has been reported that PEth can be used as a marker for low or moderate alcohol consumption using a method with improved analytical sensitivity [28].…”

Section: Discussionmentioning

confidence: 99%

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Alcohol Consumption in Obese Patients Before and After Gastric Bypass as Assessed with the Alcohol Marker Phosphatidylethanol (PEth)

Walther

Brodén²,

Isaksson

et al. 2018

OBES SURG

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Introduction Roux-en-Y gastric bypass (RYGB) causes more rapid and enhanced absorption of alcohol. RYGB patients have also been reported to use more inpatient care for alcohol-related disease than do patients after other bariatric procedures. The present study was designed to evaluate alcohol consumption level before and after gastric bypass using a sensitive and specific alcohol biomarker. Materials and Methods Two separate consecutive groups of patients and a group of healthy blood donors, as reference group, were included in the study. Alcohol intake was assessed using the alcohol marker phosphatidylethanol (PEth) at preoperative baseline and at 1 and 2 years postoperatively. In the first patient group (n = 133), neither surgeon nor patient was informed about the results of PEth testing. In the second group (n = 214), PEth results above 0.30 μmol/L were considered to indicate excessive alcohol consumption and led to preoperative alcohol counseling. The groups were followed for 2 and 1 year, respectively. Results PEth results were significantly lower in both patient groups at baseline as well as postoperatively compared with the reference group. In both patient groups, there was a significant increase in PEth values at postoperative follow-up compared to baseline. Conclusions Several physiological changes postoperatively have to be considered when interpreting PEth results in obese patients with dramatic weight reductions. According to results for PEth, obese patients treated with bariatric surgery would seem to have lower alcohol consumption compared with the reference group. Although slightly increasing their PEth values postoperatively, the RYGB patients did not reach the PEth values of the reference group.

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“…It should, however, be noted that recent clinical trials in alcohol-dependent individuals were unable to find a beneficial effect of varenicline based on self-reported alcohol consumption [212,213]. Nevertheless, when also monitoring the selective alcohol biomarker phosphatidylethanol (PEth) in the blood of the subjects in the above-mentioned clinical trial [212], it was found that varenicline indeed had effect on this objective measure of alcohol consumption [214] strengthening the potential of varenicline as potential novel medication for alcohol dependence. Besides glycine receptors and nAChR, there are various signalling systems indirectly targeting the mesolimbic dopamine system with promising preclinical findings on alcohol-mediated behaviours.…”

Section: Clinical Evidence For the Use Of Indirect Modulation Of Dopamentioning

confidence: 99%

Dopamine and Alcohol Dependence: From Bench to Clinic

Jayaram‐Lindström¹,

Ericson²,

Steensland³

et al. 2016

Recent Advances in Drug Addiction Research and Clinical Applications

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Alcohol dependence, a chronic relapsing psychiatric disorder, is a major cause of mortality and morbidity. The role of dopamine in alcohol-induced reward as well in the development of alcohol dependence is reviewed herein. Both preclinical and clinical studies have suggested that alcohol activates the mesolimbic dopamine system (defined as a dopamine projection from the ventral tegmental area (VTA) to the nucleus accumbens (NAc, i.e. ventral striatum)) leading to a euphoric sensation. Alcohol dependence is characterized by a disruption in the reward-related brain areas including fewer dopamine D2 receptors in ventral striatum. Investigations of the underlying dopaminergic mechanisms involved during the development and maintenance of alcohol dependence could identify novel targets. Human and rodent experimental studies show that dopamine receptor antagonists, agonists and partial agonists as well as dopamine stabilizers influencing dopamine transmission, alter alcohol-mediated behaviours and thus may be potential treatment targets for alcohol dependence. Although there exists promising preclinical results, the majority of placebo-controlled randomized clinical trials with traditional dopamine antagonists and agonists have so far have been discouraging. Furthermore, the severe side-effect profiles of many of these compounds may limit their clinical use. Newer dopamine agents, such as partial agonists and dopamine stabilizers, attenuate alcohol-mediated behaviours in rodents as well as humans. Preclinical as well as clinical studies have shown that substances indirectly targeting the mesolimbic dopamine system may be potential targets for attenuation of alcohol reward. Collectively, the data reviewed herein may contribute to further understanding the complex mechanisms involved in development of alcohol dependence and we suggest that the newer dopamine agents as well as indirect modulators of dopamine signalling deserve to be further evaluated for treatment of alcohol dependence.

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Phosphatidylethanol is Superior to Carbohydrate‐Deficient Transferrin and γ‐Glutamyltransferase as an Alcohol Marker and is a Reliable Estimate of Alcohol Consumption Level

Cited by 91 publications

References 50 publications

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

Alcohol Consumption in Obese Patients Before and After Gastric Bypass as Assessed with the Alcohol Marker Phosphatidylethanol (PEth)

Dopamine and Alcohol Dependence: From Bench to Clinic

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