Alcohol and airways function in health and disease.
The volatility of alcohol promotes the movement of alcohol from the bronchial circulation across the airway epithelium and into the conducting airways of the lung. The exposure of the airways through this route likely accounts for many of the biologic effects of alcohol on lung airway functions. The effect of alcohol on lung airway functions is dependent on the concentration, duration, and route of exposure. Brief exposure to mild concentrations of alcohol may enhance mucociliary clearance, stimulates bronchodilation, and probably attenuates the airway inflammation and injury observed in asthma and chronic obstructive pulmonary disease (COPD). Prolonged and heavy exposure to alcohol impairs mucociliary clearance, may complicate asthma management, and likely worsens outcomes including lung function and mortality in COPD patients. Nonalcohol congeners and alcohol metabolites act as triggers for airway disease exacerbations especially in atopic asthmatics and in Asian populations who have a reduced capacity to metabolize alcohol. Research focused on the mechanisms of alcohol-mediated changes in airway functions has identified specific mechanisms that mediate alcohol effects within the lung airways. These include prominent roles for the second messengers calcium and nitric oxide, regulatory kinases including PKG and PKA, alcohol- and acetaldehyde-metabolizing enzymes such as aldehyde dehydrogenase 2. The role alcohol may play in the pathobiology of airway mucus, bronchial blood flow, airway smooth muscle regulation, and the interaction with other airway exposure agents, such as cigarette smoke, represents opportunities for future investigation.
Sisson
Joseph H
JH
University of Nebraska Medical Center, Pulmonary, Critical Care, Sleep and Allergy Section, Department of Internal Medicine, 985300 Nebraska Medical Center, Omaha, NE 68198-5300, USA. jsisson@unmc.edu
D000818:Animals; D001249:Asthma / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D002492:Central Nervous System Depressants / Q000009:adverse effects* / Q000737:chemistry; D000431:Ethanol / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D019570:Inhalation Exposure; D009079:Mucociliary Clearance / Q000187:drug effects; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D015656:Respiratory Mechanics / Q000187:drug effects; D012137:Respiratory System / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D015398:Signal Transduction / Q000187:drug effects; D014835:Volatilization
D002492:Central Nervous System Depressants; D000431:Ethanol