Effects of chronic alcohol abuse on alveolar epithelial barrier function and glutathione homeostasis.
BACKGROUND
An association between the development and severity of the acute respiratory distress syndrome has been described in individuals who abuse alcohol chronically, possibly through a mechanism involving the deficiency of pulmonary glutathione. In a rodent model of chronic alcohol abuse, this antioxidant contributes to the maintenance of alveolar-capillary membrane integrity. We postulated that humans who chronically abuse alcohol will have similar alterations in alveolar-capillary barrier function.


METHODS
Bronchoalveolar lavage was performed in 18 healthy chronic alcoholics and 18 control subjects; total protein and glutathione concentrations were measured within the epithelial lining fluid. To examine possible protracted effects of alcohol abuse, a subset of 11 chronic alcoholic subjects underwent a second bronchoalveolar lavage after a week of abstinence.


RESULTS
Chronic alcoholic subjects had significantly elevated protein concentrations compared with controls (8.64 microg protein/ng immunoglobulin A vs. 5.91 microg protein/ng immunoglobulin A, p = 0.01). After a week of abstinence, no significant increase in either the glutathione levels or normalization of the protein concentrations in the epithelial lining fluid was demonstrable.


CONCLUSIONS
Increased protein levels in the epithelial lining fluid of individuals who abuse alcohol chronically may signify abnormal alveolar epithelial barrier function that does not appear to readily reverse after a period of abstinence.
Burnham
Ellen L
EL
Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. eburnha@emory.edu
Brown
Lou Ann S
LA
Halls
Lynn
L
Moss
Marc
M
D000328:Adult; D000437:Alcoholism / Q000097:blood*; D015824:Blood-Air Barrier / Q000378:metabolism*; D005260:Female; D005978:Glutathione / Q000097:blood*; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000378:metabolism*; D020545:Respiratory Mucosa / Q000378:metabolism; D018709:Statistics, Nonparametric
D005978:Glutathione